Evaluation and Management of Opioid Dependence in Pregnancy

Overview

Journal Psychosomatics

Publisher Elsevier

Specialty Psychiatry

Date 2012 Aug 21

PMID 22902085

Citations 6

Authors

Eliza M Park

Samantha Meltzer-Brody

Joji Suzuki

Affiliations

Soon will be listed here.

Abstract

Background: Opioid use disorders are a growing public health problem in the United States. Most women who are opioid-dependent are of childbearing age, and management of opioid dependence during pregnancy poses unique challenges. Assessment includes evaluation for addiction, withdrawal syndromes, and comorbid psychiatric diagnoses. Consultation-liaison (C-L) psychiatrists may also be involved in acute pain management, perinatal medication management, buprenorphine induction, and stabilization. For the past four decades, the standard of care has included methadone maintenance, but the increasing use of buprenorphine creates new treatment issues and opportunities.

Objective: To educate C-L psychiatrists in emergency and obstetrical settings about the appropriate approach toward the evaluation and basic management of women with opioid dependence in pregnancy.

Method: The authors reviewed the consensus literature and all new treatment options on opioid dependence during pregnancy.

Discussion: In this review, the authors summarize known and emerging management strategies for opioid dependence in pregnancy pertinent to C-L psychiatrists.

Citing Articles

A Systematic Scoping Review of Peridelivery Pain Management for Pregnant People With Opioid Use Disorder: From the Society for Obstetric Anesthesia and Perinatology and Society for Maternal Fetal Medicine.

Lim G, Soens M, Wanaselja A, Chyan A, Carvalho B, Landau R Anesth Analg. 2022; 135(5):912-925.

PMID: 36135926 PMC: 9588509. DOI: 10.1213/ANE.0000000000006167.

Prenatal opioid exposure and vulnerability to future substance use disorders in offspring.

Abu Y, Roy S Exp Neurol. 2021; 339:113621.

PMID: 33516730 PMC: 8012222. DOI: 10.1016/j.expneurol.2021.113621.

The brain-placental axis: Therapeutic and pharmacological relevancy to pregnancy.

Behura S, Dhakal P, Kelleher A, Balboula A, Patterson A, Spencer T Pharmacol Res. 2019; 149:104468.

PMID: 31600597 PMC: 6944055. DOI: 10.1016/j.phrs.2019.104468.

Factors associated with treatment retention in pregnant women with opioid use disorders prescribed methadone or electing non-pharmacological treatment.

Jancaitis B, Kelpin S, Masho S, May J, Haug N, Svikis D Women Health. 2019; 60(1):1-11.

PMID: 31068095 PMC: 6842074. DOI: 10.1080/03630242.2019.1610829.

Maternal opioid drug use during pregnancy and its impact on perinatal morbidity, mortality, and the costs of medical care in the United States.

Whiteman V, Salemi J, Mogos M, Cain M, Aliyu M, Salihu H J Pregnancy. 2014; 2014:906723.

PMID: 25254116 PMC: 4164310. DOI: 10.1155/2014/906723.

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