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Methadone and Buprenorphine Use During the Perinatal Period

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Handbook of Methadone Prescribing and Buprenorphine Therapy

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Abstract

Opioid dependence is becoming more prevalent in perinatal populations. Numerous negative consequences have been associated with opioid use during pregnancy including increased risk of spontaneous abortion, intrauterine growth restriction, premature delivery, fetal distress, and fetal death. Methadone maintenance treatment has been shown to reduce neonatal morbidity and mortality and thus, is the recommended standard of care for the management of pregnant opioid-dependent women. Buprenorphine is also considered an alternative treatment in situations where methadone is not available or methadone is refused by the pregnant woman. A discussion of the risks and benefits of treatment compared to continued drug use should occur prior to initiation of treatment. All neonates exposed to opioids in utero require prolonged observation for neonatal abstinence syndrome using a neonatal abstinence scoring system. There is no documented long-term effect of opioid exposure in utero.

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Authors and Affiliations

  1. St. Joseph’s Health Centre, Family Medicine Centre, 30 The Queensway, Toronto, ON, Canada, M6R 1B5

    Alice Ordean MD, CCFP, MHSc, FCFP

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  1. Alice Ordean MD, CCFP, MHSc, FCFP
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Correspondence to Alice Ordean MD, CCFP, MHSc, FCFP .

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Editors and Affiliations

  1. , Dept of Pain Med and Palliative Care, Beth Israel Medical Center, Union Square East 10, New York, 10003, New York, USA

    Ricardo A. Cruciani

  2. , Dept of Pain Mgmt and Palliative Care, Beth Israel Medical Center, East 17th Street 350, New York, 10003, New York, USA

    Helena Knotkova

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Ordean, A. (2013). Methadone and Buprenorphine Use During the Perinatal Period. In: Cruciani, R., Knotkova, H. (eds) Handbook of Methadone Prescribing and Buprenorphine Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6974-2_16

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  • DOI: https://doi.org/10.1007/978-1-4614-6974-2_16

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