Treatment of opioid dependence in the setting of pregnancy.
Opioid dependence in the setting of pregnancy provides a distinct set of challenges for providers. Treatment plans must take into consideration psychiatric and medical comorbidities while balancing risks and benefits for the maternal-fetal dyad. Treatment is best offered through a comprehensive treatment program designed to effectively deliver opioid agonist maintenance treatment along with psychosocial and obstetric care. As misuse of prescription analgesics increases in the United States, identification of the problem in pregnancy will become more important because this misuse is expected to lead to an increased prevalence of opioid dependence in pregnancy. Buprenorphine as maintenance treatment of opioid dependence during pregnancy has promise and may offer some benefits, but more research is needed, especially regarding induction of actively addicted women during pregnancy. For the present, methadone maintenance remains the standard of care for agonist treatment of opioid dependence in pregnancy against which other treatments must be compared.
Vanderbilt University Medical Center, Nashville, TN 37232, USA. jessica.l.young@vanderbilt.edu
Jessica L
JL
Young
Peter R
PR
Martin
D000293:Adolescent; D019973:Alcohol-Related Disorders / Q000188:drug therapy / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000517:prevention & control*; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D059408:Pain Management / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011295:Prenatal Care / Q000379:methods / Q000458:organization & administration; D011297:Prenatal Exposure Delayed Effects; D055553:Prescription Drugs / Q000009:adverse effects; D012651:Self Medication; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D055553:Prescription Drugs; D002047:Buprenorphine; D008691:Methadone