43-53% of Pregnant Women with Opioid or Alcohol Problems Also Used Marijuana

Among 251 pregnant women with opioid use disorder and/or alcohol use, marijuana co-use was remarkably common at 43-53%, with younger age and polysubstance use as the strongest predictors.

Page, Kimberly et al.·Addiction science & clinical practice·2022·Moderate EvidenceProspective Cohort
RTHC-04124Prospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
N=125

What This Study Found

Marijuana prevalence was 43.2% in the OUD group, 52.6% in the combined OUD+Alcohol group, and 46.4% in the Alcohol group. Weekly or daily use ranged from 19-25%. Women on buprenorphine had higher marijuana use than those on methadone. Younger age and polysubstance use were independent predictors.

Key Numbers

Marijuana prevalence: OUD 43.2%, OUD+Alcohol 52.6%, Alcohol 46.4%. Weekly/daily use: 19.4%, 21.0%, 24.6% respectively. Buprenorphine patients had higher use than methadone patients (45.8% vs 37.5% in OUD; 58.3% vs 42.9% in OUD+Alcohol). Age: aOR 0.61 per 5-year increment. Polysubstance use: aOR 2.02.

How They Did This

Prospective cohort study (ENRICH-1) of 251 pregnant women classified into OUD (n=125), Alcohol (n=69), and OUD+Alcohol (n=57) groups. Substance use was assessed by self-report and biomarkers. Multivariable logistic regression identified correlates of marijuana use.

Why This Research Matters

Prenatal substance exposure research typically focuses on single substances, but these data show marijuana co-use is extremely common among pregnant women already dealing with opioid or alcohol problems. This means fetal exposure is often multi-substance, complicating risk assessment.

The Bigger Picture

The high rates of marijuana co-use highlight a gap in prenatal care: most screening and treatment programs focus on the primary substance of concern (opioids or alcohol) but may not adequately address marijuana. The buprenorphine-methadone difference is intriguing and warrants investigation.

What This Study Doesn't Tell Us

The sample was recruited from specific clinical settings and may not represent all pregnant women with substance use issues. Self-report of marijuana use may underestimate true prevalence. The study was not designed to assess fetal outcomes from marijuana co-exposure.

Questions This Raises

  • ?Does marijuana co-use affect the efficacy of methadone or buprenorphine treatment during pregnancy?
  • ?Are fetal outcomes worse with combined exposures than with single-substance exposure?
  • ?Why do buprenorphine patients have higher marijuana use rates?

Trust & Context

Key Stat:
52.6% marijuana use in pregnant women with combined OUD and alcohol problems
Evidence Grade:
Moderate: well-characterized prospective cohort with both self-report and biomarker data, though from specific clinical settings.
Study Age:
Published in 2022.
Original Title:
Prevalence of marijuana use in pregnant women with concurrent opioid use disorder or alcohol use in pregnancy.
Published In:
Addiction science & clinical practice, 17(1), 3 (2022)
Database ID:
RTHC-04124

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

Why is marijuana use so common in pregnant women with other substance problems?

Polysubstance use is common in people with substance use disorders. Marijuana may be perceived as less harmful than opioids or alcohol, and some women may use it to manage symptoms like nausea, anxiety, or pain during pregnancy.

Does marijuana use during pregnancy add risk on top of opioids or alcohol?

This study did not assess fetal outcomes, but the high co-use rates highlight that many fetuses are exposed to multiple substances simultaneously. Other research suggests combined exposures may pose greater risks than individual substances alone.

Read More on RethinkTHC

Cite This Study

RTHC-04124·https://rethinkthc.com/research/RTHC-04124

APA

Page, Kimberly; Murray-Krezan, Cristina; Leeman, Lawrence; Carmody, Mary; Stephen, Julia M; Bakhireva, Ludmila N. (2022). Prevalence of marijuana use in pregnant women with concurrent opioid use disorder or alcohol use in pregnancy.. Addiction science & clinical practice, 17(1), 3. https://doi.org/10.1186/s13722-021-00285-z

MLA

Page, Kimberly, et al. "Prevalence of marijuana use in pregnant women with concurrent opioid use disorder or alcohol use in pregnancy.." Addiction science & clinical practice, 2022. https://doi.org/10.1186/s13722-021-00285-z

RethinkTHC

RethinkTHC Research Database. "Prevalence of marijuana use in pregnant women with concurren..." RTHC-04124. Retrieved from https://rethinkthc.com/research/page-2022-prevalence-of-marijuana-use

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.