Buprenorphine Dosing for the Treatment of Opioid Use Disorder Through Pregnancy and Postpartum
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Substance Use Disorders (FG Moeller, Section Editor)
Buprenorphine Dosing for the Treatment of Opioid Use Disorder Through Pregnancy and Postpartum Caitlin E. Martin, MD, MPH1,* Caroline Shadowen, BA2 Bhushan Thakkar, PT, MS3 Travis Oakes, BS4 Tamas S. Gal, MBA, PhD5 F. Gerard Moeller, MD6 Address *,1 Department of Obstetrics and Gynecology, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Box no. 980034, 1250 E. Marshall St., Richmond, VA, 23298, USA Email: [email protected] 2 School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA 3 Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, USA 4 Clinical Research Informatics Group, C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia, USA 5 Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA 6 Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
* Springer Nature Switzerland AG 2020
This article is part of the Topical Collection on Substance Use Disorders Keywords Buprenorphine I Women I Opioid use disorder I Addiction I Pregnancy I Postpartum
Abstract Purpose of review Opioid-related deaths are a leading cause of mortality during pregnancy through 12 months postpartum. Buprenorphine use during pregnancy is increasing, yet expert opinion on its dosing through the perinatal period is limited. We provide a review of the current clinical literature on buprenorphine
Substance Use Disorders (FG Moeller, Section Editor) dosing during pregnancy through 12 months postpartum and present data from a retrospective chart review of patients at our institution describing trends in buprenorphine dosing during pregnancy and postpartum. Utilizing this information, we synthesize findings to provide clinical recommendations for providers. Recent findings Existing literature during pregnancy reflects how many women increase and split total daily buprenorphine doses as gestational age advances. Summary We present data from a retrospective chart review of patients at our institution describing trends in buprenorphine dosing during pregnancy and postpartum. Utilizing this information, we synthesize findings to provide clinical recommendations for providers. Changes in the total daily dose of buprenorphine used across pregnancy and through 12 months postpartum at the individual level do not follow consistent patterns, highlighting substantial individual variability. Altogether, buprenorphine dosing should be individualized through pregnancy and postpartum with frequent evaluations by providers and solicited input from patients.
Introduction The life expectancy in the United States is decreasing, largely due to increasing opioid overdoses during reproductive age years, with women seeing more rapid changes in these poor outcomes than men over the past decade [1]. Pregnant and postpartum wo
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