Pharmacological Management of Opioid Use Disorder in Pregnant Women

CNS Drugs
Christine M Wilder, Theresa Winhusen

Abstract

Opioid misuse during pregnancy is associated with negative outcomes for both mother and fetus due not only to the physiological effects of the drug but also to the associated social, medical and mental health problems that accompany illicit drug use. An interdisciplinary approach to the treatment of opioid use disorder during pregnancy is most effective. Ideally, obstetric and substance use treatment are co-located and ancillary support services are readily available. Medication-assisted treatment with methadone or buprenorphine is intrinsic to evidence-based care for the opioid-using pregnant woman. Women who are not stabilized on an opioid maintenance medication experience high rates of relapse and worse outcomes. Methadone has been the mainstay of maintenance treatment for nearly 50 years, but recent research has found that both methadone and buprenorphine maintenance treatments significantly improve maternal, fetal and neonatal outcomes. Although methadone remains the current standard of care, the field is beginning to move towards buprenorphine maintenance as a first-line treatment for pregnant women with opioid use disorder, because of its greater availability and evidence of better neonatal outcomes than methadone. Howev...Continue Reading

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Citations

Jun 1, 2017·Journal of Midwifery & Women's Health·Van Roper, Kim J Cox
Aug 2, 2018·Toxicology Mechanisms and Methods·Stuart J KnightAbby C Collier
Jul 13, 2018·Obstetric Medicine·Kerry-Ann Louw
Apr 25, 2017·The Journal of Perinatal & Neonatal Nursing·Rebecca R Safley, Jamie Swietlikowski
Apr 21, 2017·Clinical Obstetrics and Gynecology·Aileen Pan, Mark Zakowski

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