Medication Assisted Treatment and Pregnancy



so in terms of treatment for women who become pregnant or plan to get pregnant who have opioid use disorders the biggest risk the concern really would be active drug use overdose while pregnant were you know sort of withdrawal severe withdrawal even if it's in a detoxification program and for that reason the gold standard treatment for women who are pregnant for years now has been methadone because methadone has the best results in terms of retention and treatment reducing recreational drug use at the same time we've had buprenorphine for the last 14 years or so and more and more studies are coming out that suggests that women who are taking every preneur fiend during pregnancy actually have better outcomes there have been some large studies that have shown that their risk for neonatal abstinence syndrome is attenuated for fetuses or babies that are born into women who are on buprenorphine rather than methadone it's at the end of the day either treatment that's working for a woman is what you'd want to continue largely to prevent the possibility of relapse overdose withdrawal because that's what could we do fetal distress and there are much lower concerns lesser concerns about the potential impact of methadone or buprenorphine or the developing fetus or newborn the real risk is overdose and death while pregnant so the there are some risks but it sounds like the risk of not staying on a Matt medication when a woman is pregnant it far exceeds the risk of them going off the medication it does if you look at patients with opioid use disorders the annualized mortality rate is about one to two percent a year which is really concerning if you look at the age adjusted rate of mortality for a twenty thirty year old woman the the risk of death is 6 to 20 fold higher if the woman has an opiate use disorder so a great concern anytime especially for a pregnant woman methadone buprenorphine helped save lives they help save pregnant women's lives they'll prevent relapse help prevent overdose at the same time you know obviously if there's a fetus that's exposed to methadone daily when the infant is born the infant will have some physical discontinuation symptoms from the methadone would also discontinuation symptoms which is called neonatal abstinence syndrome in response to going off with buprenorphine but an infant can't be addictive there's no loss of control drug cravings it's not interfering with daily life or the infant but there are some physical symptoms that can sometimes lead to hospitalization that thing can benefit from having morphine administered but we know that patients receive much lower doses of morphine have less distress and stay in the hospital for much shorter periods when they're born to women good men maintained on buprenorphine rather than methadone the most important thing is to be an effective treatment great thanks so much

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