It’s much safer to seek medication-assisted treatment for opioid addiction during pregnancy than not to, research reveals.
Using opioids during pregnancy is an increasingly prevalent concern due to its potential to cause complications in both the mother and baby. Research has indicated that opioid use increases the risk of preterm birth, stillbirth, miscarriage, preeclampsia, gestational diabetes, and neonatal abstinence syndrome (NAS). This can cause newborns to experience tremors, seizures, and irritability. As a result, pregnant women addicted to opioids encounter a unique set of challenges when seeking treatment. There are few specialized programs available that make it difficult to access appropriate care. Pregnant women with opioid addiction have special difficulties finding adequate help. They can fear being judged, and programs specialized for pregnant women may be hard to find. Treatment for opioid use disorder (OUD) during pregnancy is essential for the mother and child’s health and safety. Researchers have been investigating whether medication-assisted treatment (MAT) – such as methadone – combined with behavioral therapy could be safe for pregnant women with opioid use disorder (OUD).
Methadone is a medication-assisted treatment that helps reduce withdrawal symptoms, cravings, and the risk of complications that can arise from opioid use during pregnancy. Buprenorphine is another medication-assisted treatment used to treat opioid addiction in pregnant women; it blocks the effects of opioids and prevents relapse, with less risk for withdrawal symptoms in newborns.
Medication-assisted treatment (MAT) with drugs like methadone has been the go-to option, but its security is debatable. A study in the Journal of Addiction Medicine found that medication combined with behavioral therapy had better outcomes regarding preterm birth, neonatal abstinence syndrome (NAS), and term delivery rate. Women who received MAT and behavioral therapy had a lower rate of preterm birth, and their babies were more likely to be delivered at term with reduced occurrences of NAS.
Despite these limitations, this study adds to research demonstrating the efficacy and safety of opioid treatment while pregnant, which accentuates why it’s so vital to make evidence-based addiction treatment available to expectant mothers who have specific requirements and challenges during their pregnancy.
The American College of Obstetricians and Gynecologists (ACOG) recommends those suffering from OUD during pregnancy be treated with methadone or buprenorphine, as these treatments have been proven safe and effective for managing addiction during pregnancy. However, this study was retrospective, which may be biased, and did not compare to a control group, which could limit findings. Additionally, some pregnant women may prefer to avoid medication altogether, so individualized treatment plans should be tailored to their needs.
Although medication-assisted treatment can be beneficial for managing opioid addiction during pregnancy, it does not eliminate its long-term effects on both mother and child, including developmental delays, behavioral problems, and an increased risk of addiction in newborns. Thus, it’s essential that after childbirth, the mother continues to receive ongoing support and care to prevent relapse while also addressing any residual musings caused by opioid use throughout the pregnancy. Prevention strategies, including education on non-opioid pain management options, increasing access to mental health services/addiction treatment programs, and providing support/guidance to high-risk women, are all important tools in tackling this epidemic head-on.
Combination therapy appears safe for treating opioid use disorder during pregnancy
ACOG Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy
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