Treatment of opioid-dependent pregnant women: Clinical and research issues
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This article addresses common questions that clinicians face when treating pregnant women with opioid dependence. Guidance, based on both research evidence and the collective clinical experience of the authors, which include investigators in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) project, is provided to aid clinical decision making. The MOTHER project is a double-blind, double-dummy, flexible-dosing, parallel-group clinical trial examining the comparative safety and efficacy of methadone and buprenorphine for the treatment of opioid dependence in pregnant women and their neonates. The article begins with a discussion of appropriate assessment during pregnancy and then addresses clinical management stages including maintenance medication selection, induction, and stabilization; opioid agonist medication management before, during, and after delivery; pain management; breast-feeding; and transfer to aftercare. Lastly, other important clinical issues including managing co-occurring psychiatric disorders and medication interactions are discussed.
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Current standard of care for treatment of opioid use disorder is medication treatment, most often with methadone or buprenorphine.
“Current standard of care for treatment of OUD is medication treatment, most often with methadone or buprenorphine [1].”
From Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder (2025) · cites this paper as [1]
Section 3 (page unavailable) identifies methadone as the standard of care for opioid-dependent patients entering treatment during pregnancy. The paper discusses buprenorphine as a treatment option, but says methadone was the only medication recommended for pregnant patients at the time. It does not establish the broader claim about current treatment of OUD generally or present both medications as standard options in pregnancy. (LLM, conf=0.88)
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- Authors
- Jones, H. E., Martin, P. R., Heil, S. H., Kaltenbach, K., Selby, P., Coyle, M. G., Stine, S. M., O'Grady, K. E., Arria, A. M., & Fischer, G.
- Affiliations
- Vanderbilt University (US)
- University of Vermont (US)
- Thomas Jefferson University (US)
- University of Toronto (CA)
- Brown University (US)
- Wayne State University (US)
- University of Maryland, College Park (US)
- Medical University of Vienna (AT)
- ORCID
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 35
- Issue
- 3
- Pages
- 245-259
- ISSN
- 0740-5472 (ISSN-L)
- PMC
- PMC2633026
- OpenAlex
- W2094830932
- Cited by
- 191
- References
- 137
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 10 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 12 · 2019: 16 · 2018: 16 · 2017: 10 · 2016: 4 · 2015: 8 · 2014: 9 · 2013: 8 · 2012: 16
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Rice University
- University of Vermont
- Universität Wien
- National Institute on Drug Abuse (R01 DA15832, R01DA015778, R01DA015764, R01DA 0184103, R01DA015713, R01DA 0175138, R01DA015832, R01DA015741, R01DA015738, R01DA018410, R01DA018417)
- National Center for Research Resources (M01RR000095, M01RR000109, M01-RR-00095)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- opioid use disorder, pregnancy, maternal opioid treatment, methadone, buprenorphine, neonatal outcomes, induction, stabilization, pain management, breastfeeding, follow-up care, psychiatric comorbidity, drug interactions, clinical decision-making
- MeSH terms
- Analgesics, Opioid, Buprenorphine, Clinical Trials as Topic, Decision Making, Female, Humans, Infant, Newborn, Methadone, Opioid-Related Disorders, Pain, Pregnancy, Pregnancy Complications
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