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• The clinician may also recommend methadone or
buprenorphine for pregnant women who are in recovery from
opioid use disorder if the patient is at risk for relapse during
pregnancy.
• Methadone or buprenorphine are the best options to treat
opioid use disorder during pregnancy. However, if the patient
is taking naltrexone prior to pregnancy and wants to continue
it, the patient should discuss the potential risks with a
clinician. Not enough is known about the safety of naltrexone
during pregnancy.
• While methadone and buprenorphine have some similarities
to other opioids like heroin or oxycodone, their specific
properties make them much safer during pregnancy when
used under the care of a clinician. These medications are
longer acting, preventing opioid withdrawal, opioid overdoses,
and the highs and lows that can harm the development of the
fetus.
• Later in pregnancy the clinician may increase the dose of
medication or have the patient take the medication more
frequently to prevent cravings and support a more stable
environment for the fetus.
• The clinician may recommend counseling or other behavioral
treatments in addition to medication.
• Patients who are taking methadone or buprenorphine as
prescribed, and are without other contraindications for
breastfeeding, can and should breastfeed.
• After delivery the clinician will evaluate the patient to
see if there is a need to adjust the dose of methadone or
buprenorphine. Since there is a risk for relapse and overdose
in the first year after delivery, patients should not stop taking
these medications during this time.
