Treatment of Perinatal Opioid Use Disorder

Obstet Gynecol Clin North Am. 2018 Sep;45(3):511-524. doi: 10.1016/j.ogc.2018.05.001.

Abstract

Opioid agonist therapy is the standard of care for pregnant women with Opioid Use Disorder, but medication-assisted withdrawal from opioid agonist therapy is increasingly prevalent. We review available literature evaluating the risks and benefits of medication-assisted withdrawal. We highlight the importance of supporting women in making an informed treatment choice that is best for them. Although it is tempting to choose medication-assisted withdrawal to decrease the risk of newborn opioid withdrawal, we caution against this practice. Facilitating treatment that assists pregnant women in recovery ultimately produces the best outcome for women and their children.

Keywords: Buprenorphine; Medication-assisted withdrawal; Methadone; Opioid agonist therapy; Opioid use disorder; Pregnancy.

Publication types

  • Review

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Decision Making
  • Female
  • Humans
  • Infant, Newborn
  • Methadone
  • Neonatal Abstinence Syndrome / drug therapy*
  • Neonatal Abstinence Syndrome / prevention & control
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / complications*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / physiopathology
  • Opioid-Related Disorders / psychology
  • Patient Education as Topic
  • Physician-Patient Relations
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / physiopathology
  • Pregnancy Complications / psychology
  • Pregnant Women / psychology
  • Substance Withdrawal Syndrome / complications
  • Substance Withdrawal Syndrome / drug therapy*
  • Substance Withdrawal Syndrome / psychology

Substances

  • Analgesics, Opioid
  • Methadone