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Trends in prenatal prescription opioid use among Medicaid beneficiaries in Wisconsin, 2010–2019

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

To examine changes in prenatal opioid prescription exposure following new guidelines and policies.

Study design

Cohort study of all (262,284) Wisconsin Medicaid-insured live births 2010–2019. Prenatal exposures were classified as analgesic, short term, and chronic (90+ days), and medications used to treat opioid use disorder (MOUD). We describe overall and stratified temporal trends and used linear probability models with interaction terms to test their significance.

Result

We found 42,437 (16.2%) infants with prenatal exposure; most (90.5%) reflected analgesic opioids. From 2010 to 2019, overall exposure declined 12.8 percentage points (95% CI = 12.1–13.1). Reductions were observed across maternal demographic groups and in both rural and urban settings, though the extent varied. There was a small reduction in chronic analgesic exposure and a concurrent increase in MOUD.

Conclusion

Broad and sustained declines in prenatal prescription opioid exposure occurred over the decade, with little change in the percentage of infants chronically exposed.

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Fig. 1: Percentage of infants exposed to opioid prescriptions prenatally by type, Wisconsin Medicaid-insured live births, 2010–2019.
Fig. 2
Fig. 3: Percentage of infants with chronic use (90+ days of fills) of any analgesic opioid, MOUD alone, or either, among Wisconsin Medicaid-insured live births, 2010–2019.

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Data availability

The data used in this study are proprietary administrative data owned by the State of Wisconsin Department of Children and Families and Department of Health Services. They were made available to the authors for this research under data use agreements between each agency and the Institute for Research on Poverty at the University of Wisconsin-Madison. Wisconsin state law prohibits sharing these data or making them publicly available.

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Acknowledgements

We thank the Wisconsin Department of Health Services for the use of data for this research but acknowledge that these agencies do not certify the accuracy of the analyses presented. We are grateful for excellent data access and programming assistance provided by HeeJin Kim, Hsiang-Hui (Daphne) Kuo, Krista Bryz-Gornia, Steven Cook, Dan Ross, and Lynn Wimer. The content is solely the responsibility of the authors.

Funding

This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant #R01HD102125 (MPI Ehrenthal and Berger), with additional support from the Social Science Research Institute at The Pennsylvania State University and the Institute for Research on Poverty at the University of Wisconsin-Madison and. The funders had no role in the design or conduct of the study.

Author information

Authors and Affiliations

  1. Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA

    Deborah B. Ehrenthal

  2. Social Science Research Institute, The Pennsylvania State University, University Park, PA, USA

    Deborah B. Ehrenthal & Yi Wang

  3. Silberman School of Social Work, Hunter College, City University of New York, New York, NY, USA

    Yi Wang

  4. Sandra Rosenbaum School of Social Work, College of Letters and Sciences, University of Wisconsin-Madison, Madison, WI, USA

    Jessica Pac & Lawrence M. Berger

  5. Institute for Research on Poverty, College of Letters and Sciences, University of Wisconsin-Madison, Madison, WI, USA

    Jessica Pac, Christine Piette Durrance & Lawrence M. Berger

  6. La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA

    Christine Piette Durrance

  7. Chiles Center, College of Public Health, University of South Florida, Tampa, FL, USA

    Russell S. Kirby

Authors
  1. Deborah B. Ehrenthal
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  2. Yi Wang
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  4. Christine Piette Durrance
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  5. Russell S. Kirby
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  6. Lawrence M. Berger
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Contributions

All authors meet all four criteria for authorship and have approved the manuscript. DE: Conceived of and designed the work; co-led data acquisition; contributed to the interpretation of data; drafted, edited, and approved the final manuscript; and agrees to be accountable for the work. YW: Made substantial contributions to the conception and design of the work; conducted the analysis; contributed to the interpretation of data; edited and approved the final manuscript; and agrees to be accountable for the work. JP: Made substantial contributions to the conception and design of the work; contributed to the interpretation of data; edited and approved the final manuscript; and agrees to be accountable for the work. CD: Made substantial contributions to the conception and design of the work; contributed to the interpretation of data; edited and approved the final manuscript; and agrees to be accountable for the work. RK: Made substantial contributions to the conception and design of the work; contributed to the interpretation of data; edited and approved the final manuscript; and agrees to be accountable for the work. LB: Made substantial contributions to the conception and design of the work; co-led the acquisition of data; contributed to the interpretation of data; edited and approved the final manuscript; and agrees to be accountable for the work.

Corresponding author

Correspondence to Deborah B. Ehrenthal.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the University of Wisconsin-Madison and the Pennsylvania State University Institutional Review Boards and was performed in accordance with the Declaration of Helsinki.

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Ehrenthal, D.B., Wang, Y., Pac, J. et al. Trends in prenatal prescription opioid use among Medicaid beneficiaries in Wisconsin, 2010–2019. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01954-y

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