University of Oulu

Beltrán-Arzate, K., Hodson, K., Tes, H. K., Bowyer, S.-A. H., Ratliff, H. C., Abraham, M. M., Johnson, E., Harris, M., & Jaekel, J. (2021). Contextual risk and psychosocial profiles of opioid-using mothers: A mixed-methods study. Women’s Health.

Contextual risk and psychosocial profiles of opioid-using mothers : a mixed-methods study

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Author: Beltrán-Arzate, Karina1; Hodson, Kevin1; Tes, Haley K.1;
Organizations: 1Department of Child and Family Studies, University of Tennessee Knoxville, Knoxville, TN, USA
2Department of Neonatology, East Tennessee Children’s Hospital, Knoxville, TN, USA
3Department of Psychology, University of Oulu, Oulu, Finland
4Department of Psychology, University of Warwick, Coventry, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: SAGE Publications, 2021
Publish Date: 2022-02-02


Introduction: There is an increase in cases of mothers using opioids during pregnancy in the United States but research investigating mothers’ psychosocial environments along with individual variability among this high-risk group of women is scarce.

Methods: This mixed-methods study aims to examine the complex interplay of contextual risks and experiences of opioid-using mothers. A sample of 50 opioid-using biological mothers of infants diagnosed with neonatal opioid withdrawal syndrome (NOWS) were studied using a set of standardized and open-ended questions, along with medical records extraction.

Results: A high-risk subgroup of 36 mothers was identified using cluster analysis, characterized by a distinct profile of psychosocial risk. Thematic content analysis revealed four themes: (1) barriers to communication and mistrust of health professionals, (2) limitations of access to health care and the amplification of disadvantages related to COVID-19, (3) lifelong consequences of adverse childhood experiences (ACEs), and (4) intimate partner violence and its influence on drug use.

Conclusion: Our findings highlight important information toward health services provision for opioid-using women of childbearing age. Efforts to reduce opioid usage in mothers need to consider psychosocial and contextual risks.

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Series: Women's health
ISSN: 1745-5057
ISSN-E: 1745-5065
ISSN-L: 1745-5057
Volume: 17
Pages: 1 - 14
DOI: 10.1177/17455065211060624
Type of Publication: A1 Journal article – refereed
Field of Science: 515 Psychology
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Office of Research and Engagement of the University of Tennessee Knoxville (#2018 SEED Jaekel). Funding for open access to this research was provided by the University of Tennessee’s Open Publishing Support Fund.
Copyright information: © The Author(s) 2021. Article reuse guidelines: DOI: 10.1177/17455065211060624. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (