Utilization of health and education services amongst children with prenatal opioid exposure: A mixed methods and community-initiated analysis

Background Research suggests long-term developmental implications of prenatal opioid exposure (POE) that may contribute to healthcare and educational service utilization patterns, such as lower utilization of preventative healthcare services, higher utilization of emergency department and inpatient services, and higher utilization of supportive educational services. However, research on how families navigate these services, including challenges and benefits, is limited. Methods Parents and caregivers of children with POE partnered with the study team to create a survey (n = 148) and focus group protocols (n = 15) for a convenience sample (75% in West Virginia and Massachusetts) of families raising children with POE. Those with lived experience analyzed the resulting data, alongside the study team. Results The vast majority of children in the sample received some type of supportive service, with Early Intervention (80%) and/or Individualized Education Plans (39%) being the most commonly reported. Additionally, children commonly received outpatient services such as occupational therapy (35%) or mental health counseling (31%), among others. Caregivers expressed navigating significant challenges in trying to access services for their children with POE, from a fractured and complex system to providers who do not see their child’s struggles or believe they are connected to POE. Utilization patterns did not vary between children with just POE and children with exposures to additional substances prenatally. Conclusions Based on families’ reported experiences, investments in professional development for pediatricians and educators, a clinical understanding of the long-term implications of POE, best practices beyond the NICU, more integrated screening and services, and greater access to mental health services are top priorities.