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Correlates of Treatment Retention and Opioid Misuse Among Postpartum Women in Methadone Treatment

Ellis, Jennifer D., MA; Cairncross, Molly, MA; Struble, Cara A., MA; Carr, Meagan M., MS; Ledgerwood, David M., PhD; Lundahl, Leslie H., PhD

doi: 10.1097/ADM.0000000000000467
Original Research

Objectives: The postpartum period is a particularly challenging time for women in methadone treatment. Unfortunately, this is also the time when women are vulnerable to treatment discontinuation and opioid misuse. The purpose of the present exploratory study was to examine demographic, treatment, and delivery factors that may be associated with postbirth retention in treatment and opioid misuse.

Methods: A chart review was conducted among postpartum women (n = 81) receiving opioid agonist treatment during pregnancy.

Results: Results revealed that treatment discharge and postbirth opioid misuse were common after delivery. Longer treatment duration before delivery was associated with a lower likelihood of opioid misuse in the month after delivery. Women who delivered via cesarean section and received a discharge opioid medication were also more likely to engage in opioid misuse (ie, providing an opioid-positive urine toxicology screen outside the window of detection for the discharge opioid prescription) in the month after delivery.

Conclusions: Increasing support to minimize the likelihood of treatment discontinuation or opioid misuse may be particularly important in this period, especially for this vulnerable group.

Department of Psychiatry & Behavioral Neuroscience, Wayne State University (JDE, MC, CAS, MMC, DML, LHL); Department of Psychology, Wayne State University (JDE, CAS); Department of Psychology, University of Windsor (MC); Department of Psychology, Eastern Michigan University (MMC).

Send correspondence to Leslie H. Lundahl, PhD, 3901 Chrysler Drive, Detroit, MI. E-mail:

Received 29 May, 2018

Accepted 8 October, 2018

Funding: This project was funded in part by Joe Young Sr./Helene Lycaki Funds from the State of Michigan.

The authors report no conflicts of interest.

© 2019 American Society of Addiction Medicine