Skip to main content

Advertisement

Log in

When treating pregnant women with opioid use disorder, the benefits of using opioid maintenance treatment outweigh the risks

  • Disease Management
  • Published:
Drugs & Therapy Perspectives Aims and scope Submit manuscript

Abstract

Pregnant women with opioid use disorder should receive medication-assisted treatment, as the benefits to both mother and fetus/offspring outweigh the risks. While methadone is the first-line option, preference for buprenorphine is increasing. Multiple factors should be considered when managing this high risk, complex and challenging patient group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wilder CM, Winhusen T. Pharmacological management of opioid use disorder in pregnant women. CNS Drugs. 2015;29(8):625–36.

    Article  CAS  PubMed  Google Scholar 

  2. Young JL, Martin PR. Treatment of opioid dependence in the setting of pregnancy. Psychiatr Clin North Am. 2012;35(2):441–60.

    Article  PubMed  Google Scholar 

  3. Sundelin Wahlsten V, Sarman I. Neurobehavioural development of preschool-age children born to addicted mothers given opiate maintenance treatment with buprenorphine during pregnancy. Acta Paediatr. 2013;102(5):544–9.

  4. Burns L, Conroy E, Mattick RP. Infant mortality among women on a methadone program during pregnancy. Drug Alcohol Rev. 2010;29(5):551–6.

    Article  PubMed  Google Scholar 

  5. ACOG Committee on Health Care for Underserved Women. American Society of Addiction Medicine. ACOG Committee Opinion No. 524: opioid abuse, dependence, and addiction in pregnancy. Obstet Gynecol. 2012;119(5):1070–6.

    Article  Google Scholar 

  6. National Collaborating Centre for Women’s and Children’s Health. Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. London: Royal College of Obstetricians and Gynaecologists; 2010.

    Google Scholar 

  7. Jones HE, Finnegan LP, Kaltenbach K. Methadone and buprenorphine for the management of opioid dependence in pregnancy. Drugs. 2012;72(6):747–57.

    Article  CAS  PubMed  Google Scholar 

  8. Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med. 2010;363(24):2320–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. Geneva: World Health Organization; 2014.

  10. Soyka M, Kranzler HR, van den Brink W, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of substance use and related disorders. Part 2: opioid dependence. World J Biol Psychiatry. 2011;2(3):160–87.

    Article  Google Scholar 

  11. Wong S, Ordean A, Kahan M, et al. SOGC clinical practice guidelines: substance use in pregnancy: no. 256, April 2011. Int J Gynaecol Obstet. 2011;114(2):190–202.

    Article  PubMed  Google Scholar 

  12. Jones HE, Jansson LM, O’Grady KE, et al. The relationship between maternal methadone dose at delivery and neonatal outcome: methodological and design considerations. Neurotoxicol Teratol. 2013;39:110–5.

    Article  CAS  PubMed  Google Scholar 

  13. Mactier H, Shipton D, Dryden C, et al. Reduced fetal growth in methadone-maintained pregnancies is not fully explained by smoking or socio-economic deprivation. Addiction. 2014;109(3):482–8.

    Article  PubMed  Google Scholar 

  14. Jones HE, Martin PR, Heil SH, et al. Treatment of opioid-dependent pregnant women: clinical and research issues. J Subst Abuse Treat. 2008;35(3):245–59.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Meyer M, Crocker A, Heil S, et al. Buprenorphine induction during pregnancy: cardiovascular changes in response to opioid withdrawal. Am J Obstet Gynecol. 2014;210(1 Suppl):S344.

    Article  Google Scholar 

  16. Center for Substance Abuse Treatment. Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction (Treatment Improvement Protocol Series 40) [report no. (SMA) 04-3939]. Rockville: US Department of Health and Human Services; 2004.

  17. Jones HE, Deppen K, Hudak ML, et al. Clinical care for opioid-using pregnant and postpartum women: the role of obstetric providers. Am J Obstet Gynecol. 2014;210(4):302–10.

    Article  PubMed  Google Scholar 

  18. Fullerton CA, Kim M, Thomas CP, et al. Medication-assisted treatment with methadone: assessing the evidence. Psychiat Serv. 2014;65(2):146–57.

    Article  Google Scholar 

  19. Kandall SR, Albin S, Gartner LM, et al. The narcotic-dependent mother: fetal and neonatal consequences. Early Hum Dev. 1977;1(2):159–69.

    Article  CAS  PubMed  Google Scholar 

  20. Burns L, Mattick RP, Lim K, et al. Methadone in pregnancy: treatment retention and neonatal outcomes. Addiction. 2007;102(2):264–70.

    Article  PubMed  Google Scholar 

  21. Lacroix I, Berrebi A, Garipuy D, et al. Buprenorphine versus methadone in pregnant opioid-dependent women: a prospective multicenter study. Eur J Clin Pharmacol. 2011;67(10):1053–9.

    Article  CAS  PubMed  Google Scholar 

  22. Jones HE, O’Grady K, Dahne J, et al. Management of acute postpartum pain in patients maintained on methadone or buprenorphine during pregnancy. Am J Drug Alcohol Abuse. 2009;35(3):151–6.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Pritham UA. Breastfeeding promotion for management of neonatal abstinence syndrome. J Obstet Gynecol Neonatal Nurs. 2013;42(5):517–26.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Consortia

Ethics declarations

The article was adapted from CNS Drugs 2015;29(8):625–36 [1] by salaried/contracted employees of Adis/Springer and was not supported by any external funding.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adis Medical Writers. When treating pregnant women with opioid use disorder, the benefits of using opioid maintenance treatment outweigh the risks. Drugs Ther Perspect 32, 186–190 (2016). https://doi.org/10.1007/s40267-016-0281-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40267-016-0281-x

Keywords

Navigation