Addiction treatment in the postpartum period: an opportunity for evidence-based personalized medicine

Int Rev Psychiatry. 2021 Sep;33(6):579-590. doi: 10.1080/09540261.2021.1898349. Epub 2021 Jul 8.

Abstract

Substance use disorders (SUD) are becoming rapidly more prevalent in women and a leading cause of pregnancy associated deaths, with most deaths occurring during the 12 months after pregnancy. The postpartum period can be quite intense, especially for women seeking addiction recovery. There is a call to reconceptualize the obstetrical postpartum care model into one that extends specialised care and is tailored to an individual's specific needs. Although SUD treatment improves maternal and infant outcomes as well as decreases overdose risk, many women do not receive consistent SUD treatment during the postpartum period. Thus, SUD treatments should consider following the same guidance as obstetrics to reconceptualize how SUD treatment is delivered postpartum. Clinically, this translates into substantially modifying traditional siloed SUD treatment structures to meet the unique needs of this vulnerable patient population. At the same time, more research is urgently needed to inform these advancements in clinical care to ensure they are evidence-based and effective. In this article, we review the existing evidence as well as highlight opportunities for both clinicians and researchers to advance the integration of tailored approaches for postpartum women into personalised SUD medical and behavioural treatments.

Keywords: Addiction; opioid use disorder; postpartum; pregnancy; substance use disorder.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Behavior, Addictive / therapy*
  • Drug Overdose / prevention & control
  • Female
  • Humans
  • Postpartum Period*
  • Precision Medicine*
  • Pregnancy
  • Substance-Related Disorders / therapy*