“They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states
Background: Many pregnant individuals with opioid use disorder (OUD) spend time in jail, yet access to standard of care medications for OUD (MOUD) in jail is limited. Though qualitative studies of non-incarcerated pregnant and non-pregnant incarcerated individuals with OUD demonstrate complexities t...
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| Language: | English |
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Elsevier
2024-12-01
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| Series: | SSM: Qualitative Research in Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321524000623 |
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| author | Carolyn Sufrin Tali Ziv Lauren Dayton Carl Latkin Camille Kramer |
| author_facet | Carolyn Sufrin Tali Ziv Lauren Dayton Carl Latkin Camille Kramer |
| author_sort | Carolyn Sufrin |
| collection | DOAJ |
| description | Background: Many pregnant individuals with opioid use disorder (OUD) spend time in jail, yet access to standard of care medications for OUD (MOUD) in jail is limited. Though qualitative studies of non-incarcerated pregnant and non-pregnant incarcerated individuals with OUD demonstrate complexities that must be considered in delivering effective care, studies with pregnant, incarcerated patients with OUD are lacking. Methods: We conducted semi-structured qualitative interviews from October 2020–November 2021 with pregnant and postpartum people with OUD who were currently or previously in jail in Florida, Maryland, Ohio, and Virginia. Interview guides incorporated understandings of the power dynamics of incarceration and gendered expectations of motherhood. We analyzed transcripts using descriptive phenomenology to identify themes around experiences of treatment or withdrawal in jail and upon release. Results: We interviewed 32 women, 23 pregnant and nine postpartum. Some received MOUD in jail and others endured withdrawal. All participants expressed concern for their babies. Five themes emerged: 1)lack of counseling or accurate information about MOUD in pregnancy; 2)absent, delayed, or coercive care in jail; 3)experiences of stigma and discrimination from staff and caregivers; 4)structural barriers to safe transitions and continuing MOUD; and 5)the destructive presence of child protective services for care continuity. These factors all influenced their ability to recover. Conclusions: Jails must provide OUD care that is attentive to pregnancy physiology, pregnancy-stigma, reentry needs, and patients’ fetal-newborn concerns. Tailoring care specific to pregnancy and postpartum context can improve recovery success, reduce overdose, and promote intergenerational equity. |
| format | Article |
| id | doaj-art-7bded72cb9b64480b605c78a2bed0722 |
| institution | Kabale University |
| issn | 2667-3215 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-7bded72cb9b64480b605c78a2bed07222024-12-13T11:07:30ZengElsevierSSM: Qualitative Research in Health2667-32152024-12-016100453“They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. statesCarolyn Sufrin0Tali Ziv1Lauren Dayton2Carl Latkin3Camille Kramer4Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 4940 Eastern Ave, Baltimore, MD, 21224, USA; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA; Corresponding author. Department of Gynecology and Obstetrics Johns Hopkins School of Medicine, 4940 Eastern Ave, Baltimore, MD, 21224, USA.Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD, 21205, USADepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USADepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USADepartment of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 4940 Eastern Ave, Baltimore, MD, 21224, USABackground: Many pregnant individuals with opioid use disorder (OUD) spend time in jail, yet access to standard of care medications for OUD (MOUD) in jail is limited. Though qualitative studies of non-incarcerated pregnant and non-pregnant incarcerated individuals with OUD demonstrate complexities that must be considered in delivering effective care, studies with pregnant, incarcerated patients with OUD are lacking. Methods: We conducted semi-structured qualitative interviews from October 2020–November 2021 with pregnant and postpartum people with OUD who were currently or previously in jail in Florida, Maryland, Ohio, and Virginia. Interview guides incorporated understandings of the power dynamics of incarceration and gendered expectations of motherhood. We analyzed transcripts using descriptive phenomenology to identify themes around experiences of treatment or withdrawal in jail and upon release. Results: We interviewed 32 women, 23 pregnant and nine postpartum. Some received MOUD in jail and others endured withdrawal. All participants expressed concern for their babies. Five themes emerged: 1)lack of counseling or accurate information about MOUD in pregnancy; 2)absent, delayed, or coercive care in jail; 3)experiences of stigma and discrimination from staff and caregivers; 4)structural barriers to safe transitions and continuing MOUD; and 5)the destructive presence of child protective services for care continuity. These factors all influenced their ability to recover. Conclusions: Jails must provide OUD care that is attentive to pregnancy physiology, pregnancy-stigma, reentry needs, and patients’ fetal-newborn concerns. Tailoring care specific to pregnancy and postpartum context can improve recovery success, reduce overdose, and promote intergenerational equity.http://www.sciencedirect.com/science/article/pii/S2667321524000623 |
| spellingShingle | Carolyn Sufrin Tali Ziv Lauren Dayton Carl Latkin Camille Kramer “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states SSM: Qualitative Research in Health |
| title | “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states |
| title_full | “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states |
| title_fullStr | “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states |
| title_full_unstemmed | “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states |
| title_short | “They talked to me like I was dirt under their feet:” Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states |
| title_sort | they talked to me like i was dirt under their feet treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four u s states |
| url | http://www.sciencedirect.com/science/article/pii/S2667321524000623 |
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