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. 2018 Apr;31(2):122-127.
doi: 10.1016/j.jpag.2017.11.002. Epub 2017 Nov 21.

A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder

Caitlin J Handy  1 , Hannah L H Lange  2 , Brittny E Manos  3 , Elise D Berlan  4 , Andrea E Bonny  5
Affiliations

A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder

Caitlin J Handy et al. J Pediatr Adolesc Gynecol. 2018 Apr.

Abstract

Study objective: To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder.

Design: Retrospective chart review.

Setting: Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults.

Participants: Nonpregnant female adolescents who presented for treatment from January 1, 2013 to January 31, 2016 (N = 123).

Interventions: None.

Main outcome measures: Prescription contraceptive use at baseline and initiation of a new method within 90 days.

Results: Of 123 female adolescents who presented for treatment of opioid use disorder, 113 (91.9%) reported sexual activity and 80 (65.0%) were not using prescription contraception at intake. Previous pregnancy was reported by 43 (35.0%) and 20 (16.3%) were positive for a sexually transmitted infection. Contraceptive counseling was not documented for 73 (59.3%) patients. Among patients with no prescription contraception at baseline, 56 of 80 (70.0%) initiated a method within the study window. Significant predictors (odds ratio [OR]; 95% confidence interval) of contraceptive initiation included previous pregnancy (8.6; 1.39-52.99), education of less than a high school diploma/general equivalency diploma (7.4; 1.63-33.41), and return for follow-up visit (9.8; 2.18-43.69).

Conclusion: Young women who presented for opioid use disorder treatment were at high risk of adverse reproductive health outcomes. Most were sexually active and not using prescription contraception. Findings underscore the need for contraceptive counseling in this patient population. Optimally, these services would be provided in conjunction with substance use treatment. Improved contraceptive counseling documentation will allow evaluation of effective contraceptive counseling strategies for adolescents with opioid use disorders and might serve to inform future interventions.

Keywords: Adolescent medicine; Contraception; Opioid use disorder; Reproductive health.

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Conflict of interest statement

Conflict of Interest/Financial Disclosures:

Dr. Berlan receives honoraria from Merck & Co for being a Nexplanon trainer. There are no other potential conflicts of interest to report. The content of this manuscript is solely the responsibility of the authors.

This work received support from Research Data & Computing (RDC) Services at Nationwide Children’s Hospital, the Center for Clinical and Translational Science at The Ohio State University (CTSA UL1TR001070), and the Ohio State University College of Medicine Bennett Research Scholarship awarded to Ms. Handy. No funding source had any influence on the design of the study or the content of the manuscript.

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