Dissertation research

For my dissertation, I conducted a convergent mixed-method study to describe trends and influences on opioid agonist therapy (OAT), like methadone, during pregnancy in Ontario, Canada.

For the quantitative stream, I analyzed population-level administrative health data to better understand who and how many people have been prescribed OAT during pregnancy. I conducted an interrupted time series analysis of routinely collected data about prescriptions dispensed at pharmacies in Ontario and examined the impact of three population level changes (buprenorphine added to the public insurance formulary, new clinical guidelines and the start of COVID-19) on the rates of OAT over time.

For the qualitative stream, I conducted life course interviews with 25 pregnant or recently people who used opioids or OAT prior to their most recent pregnancy. In these interviews, I explore what influenced their decision to use or not use OAT, and their experiences of opioid use and motherhood.

My project was conducted in collaboration with a community advisory board (CAB) comprised of mothers with the living and lived experiences of pregnancy, opioid use and OAT. CAB members were involved at all stages of my community-engaged research project including providing input into the research design, as well as interpreting, confirming, and triangulating my results with their lived experience. During the final stage of my project, I used interpretive focus groups with the CAB to collaboratively synthesize the data from the two research streams of research to better understand different trajectories of opioid and OAT use in the context of pregnancy.

While many studies on drug use may account for multiple levels of influence, they do not often look at the influences of these changes over time. My research led to a greater understanding of how factors at multiple levels impact decision-making regarding accessing treatment for opioid use disorders during pregnancy.

Selected publications

Please see my Google Scholar for a complete list of publications.

Schmidt, R.A.,  Everett, K., Perez-Brumer, A.,  Strike, C., Rush, B. & Gomes, T. (2024). A population-based time-series analysis of opioid agonist treatment dispensed during pregnancy. Addiction, 119(6), 1111–1122.

Schmidt, R. A., et al. (2023). ‘I don’t chase drugs as much anymore, and I’m not dead’: Client reported outcomes associated with safter opioid supply programs in Ontario, Canada. Drug and Alcohol Review, 42(7), 1825-1837.

Schmidt, R. A., Wey, T. W., Harding, K. D., et al. (2023). A harmonized analysis of five Canadian pregnancy cohort studies: exploring the characteristics and pregnancy outcomes associated with prenatal alcohol exposure. BMC Pregnancy and Childbirth, 23(1).

Gagnon, M., Rudzinski, K., Guta, A., Schmidt, R. A., Kryszajtys, D. T., Kolla, G., & Strike, C. (2023). Impact of safer supply programs on injection practices: client and provider experiences in Ontario, Canada. Harm Reduction Journal, 20(1).

Wolfson, L., Schmidt, R. A., Stinson, J., & Poole, N. (2021). Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework. Health and Social Care in the Community.

Schmidt, R. A., Genois, R., Jin, J., Vigo, D., Rehm, J., & Rush, B. (2021). The early impact of COVID-19 on the incidence, prevalence and severity of alcohol use and other drugs: A systematic review. Drug and Alcohol Dependence, 228.