Study finds buprenorphine enhances opioid recovery in soon-to-be mothers.
A new government-supported clinical trial has found that a weekly injectable medication may help pregnant people with opioid use disorder (OUD) stay off illicit opioids more effectively than a commonly used daily OUD treatment. Researchers say the findings offer another treatment option during pregnancy, a time when both parent and baby face increased health risks connected to untreated addiction.
Opioid use disorder during pregnancy has been a growing concern in the United States as overdose deaths and opioid misuse continue to affect families nationwide. When opioid addiction is not treated, pregnant individuals face higher risks of overdose and medical complications. Babies may also experience health problems after birth, including neonatal opioid withdrawal syndrome, a condition in which newborns go through withdrawal symptoms because of exposure to opioids before delivery.
For many years, one of the main OUD treatment protocols has been buprenorphine taken daily under the tongue. This medication helps reduce cravings and withdrawal symptoms, allowing patients to stabilize and avoid illicit drug use. While effective, daily dosing can create challenges. Some patients struggle to remember doses or maintain consistent routines, and medication levels in the body can rise and fall throughout the day. These shifts may leave periods when cravings or discomfort return.
Researchers wanted to know whether a longer-acting form of the medication could improve outcomes. The study tested a weekly injectable version of extended-release buprenorphine, which is placed under the skin and slowly releases medication over time. The goal was to provide steady medication levels without requiring daily dosing.
The clinical trial included 140 pregnant adults receiving treatment for opioid use disorder at multiple medical centers. Participants were randomly assigned to receive either the weekly injection or the standard daily medication. After delivery, some participants receiving injections had the option to switch to a monthly version if they were not breastfeeding.
Drug testing throughout pregnancy showed that participants receiving the weekly injections had higher rates of abstinence from illicit opioids compared with those taking the daily medication. After childbirth, outcomes between the two groups were similar, suggesting the injectable treatment worked at least as well during the postpartum period.
Safety was also closely monitored. Non-serious side effects occurred at similar rates between groups, although those receiving injections were somewhat more likely to have symptoms considered related to the medication. However, serious medical complications were reported less often among participants receiving the extended-release injections. Researchers also found no meaningful differences between groups in newborn withdrawal outcomes, an important measure when evaluating treatments during pregnancy.
Health experts say stable treatment during pregnancy is important because sudden withdrawal or continued illicit opioid use can place stress on both parent and fetus. Consistent medication levels may help reduce cravings and lower the risk of relapse, which remains one of the biggest dangers for people recovering from opioid addiction.
Another advantage of weekly treatment is reduced need for daily medication management. For some patients, fewer dosing decisions may lower stress and reduce opportunities for missed doses or misuse. Regular clinic visits for injections can also strengthen contact with healthcare providers, allowing closer monitoring and support during pregnancy.
Researchers noted that this was the first randomized clinical trial to study extended-release buprenorphine specifically in pregnant and postpartum populations. Earlier research had already shown benefits in non-pregnant adults, but pregnancy introduces unique medical considerations, making dedicated research necessary before treatment recommendations can change.
Public health leaders continue to emphasize that opioid use disorder is a medical condition that can be treated and managed. Stigma and fear often prevent people from seeking help, especially during pregnancy, when concerns about judgment or legal consequences may increase hesitation. Expanding treatment choices may help more patients find options that fit their needs and circumstances.
The study’s findings suggest that weekly injectable buprenorphine could become an additional evidence-based option for OUD treatment during pregnancy. Researchers say continued study will help determine how widely the treatment should be adopted and which patients may benefit most. As the opioid crisis continues to affect communities across the country, improving treatment access and effectiveness during pregnancy remains an important part of protecting both maternal and infant health.
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