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Non-Medical Opioid Use among Rural and Urban Pregnant Women, 2007-2014

Posted 6/30/2020

The opioid epidemic has reached crisis levels, and its effects are especially apparent in rural communities. One consequence of the opioid epidemic is opioid-affected births. Non-medical opioid use during pregnancy has potential health consequences for pregnant women and their infants, yet little information is available about its prevalence and associated factors in rural communities. This brief presents data on rural-urban differences in non-medical opioid use among pregnant women to inform policy, programmatic, and clinical efforts to address this crisis.


  • Nearly 7% of rural pregnant women reported non-medical opioid use in the past 12 months, compared with 5% of urban pregnant women. This difference was not statistically significant at p<0.05.
  • Use of alcohol, tobacco, and marijuana, and having a diagnosis of anxiety or depression were each associated with non-medical opioid use for pregnant women in both rural and urban communities.
  • Rural pregnant women who were high school graduates or had less than a high school education had increased odds of non-medical opioid use.
  • Urban pregnant women who were non-Hispanic White, unmarried, or uninsured had increased.

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