MAT use in the pregnant woman with OUD is especially useful to stabilize the patient in order to prevent withdrawal and the associated risk of miscarriage, premature delivery, and other serious complications.
Full Answer
Is mat safe for pregnant women with opioid use disorder?
Pregnant women with opioid use disorder should be encouraged to start MAT with methadone or buprenorphine (without naloxone). Like many medications taken during pregnancy, MAT has unique benefits and risks to pregnant women and their babies.
Should pregnant women with opioid use disorder (OUD) receive supervised withdrawal?
Current clinical recommendations for pregnant women with OUD include treatment with medication for opioid use disorder (MOUD), rather than supervised withdrawal, due to a higher likelihood of better outcomes and a reduced risk of relapse. Medication for Opioid Use Disorder (MOUD) refers to the use of medication to treat opioid use disorder.
What are the benefits of mat for pregnant patients with Oud?
Benefits of MAT for pregnant patients with OUD include: Stabilizes drug level over the course of the day and prevents opioid withdrawal symptoms Reduces the risk of relapse and its associated consequences including risk of infectious diseases Improves adherence to prenatal care, addiction treatment programs, and preparation for delivery ...
Which medications are used to treat opioid dependence during pregnancy?
MAT has become the gold standard for opioid dependence in pregnant women ( Timmermans and Berg, 2010; Klaman et al., 2017; Reddy et al., 2017; Verduin, 2017 ). MAT used in the United States include methadone, an opioid agonist, burprenorphine, a partial opioid agonist, and naloxone and naltrexone, which are opioid antagonists.
Which medication is the gold standard for treating opioid dependence in pregnancy?
Methadone maintenance therapy is the gold standard for treating opioid dependence in pregnancy.
What is the gold standard opioid?
Opioid Agonist Treatment (OAT): The Gold Standard for Opioid Use Disorder Treatment. Opioid Agonist Treatment (OAT) is the safest and most effective method for treating opioid use disorders.
What is the #1 substance that is used and abused during pregnancy?
The most commonly used substance in pregnancy is nicotine, followed by alcohol, marijuana and cocaine 7, 8. However, polysubstance use is as high as 50% in some studies 7, 9. Recently, there has been an increase in opiate use in pregnancy.
What opioids are used during pregnancy?
Buprenorphine and methadone have both been shown to be safe and effective treatments for opioid use disorder during pregnancy.
Why is methadone the gold standard?
Studies show that, compared to getting no medicines, methadone and buprenorphine keep people in treatment for longer and reduce how much they cheat with illicit opioids. The medicines also save lives: Compared to getting no treatment, methadone can cut death rates by 75 percent.
Which medications are commonly used to treat opioid addiction?
The most common medications used in treatment of opioid addiction are methadone and buprenorphine. Sometimes another medication, called naltrexone, is used. Cost varies for the different medications.
What happens when a man sleeps with a pregnant woman?
Having sex in pregnancy Sex during pregnancy can feel quite different from how it felt before. You might also worry that sex will harm the baby. But your baby is well protected and sealed off in the amniotic sac, so you can't hurt your baby by having sex.
Which of the following drugs can be safely prescribed in pregnancy?
Safe Medications to Take During PregnancyAluminum hydroxide/magnesium carbonate (Gaviscon®)*Famotidine (Pepcid AC®)Aluminum hydroxide/magnesium hydroxide (Maalox®)Calcium carbonate/magnesium carbonate (Mylanta®)Calcium carbonate (Titralac®, Tums®)Ranitidine (Zantac®)
What is pregnant care drug use for?
This medication is a multivitamin product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. Vitamins are important building blocks of the body and help keep you in good health.
What is the primary reason for opioid abuse?
Among those with chronic pain who reported pain relief as the primary initial reason for prescription opioid use, 56.5% reported that avoiding withdrawal was their primary current reason for use. The second most common current reason for use was pain relief (22.6%), followed by getting high (13.9%).
What is NAS diagnosis?
What is neonatal abstinence syndrome? Neonatal abstinence syndrome (also called NAS) is a group of conditions caused when a baby withdraws from certain drugs he's exposed to in the womb before birth. NAS is most often caused when a woman takes drugs called opioids during pregnancy.
What analgesia is safe in pregnancy?
Acetaminophen. Acetaminophen, a nonsalicylate similar to aspirin in analgesic potency, has demonstrated efficacy and apparent safety at all stages of pregnancy in standard therapeutic doses.
When should women with opioid use disorder continue MAT?
As recommended by SAMHSA and ACOG, women with opioid use disorder should continue MAT as prescribed in the postpartum period.
What is MAT treatment?
Medication-assisted treatment (MAT) uses a combination of medications, counseling, and behavioral therapies to treat substance use disorders. This treatment combination can lead to more favorable outcomes. are first-line therapy options for pregnant women with opioid use disorder.
Why do women take opioids during pregnancy?
Some women need to take an opioid medication during pregnancy to manage pain or to treat opioid use disorder. Creating a treatment plan for opioid use disorder, as well as other co-occurring health conditions, before pregnancy can help a woman increase her chances of a healthy pregnancy. .
Why is it important to work closely with a pregnant woman?
It is important for healthcare providers to work closely with pregnant women to manage the medical care for both mother and baby during pregnancy and after delivery . Coordination of care between an obstetrician-gynecologist (OB-GYN) and an addiction specialist is important for pregnant women with opioid use disorder.
What is a plan of safe care for a newborn?
Families and caregivers with an infant who is affected by NAS and other prenatal substance exposure should be provided with a Plan of Safe Care . The objectives of the plans include strengthening the family, optimizing the child’s safety, and linking the family with services and other supports in their community. This plan is individually designed for each infant and caregiver to identify and outline a plan to address the needs of the infant (for example, services and supports available to meet health and developmental needs) and the caregiver and family (for example, substance use treatment). Plans can specify agencies within the community that provide services and can help guide communication and coordination.
Can you stop taking opioids while pregnant?
As noted in their recommendations, quickly stopping opioids during pregnancy is not recommended, as it can have serious consequences, including preterm labor, fetal distress, or miscarriage. Current clinical recommendations for pregnant women with opioid use disorder include medication-assisted treatment, rather than supervised withdrawal, ...
Can women with opioid use disorder have other mental health conditions?
Women with opioid use disorder may also have other mental health conditions, including depression and anxiety. They should receive recommended screening for depression as well as other mental health conditions. Access to appropriate psychosocial support should be available.
Associated Data
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Abstract
Women of childbearing age who misuse opioids are a particularly vulnerable population, and their barriers to treatment are unique because of their caregiver roles. Research on treatment for opioid use generally draws from urban and rural areas.
Introduction
Over the last two decades, drug overdose deaths have more than quadrupled in number ( Scholl et al., 2019 ). Between 2010 and 2017, opioid-related overdose deaths increased five-fold ( Hedegaard et al., 2019 ).
Materials and Methods
The data analyzed for this paper were drawn from the Suburban Opioid Study (SOS). The goal of the study was to fill a gap in our understanding of opioid use patterns in suburban communities where overdose mortality rates were increasing.
Results
We uncovered several barriers to seeking opioid treatment in our qualitative interviews. The life history data used in the analysis relate to when women were pregnant or caring for small children while they were opioid dependent.
Discussion
This is the first qualitative study investigating barriers and facilitators to treatment among mothers and pregnant women who use opioids living in suburban environments.
Data Availability Statement
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Risks of Opioid Misuse During Pregnancy
What Is Neonatal Abstinence Syndrome?
- Neonatal abstinence syndrome (NAS) occurs when an infant becomes dependent on opioids or other drugs used by the mother during pregnancy. The infant experiences withdrawal symptoms that can include (but are not limited to) tremors, diarrhea, fever, irritability, seizures, and difficulty feeding.5 NAS increased nearly fivefold nationally between 2000 to 2012,6,7 coinciding with risi…
Improving Engagement in Treatment
- Stigma and bias among healthcare providers can result in both under-reporting of drug use and insufficient medication dosing, which often lead to delayed or ineffective treatments.14,15
- Eighteen states classify maternal drug use as child abuse, and three states consider it as reason for involuntary hospitalization, disincentivizing women from seeking treatment.5
- Women who are allowed to stay with their children during treatment are more likely to start tr…
- Stigma and bias among healthcare providers can result in both under-reporting of drug use and insufficient medication dosing, which often lead to delayed or ineffective treatments.14,15
- Eighteen states classify maternal drug use as child abuse, and three states consider it as reason for involuntary hospitalization, disincentivizing women from seeking treatment.5
- Women who are allowed to stay with their children during treatment are more likely to start treatment and maintain abstinence.14
Where Can I Get More Information?
- If you or someone you care about is pregnant and has an opioid use disorder: 1. Ask your healthcare provider about treatment options. 2. To find treatment services in your area, visit SAMHSA's treatment locator and HRSA's Find a Health Center. 3. Visit NIDA's webpages: NAS, heroin and pregnancy, and Effective Treatments for Opioid Addiction. Visit SAMHSA’s webpage: …
References