Pediatricians' Attitudes Toward and Use of Terminology About Mothers With Opioid Use Disorder

Stigmatizing experiences for mothers with opioid use disorder (OUD) may impede health care engagement. We sought to characterize attitudes and terminology use among pediatric primary care clinicians as a potential target for improvement.

We conducted a cross-sectional survey of 1004 clinicians at 28 clinics affiliated with 7 US residency programs (April to June 2022). Survey questions focused on trust, blame, and support for mothers with OUD were adapted from prior studies of self-reported attitudes, and terminology was categorized as preferred versus nonpreferred based on national recommendations. Frequencies were tabulated, and a 2-stage process of factor analysis and k-means clustering was used to group respondents by attitudinal responses. Multivariable logistic regression evaluated the association between participant characteristics and attitudinal groups.

Of 272 respondents (response rate 27.1%), most were female, non-Hispanic White residents; the distribution of clinical roles was similar among nonrespondents. Use of nonpreferred terminology was infrequent, although over 69% reported usual or occasional use of "substance abuse." Analyses supported clustering respondents across 3 main constructs of trust, blame, and support. About 27% were categorized as having a low level of blame, and about 38% had a high level of trust. Adjusting for covariates, high trust was associated with confidence in training to provide care for opioid-exposed children (adjusted odds ratio [AOR] 1.84, P =0.04), and low blame was associated with education on OUD stigma (AOR 3.43, P =0.001).

Pediatrician attitudes reflecting mistrust and blame toward mothers with OUD are not uncommon but may be addressed through training and education.