摘要：Objectives. To determine the prevalence and patterns of polysubstance use among US reproductive-aged women who use opioids for nonmedical purposes. Methods. We used the National Survey of Drug Use and Health (2005–2014) data on female respondents aged 18 to 44 years reporting nonmedical opioid use in the past 30 days (unweighted n = 4498). We categorized patterns of polysubstance use in the past 30 days, including cigarettes, binge drinking, and other legal and illicit substances and reported prevalence adjusted for age, race/ethnicity, and educational attainment. Results. Of all women with nonmedical opioid use, 11% reported only opioid use. Polysubstance use was highest in non-Hispanic White women and women with lower educational attainment. The most frequently used other substances among women using opioids nonmedically were cigarettes (56.2% smoked > 5 cigarettes per day), binge drinking (49.7%), and marijuana (32.4%). Polysubstance use was similarly prevalent among pregnant women with nonmedical opioid use. Conclusions. Polysubstance use is highly prevalent among US reproductive-aged women reporting nonmedical opioid use. Public Health Implications. Interventions are needed that address concurrent use of multiple substances. Reproductive-aged women experienced a 400% increase in overdoses resulting from prescription opioid pain relievers between 1999 and 2010. 1 The increase in mortality has been concentrated among non-Hispanic White women, 1 those in rural areas, and those with lower socioeconomic status. 2 Increasing prevalence of opioid use disorder among women has been accompanied by an increase in adverse pregnancy and birth outcomes, including neonatal abstinence syndrome. 3,4 Analysis of premature mortality in the United States suggests that public health gains in areas such as smoking cessation and HIV treatment have been offset among White adults by high rates of opioid-related deaths. 5 Despite evidence of long-term effectiveness of substance use disorder treatment programs for women, a high unmet need exists for women-centered or pregnancy-focused substance use disorder treatment. 6 Recent public health policies have focused on improving access to treatment in and around the time of pregnancy; for example, the federal Comprehensive Addiction and Recovery Act includes grants for states to expand services for pregnant women and those women with dependent children. Limited evidence is available to inform this service expansion, because little is known about the prevalence and patterns of use of other legal and illicit substances among women who use opioids for nonmedical purposes. Our objective was to determine the national prevalence of polysubstance use among reproductive-aged women with nonmedical opioid use and to assess patterns of polysubstance use.
