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BMC: Naltrexone Promising Treatment for Opioid Use Disorder During Pregnancy

Infants born to mothers taking naltrexone to treat opioid use disorder (OUD) developed no signs of neonatal opioid withdrawal syndrome (NOWS) while hospitalized, a new study from association member Boston Medical Center shows.

NOWS has increased fivefold over the past decade, with approximately 50 to 80 percent of opioid-exposed infants requiring medication to manage irritability, trouble eating and sleeping, diarrhea, muscle rigidity, and other withdrawal symptoms.

Previous research has found buprenorphine a favorable alternative to methadone in caring for pregnant people with OUD. The Food and Drug Administration in 2010 approved the use of naltrexone during pregnancy.

The study, published in Clinical Therapeutics, followed 18 mothers and their infants during pregnancy and after delivery between 2017 and 2019. Six mothers took naltrexone to treat OUD before and during their pregnancy, and 12 took buprenorphine. Infants born to mothers taking naltrexone showed no NOWS symptoms, while 92 percent of infants exposed to buprenorphine showed NOWS symptoms, 46 percent of whom required medication.

Among those exposed to naltrexone, infants had shorter hospital stays than those exposed to buprenorphine, 83 percent of mothers breastfed without issues in the perinatal period, and mothers reported no other opioid use during their pregnancy. These findings, while preliminary, support continued and expanded research to examine the drug’s long-term safety and efficacy outcomes.

BMC has a long history of innovative care for patients with OUD and received a 2018 Gage Award for Quality from America’s Essential Hospitals for nonpharmacological approaches to treating neonatal abstinence syndrome.

America’s Essential Hospitals has established a resource page for the opioid epidemic.

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About the Author

Emily Schweich is a senior communications associate for America's Essential Hospitals.

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