Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov:80:23-31.
doi: 10.1016/j.ypmed.2015.04.008. Epub 2015 Apr 18.

Contraceptive use and method choice among women with opioid and other substance use disorders: A systematic review

Mishka Terplan  1 , Dennis J Hand  2 , Melissa Hutchinson  1 , Elizabeth Salisbury-Afshar  1 , Sarah H Heil  3
Affiliations

Contraceptive use and method choice among women with opioid and other substance use disorders: A systematic review

Mishka Terplan et al. Prev Med. 2015 Nov.

Abstract

Aim: To systematically review the literature on contraceptive use by women with opioid and other substance use disorders in order to estimate overall contraceptive use and to examine method choice given the alarmingly high rate of unintended pregnancy in this population.

Method: Pubmed (1948-2014) and PsycINFO (1806-2014) databases were searched for peer-reviewed journal articles using a systematic search strategy. Only articles published in English and reporting contraceptive use within samples of women with opioid and other substance use disorders were eligible for inclusion.

Results: Out of 580 abstracts reviewed, 105 articles were given a full-text review, and 24 studies met the inclusion criteria. The majority (51%) of women in these studies reported using opioids, with much smaller percentages reporting alcohol and cocaine use. Across studies, contraceptive prevalence ranged widely, from 6%-77%, with a median of 55%. Results from a small subset of studies (N=6) suggest that women with opioid and other substance use disorders used contraception less often than non-drug-using comparison populations (56% vs. 81%, respectively). Regarding method choice, condoms were the most prevalent method, accounting for a median of 62% of contraceptives used, while use of more effective methods, especially implants and intrauterine devices (IUDs), was far less prevalent 8%.

Conclusions: Women with opioid and other substance use disorders have an unmet need for contraception, especially for the most effective methods. Offering contraception services in conjunction with substance use treatment and promoting use of more effective methods could help meet this need and reduce unintended pregnancy in this population.

Keywords: Contraceptive use; Opioids; Substance use disorders; Unintended pregnancy; Women.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Search strategy.
See this image and copyright information in PMC

References

    1. Abdala N, Kershaw T, Krasnoselskikh TV, Kozlov AP. Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia. J Fam Plann Reprod Health Care. 2011;37(3):158–164. http://dx.doi.org/10.1136/jfprhc-2011-0079. - DOI - PMC - PubMed
    1. American College of Obstetricians and Gynecologists (ACOG) Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. ACOG Committee Opinion No 450. Obstet Gynecol. 2009;114:1434–1438. - PubMed
    1. American College of Obstetricians and Gynecologists (ACOG) Adolescents and long-acting reversible contraception: implants and intrauterine devices. ACOG Committee Opinion No 539. Obstet Gynecol. 2012;120:983–988. - PubMed
    1. Ariely D, Loewenstein G. The heat of the moment: the effect of sexual arousal on sexual decision making. J Behav Decis Mak. 2006;19(2):87–98. http://dx.doi.org/10.1002/bdm.501. - DOI
    1. Armstrong KA, Kenen R, Samost L. Barriers to family planning services among patients in drug treatment programs. Fam Plan Perspect. 1991;23(6):264–266. 270–271. - PubMed

Publication types