Polysubstance use of psychoactive stimulants and receipt of medications for opioid use disorder among pregnant women in U.S. treatment facilities

Objectives Prenatal polysubstance use (PSU) involving opioids and psychoactive stimulants is linked to adverse gestational outcomes, yet limited research examines PSU and receipt of medications for opioid use disorder (MOUD). This study aimed to (1) determine the prevalence of PSU among pregnant women in U.S. treatment facilities diagnosed with opioid dependence and (2) assess associations between PSU and MOUD receipt.Methods Data were drawn from the 2015–2022 Treatment Episode Data Set. The sample included 4,821 pregnant women with opioid dependence and no prior treatment episodes. Analyses included descriptive statistics, bivariate tests, and multivariable logistic regression to examine associations between PSU status and MOUD receipt.Results About 23.8% of the sample were polysubstance opioid users (POU). Monosubstance opioid users (MOU) had higher odds of receiving MOUD (AOR = 1.43, 95% CI: 1.22–1.67) than POU. MOUD receipt was most likely among women who were married, aged 30–39, or living in the Northeast. Higher likelihood of MOUD receipt was also observed among women in ambulatory care settings, with treatment durations of 365 days or more, and those with dependent living situations at discharge.Conclusions POU reduced the likelihood of MOUD receipt during pregnancy, underscoring the need for policies supporting PSU populations at risk.