Journal ArticleDOI
Clinical Care for Opioid-using Pregnant and Postpartum Women: The Role of Obstetric Providers
Hendrée E. Jones,Krisanna Deppen,Mark L. Hudak,Lisa Leffert,Carol McClelland,Leyla Sahin,Jacquelyn Starer,Mishka Terplan,John M. Thorp,James W. Walsh,Andreea A. Creanga +10 more
TLDR
In this article, the authors review clinical care issues that are related to illicit and therapeutic opioid use among pregnant women and women in the postpartum period and outline the major responsibilities of obstetrics providers who care for these patients during the antepartum, intrapartum and post-partum periods.Abstract:
We review clinical care issues that are related to illicit and therapeutic opioid use among pregnant women and women in the postpartum period and outline the major responsibilities of obstetrics providers who care for these patients during the antepartum, intrapartum, and postpartum periods. Selected patient treatment issues are highlighted, and case examples are provided. Securing a strong rapport and trust with these patients is crucial for success in delivering high-quality obstetric care and in coordinating services with other specialists as needed. Obstetrics providers have an ethical obligation to screen, assess, and provide brief interventions and referral to specialized treatment for patients with drug use disorders. Opioid-dependent pregnant women often can be treated effectively with methadone or buprenorphine. These medications are classified as pregnancy category C medications by the Food and Drug Administration, and their use in the treatment of opioid-dependent pregnant patients should not be considered "off-label." Except in rare special circumstances, medication-assisted withdrawal during pregnancy should be discouraged because of a high relapse rate. Acute pain management in this population deserves special consideration because patients who use opioids can be hypersensitive to pain and because the use of mixed opioid-agonist/antagonists can precipitate opioid withdrawal. In the absence of other indications, pregnant women who use opioids do not require more intense medical care than other pregnant patients to ensure adequate treatment and the best possible outcomes. Together with specialists in pain and addiction medicine, obstetricians can coordinate comprehensive care for pregnant women who use opioids and women who use opioids in the postpartum period.read more
Citations
More filters
Journal ArticleDOI
Gender Considerations in Addiction: Implications for Treatment.
TL;DR: Clinicians should consider patient gender, as well as hormonal and other biological factors, when making treatment recommendations for men and women with SUD, and the field of pharmacogenomics offers additional promise for identifying the most effective pharmacotherapies for specific patients with Sud.
Journal ArticleDOI
Pharmacological Management of Opioid Use Disorder in Pregnant Women
TL;DR: The field is beginning to move towards buprenorphine maintenance as a first-line treatment for pregnant women with opioid use disorder, because of its greater availability and evidence of better neonatal outcomes than methadone.
Journal Article
Optimiser la continuité des soins durant les incarcérations
TL;DR: Au Canada, environ 250 000 adultes et 1500 jeunes sont incarceres chaque annee dans des etablissements correctionnels and, en moyenne a chaque jour, approximately 40 000 personnes sont detenues dans ces prisons as mentioned in this paper.
Related Papers (5)
Substance Use in Pregnancy
Suzanne Wong,Alice Ordean,Meldon Kahan,Robert Gagnon,Lynda Hudon,Melanie Basso,Hayley Bos,Joan Crane,Gregory A.L. Davies,Marie-France Delisle,Dan Farine,Savas Menticoglou,William Mundle,Lynn Murphy-Kaulbeck,Annie Ouellet,Tracy Pressey,Anne Roggensack,Frank Sanderson,William Ehman,Anne Biringer,Andrée Gagnon,Lisa Graves,Jonathan Hey,Jill Konkin,Francine Léger,Cindy Marshall,Deborah Robertson,Douglas Bell,George Carson,Donna Gilmour,Owen Hughes,Caroline Le Jour,Dean Leduc,Nicholas Leyland,Paul Martyn,André Masse,Ron Abrahams,Sanja Avdic,Howard Berger,Mike Franklyn,Samuel Harper,Georgia Hunt,Patricia Mousmanis,Kellie E. Murphy,Sarah Payne,Deana Midmer,Sandra de la Ronde +46 more