Pregnant and Addicted to Opioids

A research review conducted for the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) seeks to advance the goal of creating evidence-based recommendations for treating pregnant and parenting women with opioid use disorder (OUD). The report, prepared by researchers from University of North Carolina at Chapel Hill gives a green-light to buprenorphine or methadone assisted treatment for women with OUD and rates it superior to opioid withdrawal or ‘detox’ as a therapeutic approach. Infants born to mothers with OUD are at risk for neonatal abstinence syndrome (NAS), and the incidence of pregnant women with OUD increases, the need for identification of evidence-based treatment responses is urgent.

The researchers examined 75 studies of treatment methods for OUD in pregnant and parenting women and concluded that medication-assisted treatment (MAT) with the opioid agonists buprenorphine or methadone are effective in limiting opioid abuse, promoting abstinence, and forestalling relapse. They recommend that MAT be engaged in combination with obstetric care and behavioral modification but also note that much remains to be done to address the shortfall in comprehensive treatment capacity in the US. Commenting on the recommendations, Mishka Terplan, MD, MPH, of Virginia Commonwealth University, Richmond, writes, "Unfortunately, the majority of pregnant women who need addiction treatment are unable to receive it."

Read more about the conclusions here.

The abstract of Dr. Terplan’s commentary may be read here.

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• pediatrics

• primary care