ABSTRACT

The purpose of this study was to identify a potential relationship between childhood sexual abuse and opioid misuse in pregnancy and to illustrate the need for better integration and collaboration between the medical and psychological disciplines to combat the opioid crisis. We sampled 93 pregnant women at a high-risk pregnancy clinic within a university medical center who were in their second trimester or beyond. Fifty-five women were considered high-risk due to opioid misuse and 38 women were considered high-risk due to medical reasons other than drug use. Our findings reveal both presence of and severity of sexual abuse were significantly associated with opioid misuse in pregnancy, while physical abuse, emotional abuse, and neglect were not. While childhood sexual abuse is a significant risk factor for opioid misuse in pregnancy, most doctors do not feel comfortable asking about trauma history. A public health approach to opioid misuse in pregnancy must consider how “diseases of despair” disproportionately impact women with limited access to adequate psychological and medical care. A preventative model of care, which targets screenings for ACEs in primary care and gynecological visits may help decrease the impact of sexual abuse.

摘要

本研究的目的是确定儿童性虐待与怀孕期间阿片类药物滥用之间的潜在关系，并说明需要更好地整合医学和心理学学科之间的合作以应对阿片类药物危机。我们在大学医疗中心内的高危妊娠诊所抽取了 93 名处于妊娠中期或更长时间的孕妇进行抽样。55 名女性因滥用阿片类药物而被认为是高风险的，38 名女性因吸毒以外的医疗原因被认为是高风险的。我们的研究结果表明，性虐待的存在和严重程度与怀孕期间阿片类药物的滥用显着相关，而身体虐待、情感虐待和忽视则不然。虽然儿童期性虐待是孕期阿片类药物滥用的一个重要风险因素，大多数医生不愿意询问创伤史。对怀孕期间阿片类药物滥用的公共卫生方法必须考虑“绝望疾病”如何不成比例地影响获得足够心理和医疗服务的妇女。针对初级保健和妇科就诊中 ACE 筛查的预防性护理模式可能有助于减少性虐待的影响。