title: A Multidisciplinary Approach to the Treatment of Co-occurring Opioid Use Disorder and Posttraumatic Stress Disorder in Pregnancy: A Case Report.
abstract: Perinatal opioid use disorders negatively impact maternal and neonatal outcomes and are a public health problem of increasing severity. More than half of women with a substance use disorder have a history of posttraumatic stress disorder that, if not adequately addressed, can impede substance use disorder treatment. This case report describes complexities in the treatment of a pregnant woman with opioid use disorder and posttraumatic stress disorder and reviews the psychotherapeutic and pharmacologic approaches available to treat these co-occurring disorders in pregnancy. This case demonstrates the importance of early screening and intervention for co-occurring posttraumatic stress disorder in pregnant women who use substances in a closely coordinated, multidisciplinary approach to improve outcomes for women and their infants.
authors.affiliation: a Department of Obstetrics and Gynecology , Dartmouth-Hitchcock Medical Center and Geisel School of Medicine , Lebanon , New Hampshire , USA.
authors.forename: Daisy J
authors.initials: DJ
authors.lastname: Goodman
authors.affiliation: b Department of Psychiatry , Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire , USA.
authors.forename: Catherine U
authors.initials: CU
authors.lastname: Milliken
authors.affiliation: a Department of Obstetrics and Gynecology , Dartmouth-Hitchcock Medical Center and Geisel School of Medicine , Lebanon , New Hampshire , USA.
authors.forename: Regan N
authors.initials: RN
authors.lastname: Theiler
authors.affiliation: b Department of Psychiatry , Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire , USA.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Nordstrom
authors.affiliation: b Department of Psychiatry , Geisel School of Medicine at Dartmouth , Lebanon , New Hampshire , USA.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Akerman
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use; D000069479:Buprenorphine, Naloxone Drug Combination / Q000009:adverse effects*; D003376:Counseling; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009294:Narcotics / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000523:psychology; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009294:Narcotics; D002047:Buprenorphine
keywords: PTSD; buprenorphine; methadone; multidisciplinary; opioid; perinatal; pregnancy