ORN Webinar Fall 2021 #5 - Treating Opioid Use Disorder in Pregnancy and the Perinatal Period-Event Handout

Event Handout

Pdf Summary

The document discusses the treatment of opioid use disorder in pregnancy and the perinatal period. The prevalence of opioid-affected deliveries continues to rise, leading to an increase in cases of neonatal abstinence syndrome (NAS). The document highlights the need for treatment considerations for women with opioid use disorder during pregnancy and explores the unique stigma and discrimination surrounding pregnancy and substance use disorder treatment. It also identifies opportunities for improved engagement, care, and collaboration in preparation for delivery.<br /><br />The standard of care for pregnant women with opioid use disorder is opioid agonist treatment with methadone or buprenorphine. Pharmacotherapy is preferred over medically assisted withdrawal, as withdrawal is associated with high relapse rates and worse outcomes. There are benefits and risks associated with pharmacologic treatment in pregnancy, including the reduction of illegal opioid use and improvement in maternal and infant outcomes.<br /><br />The document mentions different research studies and trials, such as the MOTHER trial that compared buprenorphine to methadone in pregnancy. It also discusses the use of buprenorphine monoproduct and buprenorphine-naloxone in pregnancy, highlighting the advantages and disadvantages of each.<br /><br />The document emphasizes the importance of shared decision-making and trauma-informed care in the treatment of pregnant women with opioid use disorder. It addresses the barriers that pregnant women may face in seeking treatment, such as shame, stigma, and fear of punitive responses.<br /><br />Postpartum risks for women with opioid use disorder are also discussed, including a higher risk of overdose. The document mentions the need for screening for parental substance use disorder and relapse and the impact of stigma on treatment access for families affected by opioid use disorder.<br /><br />The document concludes with suggestions for addressing substance use recurrence while parenting and opportunities to decrease stigma and advocate for opioid-exposed dyads. It also provides contact information for further inquiries.

Keywords

opioid use disorder

pregnancy

neonatal abstinence syndrome

treatment considerations

pharmacologic treatment

MOTHER trial

barriers to treatment

postpartum risks

screening for substance use disorder

stigma and advocacy