Grant: Project Grant - PA: Research in First Nations, Inuit and/or Métis Health

Canada is facing an opioid crisis, and the number of pregnant people using opioids continues to increase dramatically in North America. Opioid agonist therapy (OAT) is a treatment for both pregnant and non-pregnant people that includes prescribed opioids such as methadone, buprenorphine, slow-release oral morphine, hydromorphone, and fentanyl that work to prevent symptoms of withdrawal and reduce cravings in people with opioid use disorder. When a baby is born to a mother who has used opioids in pregnancy, including OAT, they can develop withdrawal. However, not all babies develop withdrawal, and some babies have very mild symptoms while others become very sick. We do not know why this is, but suspect there are some clinical and environmental factors, drug factors, and genes involved in opioid response that may determine which babies develop withdrawal and how severe the withdrawal is. Women who use substances in pregnancy are under-represented in research, and there are no research studies in Canada investigating opioid exposures in pregnancy from a holistic lens. To start addressing these questions, we brought together a team of experts from across Canada to establish the POETIC Research Network. Our multidisciplinary research team includes doctors, nurses, pharmacists, researchers, people with lived experience, a Matriarch Indigenous Elder, and social workers. We will conduct a Phase 1 study across Canada (Vancouver, Hamilton, London, Winnipeg) enrolling pregnant people on OAT. Pregnant people will be approached during their visits to their doctor/stay in hospital. We will collect surveys from a web-based online platform, information from medical charts, genetic information from saliva, and opioid levels from blood samples and breastmilk. Participants will take part in interviews at the end of the study. This information will inform a larger study across Canada, to help doctors provide better care to their patients on OAT in pregnancy, and their infants.