suboxone doctor

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Pregnancy and Methadone or Suboxone

The current treatment for woman with a dependence on opioids during pregnancy is to take methadone. While some are looking into the safety of buprenorphine to the fetus, it is still not the treatment favored by obstetricians. What this important study has done is offer a solution to the issue of infant methadone detoxification right after delivery. The infant is born addicted to methadone and this can be a challenge to the infant and requires careful medical care. In this fine research below, these pregnant women were transitioned from methadone to morphine and then to the active agent in Suboxone (buprenorphine). How did the infants and mothers do? It seems both did well, and some lessons were learned. Some withdrawal sensations occurred but nothing like what is commonly seen with methadone suddenly being removed from a new infant.

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Transferring methadone-stabilized pregnant patients to buprenorphine using an immediate release morphine transition: an open-label exploratory study.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.

A transition from methadone to buprenorphine without intervening withdrawal symptoms is critical for advancing the treatment of opioid-dependent patients. Four pregnant inpatients were transferred from methadone (65-85 mg) to five days of immediate release morphine (IRM) and then to buprenorphine (12-28 mg). Withdrawal scores decreased during the five days of IRM and subsequently increased over the first three days on buprenorphine. The transitional use of IRM appears safe for both mother and fetus. Withdrawal symptoms appeared during buprenorphine induction; however, these data suggest that the intensity of withdrawal symptoms may be lessened by the dose and frequency of buprenorphine administration.

Jones HE, Suess P, Jasinski DR, Johnson RE. American Journal of Addict. 2006;15:61-70

[Underline and italic/bold emphasis by Dr. Schaller]


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