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. Author manuscript; available in PMC: 2016 Apr 23.
Published in final edited form as: Prev Med. 2015 Apr 18;80:23–31. doi: 10.1016/j.ypmed.2015.04.008

Table 4.

Method choice among those using contraception.

Author (year) WHO Tier Women with opioid and other substance use disorders N(%) Comparison population N(%) Comments
Densen-Gerber et al. (1972) Tier 1 IUD: 7 (27) More than one method could be reported
Tier 2 OCP: 20 (77)
Tier 3 Condom: 2 (8)
Tier 3/4 Diaphragm/foam: 3 (12)
Ralph & Spigner (1986) Tier 1 TL: (24) TL: (30)

  1. More than one method could be reported in both populations

  2. N not calculable for comparison population
Tier 2 OCP: (32) OCP: (24)
Tier 3 Condom: (3)
Diaphragm: (18)		 Condom: (11)
Diaphragm: (7)
Tier 4 Foam: (3) Foam: (2)
Armstrong et al. (1991) Tier 1 TL: 160 (>100)
IUD: 9 (6)		 TL: 2,235 (5)
IUD: 446 (1)

  1. More than one method could be reported by women with substance use disorders, but only one method could be reported in comparison population

  2. Not all contraceptive users were sexually active; TL method prevalence not used in summary evaluations in results because prevalence >100%
Tier 2 OCP: 30 (21) OCP: 26,791 (65)
Tier 3 Condom: 89 (62)
Sponge: 6 (4)		 Condom: 9,506 (23)
Sponge: 453 (1)
Unk. Other: 23 (16) Other: 1834 (4)
Kouzi et al. (1992) Tier 2 OCP: 4 (9)

  1. More than one method could be reported

  2. Two women reported using contraception, but the exact methods were not specified More than one method could be reported
Tier 3 Condom: 39 (87)
White et al. (1993) Tier 1 TL: 1 (6)
IUD: 1 (6)
Tier 2 OCP/injection: 12 (75)
Tier 3 Condom: 4 (25)
Diaphragm: 0 (0)
Morrison et al. (1995) Tier 1 TL 13 (16)
IUD: 11 (13)

  1. More than one method could be reported

  2. Women with hysterectomies inextricable from those with a TL
Tier 2 Injection: 5 (6)
OCP: 18 (22)
Tier 3 Condom: 36 (44)
Natural family planning: 1(1)
Dudish and Hatsukami (1996) Tier 1 IUD: 0 (0)
Implant: 4 (15)		 Ns back-calculated
Tier 2 Injection: 15 (58)
OCP: 2 (8)
Tier 3 Condom/diaphragm: 5 (19)
Condom/diaphragm + foam: 0 (0)
Rhythm method: 0 (0)
Tier 4 Foam: 0 (0)
Harcourt et al. (2001) Tier 2 OCP: (12) OCP: (42)

  1. More than one method could be reported

  2. 26% of women with substance use disorders and 2% of comparison group reported “inadequate contraception”
Tier 3 Condom: (76) Condom: (56)
Banwell et al. (2003) Tier 1 TL/sterilization: 24 (17) TL/sterilization: (34) Sterilization included vasectomy
Tier 2 Injection: 10 (8)
OCP: 36 (26)		 Injection: not reported
OCP: (40)
Tier 1/3 IUD/condom/diaphragm: 67 (49) IUD/condom/diaphragm: (21)
Harding & Ritchie (2003) Tier 1/2 TL/injection/OCP: 5 (63)
Tier 3 Condom: 3 (38)
Harvey et al. (2003) Tier 3 Condom (any use): 43 (69)

  1. “Birth control” was not explicitly defined

  2. Ns back-calculated
Unk. Birth control (any use): 62 (100)
Vidal-Trecan et al. (2003) Tier 1 IUD: 5 (8) IUD: 20 (18)

  1. More than one method could be reported

  2. Tier 1/2 + 3 indicates dual use

  3. Other methods could include diaphragm, spermicides, withdrawal, and periodic abstinence.

  4. Ns back-calculated
Tier 2 OCP: 19 (31) OCP: 91 (83)
Tier 1/2+3 Condom + OCP/IUD: 2 (3) Condom + OCP/IUD: 1(1)
Tier 3 Condom: 52 (84) Condom: 13 (12)
Unk. Other methods: 12 (19) Other methods: 8 (7)
Weber et al. (2003) Tier 1 TL: 47 (30)
Tier 2 Injection: 10 (6)
OCP: 4 (3)
Tier 3 Condom: 101 (64)
Carrieri et al. (2006) Tier 2 OCP: 10 (17)

  1. “Other” category included withdrawal, IUD, spermicide, diaphragm, and vaginal douching

  2. Tier 2 + 3 indicates dual use

  3. Ns back-calculated
Tier 2+3 Condom + OCP: 4 (7)
Tier 3 Condom: 37 (65)
Tier 1/3/4 Other: 6 (11)
Clarke et al. (2006) Tier 3 Condom (consistent use): 50 (71)

  1. “Birth control” was not explicitly defined

  2. Ns back-calculated
Unk. Birth control (consistent use): 70 (100)
Olsen et al. (2009) Tier 1 TL: 8 (17)
Partner’s vasectomy: 3 (6)
IUD: 1 (2)		 Tier 1/2 + 3 indicates dual use
Tier 1/2 Implant/injection: 11 (23)
Tier 2 OCP: 6 (13)
Emergency Contraception: 0 (0)
Tier 1/2+3 Condom + pill/implant: 7 (15)
Tier 3 Condom: 10 (21)
Diaphragm: 1 (2)
Abdala et al. (2011) Tier 1 IUD: 0 (0)
Tier 2 OCP: 0 (0)
Tier 3 Condom: 40 (75)
Tier 4 Spermicide: 1 (2)
Douching/withdrawal: 12 (23)
Duff et al. (2011) Tier 1 TL: 35 (40)
IUD: 3 (3)		 139 reported using condoms only with clients
Tier 2 Injection: 18 (21)
OCP: 2 (2)
Tier 3 Condom: 30 (34)
Female condom: 0 (0)
Toffol et al. (2011) Tier 1 IUD: 6 (29) IUD was specifically levonorgestrel-releasing system
Tier 2 OCP: 15 (71)
Black et al. (2012) Tier 1/2 TL/IUD/implant//injection: 24 (38) One woman reported using contraception, but did not specify a method
Tier 2 OCP: 10 (16)
Tier 3 Condom: 29 (46)

Notes: WHO Tier = World Health Organization’s tiers of contraceptive effectiveness (WHO, 2007). Tier 1 = very effective (<1% of women using one of these methods will become pregnant in the first year of typical use), Tier 2 = effective (1–9% pregnancy rates), Tier 3 = moderately effective (10–25% pregnancy rates), and Tier 4 = less effective (26–32% pregnancy rates). TL = tubal ligation, IUD = intrauterine device, Injection = depot injection, OCP = oral contraceptive pills, unk. = unknown.