Investigating Maternal Opioid Use, Neonatal Abstinence Syndrome and Response in NW Tribal Communities

摘要（最多30行） 在过去的两年里，处方阿片类药物的医疗和非医疗使用在美国激增。 几十年怀孕期间阿片类药物使用的增加标志着AI/AN妇女之间的差异， 新生儿虽然有基于证据的治疗策略，建议在 在怀孕和产后使用期间，这些策略的使用率大大降低， AI/AN在美国。作为主权国家，部落往往负责政策，做法， 和基础设施的改善来解决这些问题。西北部落流行病学 中心（EpiCenter）的任务是响应43个西北部落的数据需求， 包括阿片类药物使用、新生儿戒断综合征以及获得和使用 治疗相关信息。我们是因应这些要求和需要而提出这项建议的 的部落。 我们计划进行流行病学评估，以确定 在西北部的美洲印第安人中，怀孕期间母亲使用药物和NAS。 我们将利用部落流行病学中心正在进行和计划进行的工作来估计种族- 孕期母体药物使用和住院NAS的纠正率和趋势 放电数据我们还将调查西北地区阿片类药物的使用和治疗， 印度卫生局国家数据库。我们将补充这些定量数据 定性数据，帮助我们了解环境、社会和组织 结构、流程和政策，以及影响访问或 西北部落的使用，治疗 这项建议将汇集流行病学和内容专家，作为顾问委员会成员， 对数据作出反应，并确保分析和报告对决策者有用， 各种能力。在成功完成这些建议的研究目标后，我们会 准备实施和评估未来的部落干预措施和政策，从长远来看， 可以减少阿片类药物危机对西北美洲印第安人社区的影响。

Abstract (30 lines max) Medical and nonmedical use of prescription opioids has rocketed in the US over the past two decades. The rise in opioid use during pregnancy marked disparities among AI/AN women and newborns. While there are evidence-based treatment strategies recommended for use during pregnancy and in the postnatal use period, use of these strategies is substantially lower in AI/AN across the US. As sovereign nations, tribes are often responsible for policies, practices, and infrastructure improvements to address these problems. The Northwest Tribal Epidemiology Center (The EpiCenter) is tasked with responding to the data needs of the 43 NW Tribes, including Opioid use, Neonatal Abstinence Syndrome (NAS) and access and utilization of treatment related information. We initiate this proposal in response to these requests and needs of the tribes. We plan to perform an epidemiologic assessment to determine the magnitude and impact of maternal substance use during pregnancy and NAS among American Indians in the Northwest. We will leverage ongoing and planned work in the Tribal Epidemiology Center to estimate race- corrected rates and trends of maternal substance use during pregnancy and NAS in hospital discharge data. We will also investigate opioid use and treatment in the NW as reported in Indian Health Service’s national data repository. We will complement these quantitative data with qualitative data to help us understand the environmental, social and organizational structures, processes, and policies, as well as individual behaviors that influence access to, or use of, treatment in Northwest Tribes This proposal will bring together epidemiologic and content experts, as advisory board members to respond to the data and ensure that analyses and reports are useful to decision-makers in various capacities. Upon successful completion of these study aims proposed, we will be poised to implement and evaluate future tribal interventions and policies, which in the long term could reduce the effect of the opioid crisis in Northwest American Indian communities.