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For Pregnant Women, Early Screening and Medication-Assisted Therapy Provide the Best Outcomes for Opioid Use Disorder, for Both Mothers and Infants

Pregnant women should be screened for opioid use disorder (OUD) and receive medication- assisted therapy (MAT) instead of withdrawal, according to recommendations from the American College of Obstetrics and Gynecology (ACOG). The Committee Opinion was published in August, 2017 in collaboration with the American Society of Addiction Medicine.

Some key recommendations in the Opinion include:

  • Early universal screening, brief intervention, and referral for MAT improve maternal and fetal outcomes
  • MAT is preferred to medically supervised withdrawal, “because withdrawal is associated with high relapse rates, which lead to worse outcomes”
  • Infants born to women using opioids should be monitored for neonatal abstinence syndrome. Women receiving MAT should be encouraged to breastfeed if they are not using illicit drugs or have other contraindications

In a 2016 statement, ACOG Executive Vice President and CEO Hal Lawrence, MD, said, “Of course, opioid use during pregnancy—including MAT, prescription opioid use for pain, or non-medical opioid use—can put infants at risk of neonatal abstinence syndrome (NAS). However, NAS is both expected and treatable, and evidence has shown that it does not lead to long-term complications. Because of superior outcomes associated with MAT compared with withdrawal, ACOG continues to recommend use of MAT as the standard of care during pregnancy for women with opioid use disorders.”

“Opioid Use and Opioid Use Disorder in Pregnancy.” American College of Obstetrics and Gynecology Committee on Obstetric Practice, American Society of Pain Medicine. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Opioid-Use-and-Opioid-Use-Disorder-in-Pregnancy?IsMobileSet=false

“ACOG Statement on Opioid Use During Pregnancy.” American College of Obstetrics and Gynecology Committee on Obstetric Practice. https://www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Opioid-Use-During-Pregnancy?IsMobileSet=false