Treatment of Opioid Use Disorders in Pregnancy
These resources offer guidelines for the use of Medication-Assisted Treatment (MAT) to treat opioid use disorders in pregnancy and the post-partum period. Included is information on breastfeeding while using MAT, the use of buprenorphine with pregnant women, and resources on the treatment of other substance use disorders in pregnancy.
World Health Organization: Guidelines for Identification and Management of Substance Use and Substance Use Disorders in Pregnancy. These guidelines contain recommendations on the identification and management of substance use and substance use disorders for health care services which assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol and other substance use and substance use disorders in pregnant women, with the target of healthy outcomes for both pregnant and their fetus or infant. http://www.who.int/substance_abuse/publications/pregnancy_guidelines/en/
Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. Includes information on considerations for the treatment of alcohol use disorders in pregnancy. Provides guidance for the use of medication-assisted treatment for alcoholism and alcohol abuse in clinical practice. Summarizes approved medications and discusses screening and patient assessment, treatment planning, and patient monitoring. http://store.samhsa.gov/shin/content//SMA15-4907/SMA15-4907.pdf (PDF 507 KB)
The American Congress of Obstetricians and Gynecologists (ACOG) Toolkit on State Legislation: Pregnant Women & Prescription Drug Abuse, Dependence and Addiction. This toolkit provides talking points and policy recommendations from ACOG for state legislators and other policy organizations that are addressing pregnant women and prescription opioid use during pregnancy. http://www.acog.org/-/media/Departments/Government-Relations-and-Outreach/NASToolkit.pdf (PDF 287 KB)
Webinars and Videos
- Medication-Assisted Treatment During Pregnancy, Postnatal and Beyond: Discusses the needs of pregnant women seeking medication-assisted treatment. Karol Kaltenbach, PhD presents findings from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) project. Facilitated as part of a webinar series.
- Indian Health Services Webinar Series: Addresses various issues, including Illicit Drug Use around the Time of Birth, Education and Prevention Strategies. https://www.ihs.gov/telebehavioral/seminararchive/substanceuse/
- Texas State Department of Health Services, Journeys of Hope, Mommies and Babies Overcoming Neonatal Abstinence Syndrome Video: Three mothers describe their experience in recovering from opioid use disorders during pregnancy. Professionals from child welfare, substance use treatment and the medical field discuss how providing care without judgment results in better outcomes for both mom and baby. http://www.dshs.state.tx.us/sa/nas/#journeys
Recent Research Studies
Studies on the use of methadone and buprenorphine for the treatment of opioid use disorders during pregnancy:
- Jones, H.E., Fishcer, G., Heil, S.HG., Kaltenbach, K., Martin, P.R., Coyle, M.G., Selby, P., Stine, S.M., O’Grady, K.E. & Arria, A.M. (2012). Maternal Opioid Treatment: Human Experimental Research (MOTHER) – approach, issues and lessons learned. Addiction, 107, 28-35. doi: 10.1111/j.1360-0443.2012.04036.x.
A National Institute on Drug Abuse (NIDA)-supported clinical trial that examined the use of methadone and buprenorphine maintenance therapy during pregnancy. No significant difference was found with respect to any serious maternal or neonatal adverse events. http://www.ncbi.nlm.nih.gov/pubmed/23106924
- Hall, E.S., Isemann, B.T., Wexelblatt, S.L., Meinzen-Derr, J., Wiles, J.R., Harvey, S., & Akinbi, H.T. (2016). A cohort comparison of buprenorphine versus methadone treatment for neonatal abstinence syndrome. The Journal of Pediatircs, 170, 39-44. doi: http://dx.doi.org/10.1016/j.jpeds.2015.11.039.
This study compared the duration of opioid treatment and length of stay among infants treated for neonatal abstinence syndrome (NAS) by using a pilot buprenorphine versus conventional methadone treatment. Results indicated that sublingual buprenorphine may be superior to methadone for management of NAS in infants with select intrauterine opioid exposures.protocol. http://www.jpeds.com/article/S0022-3476(15)01451-1/abstract