MAT with opioid agonists is appropriate for pregnant women with OUD

By Paul Basilio, MDLinx
Published April 17, 2017

Key Takeaways

A new review published in the Journal of Addiction Medicine states that medication for addiction treatment (MAT) with methadone or buprenorphine is appropriate for pregnant women with opioid use disorder (OUD).

Rates of prescription opioid use and misuse among women of childbearing age are increasing in the US. While withdrawal or ‘detox’ from opioids is possible during pregnancy, the relapse rates are high. This new review is another step toward evidence-based recommendations for OUD in pregnant women, mothers, and their children.

“Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child,” according to lead author Hendrée E. Jones, PhD, from University of North Carolina at Chapel Hill.

Dr. Jones and his colleagues at the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) created a formal process for evaluating the appropriateness of medical treatments. They then identified and analyzed 75 research studies for evidence for treatment methods for women with OUD who were pregnant and parenting, and for their children.

Evidence showed that MAT with the opioid agonists buprenorphine or methadone is the “accepted treatment” for such patients. The drugs were shown to be effective for reducing opioid use, promoting abstinence, and aiding recovery.

This MAT approach is used as part of a comprehensive program of obstetric care and behavioral treatment in pregnant women. Breastfeeding while continuing MAT was encourage to promote mother-infant bonding and to help reduce severity of neonatal abstinence syndrome (NAS).

The study authors note that NAS is an expected and manageable condition, and they emphasize that sustained recovery requires a comprehensive care program.

The evidence review was used in developing a recent SAMHSA report that provided guidance on the care of pregnant and parenting women with OUD, as well as their infants.

“Uptake of the guide should improve quality of care and hopefully help lessen the discrimination experienced by pregnant women with opioid use disorder,” noted Mishka Terplan, MD, MPH, of Virginia Commonwealth University, Richmond, in an accompanying commentary.

To read more about the review, go to http://journals.lww.com/journaladdictionmedicine/pages/default.aspx.

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