Methamphetamine Co-Use Among Pregnant Individuals Using Opioids in the United States, 2011-2023.

Using 2011-2023 Treatment Episodes Dataset-Admissions data, we conducted a cross-sectional analysis of trends and risk factors associated with opioid and methamphetamine co-use among pregnant individuals entering substance use disorder treatment in the United States. Opioid and methamphetamine co-use increased from 2.8% to 6.1% over the study period; opioid co-use with other substances declined. Multivariable models showed higher risk of methamphetamine co-use among pregnant individuals experiencing homelessness and those admitted to rehabilitation, whereas higher education and employment were protective. Findings highlight shifting polysubstance patterns and underscore the need for integrated, socially informed treatment approaches for pregnant individuals.