Pregnant women can receive medication-assisted treatment

By Theresa Cottom - Akron Beacon Journal (TNS)

AKRON — Medication-assisted treatment (MAT) is an option for people — including expectant moms — with opioid addictions who want to get sober.

Medication is available to suppress opioid cravings, and it can be used on its own or in combination with detox and treatment for the best results to a successful sobriety.

Summa, Cleveland Clinic Akron General and the Community Health Center all have MAT programs. The Community Health Center is treating about 600 patients in its program.

There are a couple of medication-assisted treatment options approved for pregnant women: methadone or buprenorphine. Both are opioids that lessen the sickness of withdrawals and block the euphoric effects of opioids.

Methadone is the more commonly used of the two for addicts during pregnancy and in general, and it is more effective for heavy addicts.

However, both methadone and buprenorphine use during pregnancy can result in neonatal abstinence syndrome (NAS) in newborns. Any drug that a pregnant woman uses goes to the baby, too, and if she uses a drug regularly, the baby can experience withdrawal symptoms.

Dr. Gregory Roulette, an OB-GYN at Summa, said babies born dependent on methadone typically spend four to seven more days in the hospital than those born dependent on buprenorphine. However, if a woman is taking methadone before she gets pregnant, the switch to buprenorphine would be difficult to balance.

“The usual practice is whatever you’re on, you’re on when you get pregnant,” Roulette said.

It also would be dangerous to stop or even wean a mother off the drug during pregnancy. Roulette said stopping cold turkey can send the fetus into intense withdrawal and stress that can lead to pre-term labor or stillbirth.

And weaning off a substance, which is what Roulette said many pregnant women want to do, could send the baby into a cycle of withdrawal, which also poses the risk of birth complications.

“That is the exact wrong thing to do,” Roulette said. “What is better is to come in, get stabilized on medically assisted treatment, and stay on it, and then learn everything you can to do nonpharmacologic treatment [for the baby]. Start those interventions early, and work on the underlying issues.”

Once a pregnant woman is on MAT, she can’t do much more to reduce the severity of neonatal abstinence syndrome beyond proper prenatal care. However, she can learn ways to reduce the baby’s length of the stay in the hospital through nonpharmacologic treatment, such as swaddling, feeding on demand and keeping skin-to-skin contact.

By Theresa Cottom

Akron Beacon Journal (TNS)

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