Pregnancy and opioid use: strategies for treatment

Illicit opioid consumption during pregnancy brings with it the risk of an increase in obstetric complications for the mother and a range of potential dangers for the child, both before and after birth. The primary goal when treating opioid dependence in pregnant women is to stabilise the patient and psychosocially assisted opioid substitution treatment is the preferred first-line therapy for this group. Several combinations of substitution medicines and psychosocial approaches are available. This paper reviews methadone, buprenorphine and slow-release oral morphine, used in a range of combinations with cognitive behavioural approaches and contingency management in order to identify the strengths of each medicine and method.