ONDCP Releases Report on Substance Use Disorder Treatment During Pregnancy

Outlines Key Actions the Biden-Harris Administration Will Take to Improve Access to Care and Save Lives

WASHINGTON, D.C. – For far too many mothers, complications related to pregnancy, childbirth, and postpartum can lead to devastating health outcomes — particularly for Black, Native, and rural women, who all experience maternal mortality and morbidity at significantly higher rates than their white and urban counterparts. To help facilitate universal access to treatment and reduce overdose deaths in pregnant women, the White House Office of National Drug Control Policy (ONDCP) announced the release of Substance Use Disorder in Pregnancy: Improving Outcomes for Families. The report outlines how overdose-related deaths in pregnant and postpartum women can be prevented with evidence-based treatment for opioid use disorder (OUD) like buprenorphine and methadone. It also describes systemic and cultural barriers that make accessing care difficult and outlines key actions the Biden-Harris Administration will take to connect pregnant women with substance use disorder to care. Improving maternal health outcomes and expanding access to evidence-based treatment for all, including pregnant women, are both key priorities for the Biden-Harris Administration, as laid out in President Biden’s National Drug Control Strategy and the White House Blueprint for Addressing the Maternal Health Crisis.

“As a physician, I have seen firsthand how treatment for people with substance use disorder, including pregnant women, can improve health outcomes and save lives,” said Dr. Gupta, Director of ONDCP. “But today, access to care remains inconsistent across the country. This report lays out what we must do to ensure people who need help can get it, including pregnant women. That is why, this Administration is focused on fully implementing President Biden’s Strategy to beat the overdose epidemic and providing universal access to treatment for substance use disorder.”

As detailed in the report, pregnant women with SUD are 17% less likely to be accepted for OUD treatment appointments by outpatient buprenorphine providers compared to identical non-pregnant women. Access to treatment is even more challenging for pregnant women with SUD of certain races and geographies. However, we know that medications for OUD reduce risk of relapse and death for pregnant and postpartum women and improve pregnancy outcomes – making it more likely that babies will be born at term, rather than prematurely.

While pregnant women with SUD struggle to find treatment, their children are being increasingly placed in foster care. Today, infants are the fastest growing age group in foster care, accounting for more than 20% of placements each year. Most infant foster care placements are associated with parental substance use and there are often missed opportunities to prevent unnecessary foster care placements through connecting pregnant and postpartum women to treatment and other resources.

To improve access to effective treatment for pregnant women with SUD, including for communities of color and rural and urban communities, and to prevent unnecessary foster care placement where possible, the report lays out key actions the Administration will pursue. It includes actions to:

• Develop coordinated training and technical assistance to inform the use of medications for SUD treatment for grantee recipients of the Department of Justice’s Office of Juvenile Programs (OJP) Family Treatment Court Program and the Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Administration (SAMHSA) drug treatment court programs.
• Offer SUD education to women’s health primary care providers throughout the Veterans Health Administration (VHA).
• Enhance transparency by publicly reporting data on access to SUD treatment for pregnant and postpartum women nationwide using data obtained from Substance Abuse Prevention and Treatment Block Grant (SABG) related the number of waivered buprenorphine prescribers who self-report as obstetricians and midwives.
• Expand access to medications for OUD for pregnant women and women of reproductive age within Tribal nations and living in Tribal communities.
• Provide grants to foster partnerships between hospitals and community-based organizations to implement evidence-based interventions that strengthen perinatal and postnatal support structures for individuals with SUD through HHS’s Office on Women’s Health (OWH).
• Hire a dedicated Associate Administrator for Women’s Services in HHS’s SAMHSA to lead its efforts focused on pregnancy and the postpartum period.
• Develop model national certification standards for peer recovery support specialists as part of the implementation of the President’s National Drug Control Strategy and his mental health strategy.
• Reduce the incidence and impact of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome that occurs shortly after an infant is born.
• Improve maternal mental health and outcomes for pregnant, lactating, and postpartum women with SUD.

Read one-pagers on the report HERE and HERE that outline the importance of addressing stigma and removing barriers to treatment.

Read the Biden-Harris Administration’s inaugural National Drug Control Strategy HERE and the fact sheet HERE.

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