ORN Fall 2026 - OUD Treatment: Induction, Stabilization, and Tips for Success in the Perinatal Period-2026-09-15

Video Transcription

Video Summary

The webinar, led by Dr. Elyse Wessel, focused on initiating and managing medications for opioid use disorder (MOUD) during pregnancy and the postpartum period. Key themes included the high risks of untreated OUD—especially overdose, poor prenatal care, preterm birth, and maternal mortality—and the importance of using non-stigmatizing, trauma-informed, patient-centered care. Dr. Wessel emphasized that pregnancy is an opportunity to start treatment, not a reason to delay it.<br /><br />Methadone and buprenorphine are the recommended first-line, evidence-based treatments in pregnancy. Both reduce cravings, prevent withdrawal, lower overdose risk, and improve maternal and neonatal outcomes. The choice of medication should be individualized based on patient preference, prior treatment, access, and social barriers. Initiation can occur in many settings, including the emergency department, inpatient units, OB clinics, primary care, and telehealth.<br /><br />She also reviewed dosing adjustments during pregnancy, including the need for higher or split doses as metabolism changes, and highlighted that neonatal opioid withdrawal syndrome is expected and manageable. Peripartum care should continue baseline MOUD and use multimodal pain management. Postpartum, the overdose risk rises, so continued treatment, mental health support, breastfeeding support, and wraparound services are essential.

Keywords

opioid use disorder

medications for opioid use disorder

pregnancy

postpartum care

methadone

buprenorphine

neonatal opioid withdrawal syndrome

trauma-informed care

overdose prevention