title: A woman's experience of tapering from buprenorphine during pregnancy.
abstract: Although opioid maintenance treatment (OMT) is the treatment of choice for pregnant opioid-dependent patients, some professionals argue that tapering the medication dose will reduce the severity of neonatal abstinence syndrome (NAS). This case description is based on the patient's detailed blog, and medical records from her general practitioner and the hospital. The patient is an employed, 32-year-old drug-abstinent woman in OMT. Her taper from 24 mg of buprenorphine started at 14 weeks' gestation and is slow, with withdrawal symptoms increasing gradually. In pregnancy week 31, she is off buprenorphine but she has severe withdrawal symptoms. She chose to go back on 4 mg of buprenorphine. The patient's son was born in pregnancy week 38+3, weighs 2950 g and does not require pharmacological treatment for NAS. The fetus most probably did experience fetal stress during the patient's tapering. It was the right decision by the patient to go back on buprenorphine.
authors.affiliation: Norwegian Centre for Addiction Research (Seraf), University of Oslo, Oslo, Norway Department of Psychiatry and Substance Use, Norwegian Directorate of Health, Oslo, Norway.
authors.forename: Gabrielle Katrine
authors.initials: GK
authors.lastname: Welle-Strand
authors.affiliation: Leirvik legekontor, Leirvik, Norway.
authors.forename: Odd
authors.initials: O
authors.lastname: Kvamme
authors.affiliation: Department of Pediatrics, Helse Fonna, Haugesund, Norway.
authors.forename: Andreas
authors.initials: A
authors.lastname: Andreassen
authors.affiliation: Norwegian Centre for Addiction Research (Seraf), University of Oslo, Oslo, Norway.
authors.forename: Edle
authors.initials: E
authors.lastname: Ravndal
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005333:Fetus; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009294:Narcotics; D009357:Neonatal Abstinence Syndrome; D058850:Opiate Substitution Treatment; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000150:complications / Q000188:drug therapy
chemical_list: D000701:Analgesics, Opioid; D009294:Narcotics; D002047:Buprenorphine