Medication for addiction treatment (MAT) with buprenorphine or methadone is an appropriate and accepted treatment for pregnant women with opioid use disorder (OUD), according to a new research.
The report, prepared by University of North Carolina's Hendree E. Jones and colleagues, is an important step toward developing evidence-based recommendations for treatment of pregnant and parenting women with OUD and their children.
Jones and coauthors wrote: "Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child."
Following a formal process for evaluating the "appropriateness" of medical treatments, Jones and colleagues identified and analyzed 75 research studies providing evidence on treatment methods for women with OUD who are pregnant and parenting, and for their children. Although withdrawal or 'detox' from opioids is possible during pregnancy, relapse rates are high, posing additional health risks to the mother and infant.
Based on the available evidence, medication for addiction treatment (MAT, also known as "medication-assisted treatment") with buprenorphine or methadone is the "accepted treatment" for OUD during pregnancy. These medications, called opioid agonists, are effective in reducing opioid use, promoting abstinence, and aiding recovery. ("Medication-assisted treatment" is not a preferred term because it stigmatizes the treatment, implying that medication treatment it is not as effective as it is known to be.)
In pregnant women with OUD, the MAT approach is used as part of a comprehensive program of obstetric care and behavioural treatment. Mothers are encouraged to breast-feed their infants while continuing MAT with buprenorphine or methadone--doing so can encourage and promote mother-infant bonding and may help reduce NAS severity.
"NAS is an expected and manageable condition," Jones and coauthors noted. They emphasize that sustained recovery requires a comprehensive care program that is supportive of and responsive to the mother and her baby. The authors also highlight essential areas for future research to improve outcomes for pregnant women with OUD and their infants.
The study appears in the Journal of Addiction Medicine.
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