Evidence Based, Whole Person Care for Pregnant People Who Have Opioid Use Disorder

Course overview

Course Description: This course is based on material published by the Substance Abuse and Mental Health Services Administration and is available as an open-access article. Buprenorphine and methadone can be safely used in pregnancy to treat OUD. Despite their safe use during pregnancy, changing methadone to buprenorphine or buprenorphine to naltrexone during pregnancy is not recommended. Transitioning from buprenorphine to methadone does not pose a risk of precipitated withdrawal. However, transitioning from either methadone to buprenorphine or from an agonist to an antagonist (naltrexone) does pose a risk and is not recommended. Medically supervised withdrawal from medications for OUD during pregnancy is not recommended, as it can cause harm to the pregnant person and their fetus. Breastfeeding while taking methadone or buprenorphine is recommended and beneficial for both parent and child. Pregnant people, particularly those of color, may face increased stigma and discrimination and potential child welfare involvement if they are taking medications for OUD. Also, the increased demands on time required to access treatment for OUD affects treatment rates for pregnant patients and may negatively affect the health of the pregnant person and their baby. As a result, this population often has had less access to medications for OUD and shorter retention in care. There is a need for providers to prioritize health equity for underserved pregnant people with OUD who are in critical need of culturally responsive and empathetic care. Providers should consider the needs of the pregnant person using "whole-patient" care. This includes assessing and planning for the treatment of co-occurring mental disorders in pregnant patients who have OUD. This course on treatment of opioid use disorder in pregnant people is designed for clinical social workers, psychologists, professional counselors, nurses, and substance abuse counselors who do clinical work. This course is appropriate for intermediate and advanced level practitioners who wish to develop their expertise with treatment of opioid use disorder in pregnant people. The course material includes a literature review of interventions. It may also be useful for licensed clinicians who require continuing clinical education courses for license renewal. The course is based on a journal article that includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A significant benefit of reading peer reviewed research-based articles for continuing education is that they provide practitioners with the latest findings in their field. Authors: SAMHSA Learning Objectives: This course will provide the practitioner with detailed information regarding treatment of opioid use disorder in pregnant people. Specifically, a professional will: Recognize strategies for screening and assessment of opioid use disorder in pregnant people. Identify ways to pharmacologically treat opioid use disorder in pregnant people. Describe methods for providing comprehensive, patient centered care for pregnant people with opioid use disorder. Citation: Substance Abuse and Mental Health Services Administration. (2023, May). Evidence Based, Whole Person Care for Pregnant People with Opioid Use Disorder. U.S. Department of Health and Human Services. https://store.samhsa.gov/product/prevention-core-competencies/pep20-03-08-001