Criminalizing Opioid Use during Pregnancy: Impacts on All Women’s Access to Adequate Addiction Treatment

Garnering much attention and public health concern, the opioid epidemic has generated severe health consequences across the United States. Of particular interest, opioid use during pregnancy has been criminalized by state-level and national policies to quell the rising rates of maternal addiction and neonatal abstinence syndrome. However, recent research, has found that punitive policies (PPs) may instead exacerbate addiction by disincentivizing treatment-seeking behavior in pregnant women. Using treatment facility admissions data from 2013–2020, this study applies difference-in-difference methodology to extend previous studies’ exploration of the effects that PPs have on rates of pregnant admissions. Moreover, this study discerns the effect that PPs have on the prevalence of medication-assisted treatment for women of childbearing age. The impacts of PPs were modeled within a variety of policy landscapes, accounting for potential policy and resource interactions. With support from supplemental event study models, findings suggest that 1) PPs reduce the use of medication-assisted treatment in all policy landscapes and 2) when in isolation, PPs stifle rates of pregnant admissions. When active in states with more complex policy landscapes (i.e. not just in isolation), PPs were found to have more complicated effects on pregnant admissions, dynamics which merit future exploration.