Opioid substitution in pregnancy a narrative review: contemporary evidence for use of Methadone and Buprenorphine in pregnancy

Kinsella, M., Capel, Y., Nelson, S.M. and Kearns, R.J. (2022) Opioid substitution in pregnancy a narrative review: contemporary evidence for use of Methadone and Buprenorphine in pregnancy. Journal of Substance Use, (doi: 10.1080/14659891.2022.2106600) (Early Online Publication)

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Abstract

Illicit opioid use is a growing public health emergency and is associated with adverse medical and social outcomes. Opioid use in the pregnant population is increasing globally, and optimal management incorporates opioid substitution programs with improved concurrent engagement in medical care. The two main drugs used in opioid substitution programs are methadone and buprenorphine. Methadone has been used since the 1970s and provides treatment stability leading to improved engagement with obstetric services. Buprenorphine is a newer treatment, has greater dosing flexibility, and may be associated with fewer neonatal adverse effects. Direct comparisons of methadone and buprenorphine treatments are limited but suggest that buprenorphine is associated with less severe neonatal withdrawal; however, it is not universally well-tolerated and tends to be prescribed to less severely affected mothers. Given the lack of clear evidence to support one opioid substitution therapy over another, the principal aim of therapy should be to stabilize treatment and promote more comprehensive engagement with multidisciplinary services.

Item Type:Articles
Additional Information:This work was supported by Wellbeing of Women / Chief Scientist Office, Scotland (RGS2301 - grant to RK), and an NHS Research Scotland Career Researcher Fellowship (RK).
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nelson, Professor Scott and Kearns, Dr Rachel and Kinsella, Dr Michael
Authors: Kinsella, M., Capel, Y., Nelson, S.M., and Kearns, R.J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Substance Use
Publisher:Taylor & Francis
ISSN:1465-9891
ISSN (Online):1475-9942
Published Online:01 August 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Journal of Substance Use 2022
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
310398Effects of public health policy on maternal lifestyle choices and offspring health outcomes - A population-based linkage studyRachel KearnsWellbeing of Women (WELLWOM)RGS2301School Of Medicine