Trends in Maternal Polysubstance Use During the COVID-19 Pandemic

Rates of polysubstance use have been noted to rise during the pandemic. Our objective was to analyze the substance use patterns in women enrolled in a substance use treatment program during this interval compared to past years. We conducted a retrospective study of an observational cohort between 2015-2019 and 2020-present. We evaluated polysubstance abuse reported at the initial screening visit as well as urinary drug screening at delivery and stratified the substance use patterns by year of delivery. During the pandemic (2020-present), telehealth was utilized more frequently for group therapies and clinician visits compared to past years, but no other major structural changes were initiated. 380 participants in a multidisciplinary program were included: 280 from 2015-19 and 100 from 2020-present. The demographics were similar between the groups except for race and BMI (higher BMI in 2020, P=0.018) Self-reporting in the 30 days prior to enrollment during the pandemic era, suggested a potential reduction in several illicit drugs (Table 1). However, the maternal drug screens reflected a higher use of illicit opiates and methamphetamines at time of delivery. The rate of unprescribed substance use was greater in 2020-present compared to past years. Additionally, rates of neonatal abstinence syndrome (NAS) were higher in 2020 at 53.7% versus 38%, P=0.007. Maternal polysubstance use increased in 2020-present compared to past years. Therapies employed during the pandemic were not able reduce this rate to pre-pandemic levels at the time of delivery. This finding suggests stressors existing during this interval may not be overcome by past approaches or that modes of therapy such as telehealth have limitations.