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Admissions for Cannabis Use Disorder among Pregnant Women in the United States: Publicly Funded Treatment Facilities from 2000 to 2021

Maria Carmenza Mejia
Florida Atlantic University

Co-Authors: Panagiota Kitsantas, Charles Hennekens, Allison Ferris
Florida Atlantic University

Background: This study explored admissions for cannabis use disorder (CUD) among pregnant women in publicly funded treatment facilities in the United States (US) from 2000 to 2021.

Methods: Data from the Treatment Episode Data Set-Admissions (TEDS-A) included 33,729 admissions of pregnant women with CUD. We calculated absolute as well as relative changes overall as well as by race/ethnicity, age and co-substance use.

Results: CUD-involved admissions among pregnant women increased 2.7-fold from 2.3% in 2000 to 6.2% in 2009. They steadily decreased to 4.3% in 2014 but reached a peak of 6.7% in 2018 and subsequently declined to 3.0% in 2021. Significant racial/ethnic disparities were noted, with higher rates in 2021 among White (48.8%) and Black (32.5%) non-Hispanic relative to Hispanic (9.6%). Although a decrease in CUD-involved admissions was observed among White women between 2010 (52.2%) and 2018 (45.4%), a significant increase was noted since then with a peak in 2020 at 51.2%. Since 2014 there was an increase in CUD related admissions among pregnant Black non-Hispanic women (29.6%) with a major increase in 2018/2019 (36.1%) and a 1.2-fold increase since 2014. Although CUD admissions were more prevalent between the ages of 21-29 years old, a notable decline was observed between 2018 (62.1%) and 2021 (57.2%).  A significant increase of 2.3-fold was observed in CUD admissions in women of at least 30 years of age between 2010 (12.2%) and 2021 (28.1%). CUD admissions in pregnant women deceased in those ≤20 years old with a notable increase in 2021(19.2%) which fell to 14.7% in 2021. Most co-substance use in CUD related admissions peaked in 2018 and declined since 2019 with the exception of inhalants which spiked in 2020. Narcotics, stimulants, depressants, and hallucinogens were the most prevalent co-substances among CUD admissions in pregnant women, particularly between 2017 and 2021. Overall, we observed a steady increase of narcotics from 2000 to 2017 and a decrease since then, while hallucinogens, inhalants and stimulants varied considerably from year-to-year in CUD-related admissions.

Conclusion: The data revealed significant changes in CUD admissions among pregnant women over two decades, with variations across different racial/ethnic groups and age categories. These findings suggest the necessity for tailored intervention strategies and continuous adaptation of treatment services for pregnant women with CUD in US publicly funded facilities. Future analytic studies are recommended to test the hypotheses generated by these descriptive data and address the complex needs of this population.