Medicines used to treat opioid use disorder

People who take opioids over a long period of time are at risk of developing opioid use disorder. Opioid use disorder is described as having cravings to use opioids, inability to control the use of opioids, and continued use despite having negative health and life-related consequences.

In some people, opioids can boost feelings of pleasure and create a sense of well-being. Once those feelings wear off, a person may take more opioids to get those feelings again. Over time, these individuals may need to take larger quantities to get the same feelings. This is how dependence starts. Opioid use disorder can lead to serious health problems, including overdose and death.

During pregnancy, medicines are available to treat opioid use disorder. These medicines are safe to use during pregnancy and breastfeeding and have been shown to improve outcomes both for patients and their babies through increased prenatal care and by reducing the risk of overdose and death.

For those with opioid use disorder during pregnancy, it's recommended to start these medicines as early as possible and continue use throughout pregnancy, after birth and beyond. Medicines for opioid use disorder carry a risk for neonatal abstinence syndrome, a condition where babies go through withdrawal after birth from substances they were exposed to in the womb. However, this risk is lower than in those babies exposed to nonprescribed opioids such as fentanyl or heroin and is generally less severe and for a shorter time. Medicines used may include:

• Methadone. Methadone is a long-acting opioid that reduces the effects of other opioids and reduces cravings and withdrawal symptoms. It is a preferred medicine for the treatment of opioid use disorder in pregnancy and helps individuals achieve and maintain recovery. Methadone is not associated with birth defects and is prescribed by a certified opioid treatment program.

  Due to the effects of pregnancy, it is common for people to need their methadone dose increased or split into two separate doses during pregnancy.

• Buprenorphine.Buprenorphine has some effects of opioids but also blocks other effects of opioids. It reduces cravings and withdrawal symptoms. It is a preferred medicine for the treatment of opioid use disorder in pregnancy and helps individuals achieve and maintain recovery. Buprenorphine is not associated with birth defects.

Discuss medicines for the treatment of opioid use disorder with your healthcare professional to decide which option is best for you.