Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women

  title={Methadone, Buprenorphine, and Naltrexone for the Treatment of Opioid Use Disorder in Pregnant Women},
  author={Tran H. Tran and Brooke L. Griffin and Rebecca H. Stone and Kathleen M. Vest and Timothy J. Todd},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants… 
The opioid epidemic and pregnancy: implications for anesthetic care
The dramatic rise in OUD in pregnancy has had staggering socioeconomic consequences, carrying with it profound maternal and fetal health problems, and Medication-assisted treatment utilizing either methadone, or more commonly buprenorphine is considered the standard of care for OUD during pregnancy.
Opioid Use in Pregnancy
Maintenance therapy with methadone or buprenorphine remains the standard of care for pregnant women with OUD given its consistent superiority to placebo in terms of rates of illicit drug use and pregnancy outcomes.
Efficacy and Safety of Buprenorphine Maintenance Therapy during Pregnancy: A Case Report
A case can be built supporting the notion that the use of opioid maintenance treatment at the time of conception and during pregnancy is not likely to have negative effects on pregnant women or newborns.
Potential of Methocinnamox to Treat Opioid Misuse
Methocinnamox (MCAM) is a novel mu-opioid receptor antagonist with an extended duration of action and potential to reduce the burden of the opioid epidemic through overdose rescue and could treat opioid use disorder (OUD) long-term.
Anesthetic management of the parturient with opioid addiction
This review article will provide evidence-based approaches when available and share the experience in managing labor analgesia and cesarean delivery anesthesia in pregnant women with an OUD, from admission to the labor and delivery unit until hospital discharge.
Outcomes of Neonates Exposed to Buprenorphine versus Methadone in Utero: A Systematic Review and Meta-Analysis of Safety in the Fetus and Neonate
Compared to methadone, buprenorphine is associated with less adverse neonatal outcomes in terms of gestational age at birth, birthweight, and head circumference and the prevalence of NAS continuing to rise, this study adds to the expanding academic research aimed at creating safer treatment protocols.
The Potential of Methocinnamox as a Future Treatment for Opioid Use Disorder: A Narrative Review
Methocinnamox (MCAM)’s novel pharmacokinetic and pharmacodynamic properties open a new avenue for treating opioid misuse.
Medication-Assisted Treatment for Opioid-Use Disorder.


Methadone and Buprenorphine for Opioid Dependence During Pregnancy: A Retrospective Cohort Study
Pregnancy outcomes with buprenorphine to treat opioid dependence during pregnancy in clinical practice are as good and often better than outcomes with methadone, consistent with efficacy data from randomized clinical trials.
Neonatal abstinence syndrome after methadone or buprenorphine exposure.
A comparison of the 131 neonates whose mothers were followed to the end of pregnancy according to treatment group showed that the former group required significantly less morphine, which is consistent with the use of buprenorphine as an acceptable treatment for opioid dependence in pregnant women.
Buprenorphine and Naloxone Compared With Methadone Treatment in Pregnancy
In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buPrenorphines and nAloxone had less frequent neonatal abstinence syndrome.
Methadone versus buprenorphine in pregnant addicts: a double-blind, double-dummy comparison study.
This preliminary study had limited power to detect differences but the trends observed suggest this kind of research is practicable and that further studies are warranted.
Buprenorphine, methadone, and morphine treatment during pregnancy: behavioral effects on the offspring in rats
It is suggested that buprenorphine and methadone maintenance therapy for pregnant women, like morphine, produced detrimental effects on cognitive function and social behaviors, whereas the offsprings of such women might have a lower risk of developing anxiety disorders.
Buprenorphine versus methadone in pregnant opioid-dependent women: a prospective multicenter study
Buprenorphine appears to be as safe as the currently approved substitute methadone considered to date as the reference treatment for pregnant opioid-dependent women.
Methadone maintenance vs. implantable naltrexone treatment in the pregnant heroin user
  • G. Hulse, G. O'neil, D. Arnold-Reed
  • Medicine
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 2004
Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child
Abstract Aims To assess the safety of buprenorphine compared with methadone to treat pregnant women with opioid use disorder. Methods We searched PubMed, Embase and the Cochrane Library from
Medication-Assisted Treatment of Opioid Use Disorder: Review of the Evidence and Future Directions
  • H. Connery
  • Medicine, Psychology
    Harvard review of psychiatry
  • 2015
The evidence strongly supports the use of agonist therapies to reduce opioid use and to retain patients in treatment, with methadone maintenance remaining the gold standard of care.