Full Citation

Title: Pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA

Citation Type: Journal Article

Forthcoming?: Yes

ISBN:

ISSN: 0735-0414

DOI: 10.1093/alcalc/agad056

NSFID:

PMCID:

PMID:

Abstract: Aims We examined relationships between pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA. Methods We merged state-level policy and treatment admissions data for 1992–2019. We aggregated data by state-year to examine effects of nine pregnancy-specific alcohol policies on the number of admissions of pregnant women where alcohol was reported as the primary, secondary, or tertiary substance related to the treatment episode (N = 1331). We fit Poisson models that included all policy variables, state-level controls, fixed effects for state and year, state-specific time trends, and an offset variable of the number of pregnancies in the state-year to account for differences in population size and fertility. Results When alcohol was reported as the primary substance, civil commitment [incidence rate ratio (IRR) 1.45, 95% CI: 1.10–1.89] and reporting requirements for assessment and treatment purposes [IRR 1.36, 95% CI: 1.04–1.77] were associated with greater treatment admissions. Findings for alcohol as primary, secondary, or tertiary substance were similar for civil commitment [IRR 1.31, 95% CI: 1.08–1.59] and reporting requirements for assessment and treatment purposes [IRR 1.21, 95% CI: 1.00–1.47], although mandatory warning signs [IRR 0.84, 95% CI: 0.72–0.98] and priority treatment for pregnant women [IRR 0.88, 95% CI: 0.78–0.99] were associated with fewer treatment admissions. Priority treatment findings were not robust in sensitivity analyses. No other policies were associated with treatment admissions. Conclusions Pregnancy-specific alcohol policies related to greater treatment admissions tend to mandate treatment rather than make voluntary treatment more accessible, raising questions of ethics and effectiveness.

Url: https://academic-oup-com.ezp2.lib.umn.edu/alcalc/advance-article/doi/10.1093/alcalc/agad056/7250138?login=true&token=eyJhbGciOiJub25lIn0.eyJleHAiOjE2OTg3MjUyOTcsImp0aSI6IjBiYWVkNDlhLTNmMzItNDAwZi05OWJiLTAyNmJmOGVmODljNiJ9.

User Submitted?: No

Authors: Berglas, Nancy F; Subbaraman, Meenakshi S; Thomas, Sue; Roberts, Sarah C M

Periodical (Full): Alcohol and Alcoholism

Issue:

Volume:

Pages: 1-8

Data Collections: IPUMS CPS

Topics: Health, Methodology and Data Collection, Reproductive and Sexual Health

Countries: