Clinical Grand Rounds: October Edition – Pregnancy & Substance Abuse

In October’s Clinical Grand Rounds, Dr. Hank Nusbaum, a diplomate of the American Board of Obstetrics and Gynecology and American Board of Addiction Medicine, who is also the Associate Medical Director at Root Center for Advanced Recovery, spoke about pregnancy and substance use disorder (SUD) as it pertains to individual risks to both the mother and the baby.

Chronic untreated opioid use can lead to serious risks, especially during pregnancy. If the substance use disorder remains untreated, it can lead to high-risk activities like prostitution, violence, sex for drugs, and more. When it comes to withdrawal and tapering, Dr. Nusbaum says that those methods can contribute to a higher relapse rate, which could end up resulting in a fatal overdose. Therefore, it is especially important to treat, as unintended pregnancy in women who suffer from SUD is 80 percent, compared to women who do not suffer from SUD, and have around a 25 percent chance.

Dr. Nusbaum says the key to a safe pregnancy for mothers who struggle with SUD, is to dose symptomatically, paying close attention to cravings and withdrawal. Dr. Nusbaum reiterated that there is nothing different in terms of treatment for pregnant women, compared to people who are not pregnant. He added that the medical assisted treatments (MAT) and intensive outpatient program (IOP), are safe for expecting mothers. Pregnant women have already been safely treated with methadone for more than 25 years. Dr. Nusbaum said that one thing that does further help with treatment, is patient counseling, and reassuring patients that their babies will benefit from a treatment program and following the guidance in place.

The goal of Methadone Maintenance Treatment (MMT) in pregnant clients is to increase safety, eliminate adverse substance use behaviors, reduce withdrawal symptoms and cravings, and support the well-being of the mother and child. Withdrawal management during pregnancy is critical, as withdrawal symptoms can contribute to pregnancy complications and mental and physical distress for the expectant mother. At Root Center for Advanced Recovery, you can be sure that you and your child are in good hands, and recovery is possible.

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