• July/August 2018
  • Vol. 19, No. 6

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Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants

Opioid misuse continues to negatively affect the health and well-being of individuals, families, and communities across the nation. The number of women of childbearing age who reported past-month heroin use increased by 31 percent in 2013–2014 compared with 2011–2012, and the same population who reported past-month misuse of prescription pain relievers increased by 5.3 percent during the same time period. This has led to an increase in infants diagnosed with neonatal abstinence syndrome, from 3.4 per 1,000 births in 2009 to 5.8 per 1,000 hospital births in 2012—with higher rates in rural areas. In addition, barriers to treatment, such as stigma and fear of legal consequences, prevent women with opioid use disorder and their infants from receiving care.

The U.S. Substance Abuse and Mental Health Services Administration has published a free clinical resource that provides guidance on treating pregnant and parenting women with opioid use disorder and their infants. It is meant to help health-care professionals and patients decide appropriate actions for their unique situations and inform treatment decisions.

The guide is split into three sections, each containing several factsheets pertaining to the section topic:

  • Section I: Prenatal Care—This section contains the factsheets "Prenatal Screenings and Assessments," "Initiating Pharmacotherapy for Opioid Use Disorder," "Managing Pharmacotherapy Over the Course of Pregnancy," and more
  • Section II: Infant Care—This section contains the factsheets "Screening and Assessment for Neonatal Abstinence Syndrome," "Breastfeeding Considerations for Infants at Risk for Neonatal Abstinence Syndrome," "Early Interventions Strategies and Developmental Assessments," and more
  • Section III: Maternal Postnatal Care—This section contains the factsheets "Adjusting Pharmacotherapy Dose Postpartum," "Maternal Discharge Planning," and "Maternal Return to Substance Use"

Each factsheet illustrates a clinical scenario to help the health-care professional understand the situation under consideration; clinical action steps that describe recommendations for what can or might be done, as well as what should not be done when caring for women and their infants; supporting evidence and clinical considerations that describe how to tailor recommended actions to unique patient situations and preferences, the necessary clinical experience of the provider, and available community resources; and web resources that provide additional online information.

This free, online guide can be found at https://store.samhsa.gov/product/SMA18-5054.

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