Federal and State Policy Efforts to Address Maternal Opioid Misuse: Gaps and Challenges

Jennifer B. Saunders, Marian P. Jarlenski, Robert Levy, Katy B Kozhimannil

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Opioid misuse during pregnancy is increasingly common and is associated with preterm birth and neonatal abstinence syndrome. As such, there is increased policy attention on reducing opioid misuse and increasing detection and treatment of opioid use disorder around the time of childbirth. Methods: We conducted a review of peer-reviewed and grey literature to identify policy strategies to address opioid misuse among pregnant women; to describe current federal and state laws that impact women before pregnancy, during pregnancy, at birth, and postpartum; and to identify gaps and challenges related to these efforts. Results: We identify two gaps in current efforts: 1) limited attention to prevention of opioid misuse among reproductive-age women, and 2) lack of policies addressing opioid misuse among postpartum women. We also discuss barriers to accessing care for women who misuse opioids, including provider shortages (e.g., too few addiction medicine specialists accept pregnant women or Medicaid beneficiaries as patients), logistical barriers (e.g., lack of transportation, child care), stigma, and fear of legal consequences. Conclusions: As policymakers pursue strategies to address the opioid epidemic, the unique needs of pregnant and postpartum women and barriers to treatment should be addressed.

Original languageEnglish (US)
Pages (from-to)130-136
Number of pages7
JournalWomen's Health Issues
Issue number2
StatePublished - Mar 1 2018

Bibliographical note

Funding Information:
Funding Statement: This research was supported in part by a Faculty Seed Grant to Dr. Kozhimannil and Dr. Levy from the University of Minnesota Academic Health Center. Dr. Jarlenski was supported by the Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Program (K12 HD043441). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not represent the official views of any funding organizations.

Publisher Copyright:
© 2017 Jacobs Institute of Women's Health


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