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Buprenorphine treatment of opioid‐dependent pregnant women: a comprehensive review
Author(s) -
Jones Hendrée E.,
Heil Sarah H.,
Baewert Andjela,
Arria Amelia M.,
Kaltenbach Karol,
Martin Peter R.,
Coyle Mara G.,
Selby Peter,
Stine Susan M.,
Fischer Gabriele
Publication year - 2012
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2012.04035.x
Subject(s) - buprenorphine , methadone , medicine , breastfeeding , pregnancy , randomized controlled trial , opioid , abstinence , anesthesia , obstetrics , pediatrics , psychiatry , surgery , receptor , biology , genetics
Aims This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk and longer‐term developmental effects. Methods Within each outcome area, findings are summarized first for the three randomized clinical trials and then for the 44 non‐randomized studies (i.e. prospective studies, case reports and series and retrospective chart reviews), only 28 of which involve independent samples. Results Results indicate that maternal treatment with buprenorphine has comparable efficacy to methadone, although difficulties may exist with current buprenorphine induction methods. The available fetal data suggest buprenorphine results in less physiological suppression of fetal heart rate and movements than methadone. Regarding neonatal effects, perhaps the single definitive conclusion is that prenatal buprenorphine treatment results in a clinically significant less severe neonatal abstinence syndrome ( NAS ) than treatment with methadone. The limited research suggests that, like methadone, buprenorphine is compatible with breastfeeding. Data available thus far suggest that there are no deleterious effects of in utero buprenorphine exposure on infant development. Conclusions While buprenorphine produces a less severe neonatal abstinence syndrome than methadone, both methadone and buprenorphine are important parts of a complete comprehensive treatment approach for opioid‐dependent pregnant women.