Guideline Coverage: This topic is also addressed in: 1. TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, SAMHSA 2008. 2. TIP 40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, pp.68-70. http://www.kap.samhsa.gov/products

Clinical Questions: 1. If a female patient of child-bearing age is requesting buprenorphine treatment, what should I do? (i.e. informed consent, birth control, etc) 2. If a patient is already on buprenorphine. Should I keep her on it during a pregnancy? 3. Does it matter whether she is given the mono (buprenorphine) or combo (buprenorphine/naloxone) product? 4. If a new opioid-dependent patient is pregnant and requests buprenorphine treatment, what should I do? 5. Is buprenorphine treatment during pregnancy safe? 6. How can detoxification (medically supervised withdrawal) be carried out if a pregnant patient wants to stop all opioids, including buprenorphine? 7. How does buprenorphine treatment compare with methadone treatment for pregnant women? 8. Does treatment of pregnant women change, depending on whether the patient abuses heroin or prescription opioids? 9. Is breastfeeding safe while taking buprenorphine? 10. What neonatal withdrawal is expected when mothers take buprenorphine?

[1]  C. Thomas,et al.  Medication-Assisted Treatment With Buprenorphine: Assessing the Evidence , 2015 .

[2]  H. Jones,et al.  Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy. , 2014, Drug and alcohol dependence.

[3]  C. Rose,et al.  Chronic opioid use during pregnancy: maternal and fetal implications. , 2013, Clinics in perinatology.

[4]  W. Alto,et al.  Breastfeeding rates and the relationship between breastfeeding and neonatal abstinence syndrome in women maintained on buprenorphine during pregnancy. , 2013, Journal of midwifery & women's health.

[5]  M. Soyka.  Buprenorphine Use in Pregnant Opioid Users: A Critical Review , 2013, CNS Drugs.

[6]  H. Jones,et al.  Buprenorphine + naloxone in the treatment of opioid dependence during pregnancy-initial patient care and outcome data. , 2013, The American journal on addictions.

[7]  H. Jones,et al.  A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy: Maternal and Neonatal Outcomes , 2013, Substance abuse : research and treatment.

[8]  H. Jones,et al.  Methadone and Buprenorphine for the Management of Opioid Dependence in Pregnancy , 2012, Drugs.

[9]  G. Badger,et al.  Differences in the profile of neonatal abstinence syndrome signs in methadone- versus buprenorphine-exposed neonates. , 2012, Addiction.

[10]  H. Jones,et al.  Neonatal abstinence syndrome. , 2012, JAMA.

[11]  M. Ehrlich,et al.  Sublingual Buprenorphine for Treatment of Neonatal Abstinence Syndrome: A Randomized Trial , 2008, Pediatrics.

[12]  L. Amato,et al.  Maintenance agonist treatments for opiate dependent pregnant women. , 2008, The Cochrane database of systematic reviews.

[13]  L. Simmat-Durand,et al.  Prospective multicenter observational study of 260 infants born to 259 opiate-dependent mothers on methadone or high-dose buprenophine substitution. , 2006, Drug and alcohol dependence.

[14]  H. Aschauer,et al.  Methadone versus buprenorphine in pregnant addicts: a double-blind, double-dummy comparison study. , 2006, Addiction.

[15]  M. Leamon,et al.  High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes. , 2005, American journal of obstetrics and gynecology.

[16]  B. Lester,et al.  Buprenorphine versus methadone in the treatment of pregnant opioid-dependent patients: effects on the neonatal abstinence syndrome. , 2005, Drug and alcohol dependence.

[17]  A. Berrebi,et al.  Buprenorphine in pregnant opioid-dependent women: first results of a prospective study. , 2004, Addiction.

[18]  H. Jones,et al.  Use of buprenorphine in pregnancy: patient management and effects on the neonate. , 2003, Drug and alcohol dependence.

[19]  L. Finnegan,et al.  Perinatal and developmental outcome of infants exposed to methadone in-utero. , 1987, NIDA research monograph.

[20]  L. Finnegan,et al.  The effects of maternal drug dependence on neonatal mortality. , 1977, Drug and alcohol dependence.