1 A prospective follow-up study of pregnant women in Opioid maintenance Treatment (OMT) and their partners: substance use during pregnancy and one year after Ingunn Olea Lund PhD student, Norwegian Centre for Addiction Research, University of Oslo

2 Background Every year approximately 30 children are born from mothers in opioid maintenance treatment (OMT). Substance abuse reduces parenting abilities, and most individuals in OMT have had serious polydrug problems in addition to opiate addiction. There is a lack of research that evaluates OMT womens` substance use while they are pregnant and after the children are born as well as their partners substance use in the same period.

3 Aim To investigate the prevalence of substance use in a Norwegian national cohort ( ) of OMT women and their partners when the women were pregnant and one year after they gave birth.

4 Material and methods Materials Pregnant women in OMT in Norway (n=37) and their partners (n=23) in Methods EuropASI (Substance use, Psychiatric, Medical, Employment status, Family/social relationships, Legal).

5 Results Women n=37 Men n=23 Mean age (min-max)*32 (23-44)36 (26-50) In Opioid Maintenance Treatment n (%)*37 (100)12 (52) Family and social relations n (%) Children (1-3 children)18 (49)13 (56) Daily care of children10 (57)5 (39) Background characteristics of the study population *at the time of the first interview

6 Background characteristics continued Women n=37 Men n=23 Lifetime (months) in jail/detention* 1 (0-49)9 (0-156) Lifetime OD illegal drugs n (%)26 (73)8 (40) Hepatitis n (%)32 (87)17 (74) Full or part-time work n (%)11 (31)11 (48) Unemployment n (%)14 (39)11 (48) *Median (min-max)

7 Life-time substance abuse SubstanceWomenMen Heroin36 8 (2-16)16 8 (1-19) Other opiates24 5 (1-20)13 6 (1-22) Cocaine5 3 (1-6) 5 1 (1-2) Amphetamine25 6 (1-19)13 6 (1-12) Cannabis29 10 (1-25)17 13 (1-28) Benzodiazepines32 8 (1-25)14 8 (1-22) Alcohol (heavy/ problem-drinking)13 4 (1-9)13 7 (1-20)

8 Substance use during pregnancy and one year after SubstanceFirst interview Women (n =37) Men (n =23) N % Follow-up interview Women (n =35) Men (n =19) N % p- value WomenMenWomenMenWomenMen Heroin 1 (3) Other opiates -1 (4)- - Cocaine Amphetamines 1 (3) Cannabis - 1 (3) 1 (5) Illegal substances total 1211 ns Meds (benzo etc) 3 (8)3 (13)2 (6)1 (3) Alcohol binge drinking -7 (30)5 (15)3 (16) Legal substances total 3974 p =.08p =.01** Substance abuse among pregnant women in OMT and their partners 30 days prior to interview third trimester in pregnancy and last 30 days prior to interview one year after. ** P< 0.01

9 Reported problems (number of days) during pregnancy and one year after Pregnancy women (n=37) men (n=23) N median (range) One year after women (n=35) men (n=19) N median (range) WomenMen WomenMen Somatic/medical15 30 (5-30) 5 20 (2-30) (5-30) 7 30 (14-30) Family/relatives3 3 (2-30) 1 1 (1-1) 7 1 (1-15) 2 2 (1-3) Others4 3 (1-30) 1 1 (1-1) 3 3 (1-30) 3 1 (1-30) Unemployment1 30 (30-30) 3 30(12-30) 1 8 (8) 2 18 (5-30) Psychiatric9 20 (2-30) 6 17 (1-30) 9 14 (5-30) 3 14 (10-30) Legal----

10 Discussion Main findings Lifetime substance abuse among the women and their partners showed a heavy polydrug use over many years before entering OMT. Low and stable substance use during pregnancy and one year after Limitations Small material - risk of type 2 errors. Strengths Prospective design 2-year national cohort

11 Conclusion The results suggest that a majority of women in OMT in Norway and their partners are able to abstain from most substances, during third trimester and one year after. This probably affects their parenting abilities in a positive way.