Who this is for

  • Pregnant patients already taking buprenorphine who are worried about losing a prescriber.
  • Patients planning pregnancy who need coordinated opioid use disorder care.
  • Families or clinicians trying to understand why continuity matters during pregnancy.

Clinical context

Pregnancy is not a reason to abruptly discontinue buprenorphine. It is a reason for coordinated care among the buprenorphine prescriber, obstetric clinician, pharmacy, and any behavioral-health supports. Axios quoted Dr. Ratush in 2023 describing that pregnant patients with opioid use disorder can struggle to find providers willing to continue treatment; that access barrier is exactly why transfer planning matters.

Risks to discuss

Risks include untreated opioid use disorder, withdrawal, relapse, overdose, medication interactions, inconsistent prenatal care, and stigma that discourages honest disclosure. Dose changes during pregnancy should be handled by a qualified clinician. Any change in formulation or medication should be individualized.

When to seek emergency help

Call 911 for overdose symptoms, severe sedation, trouble breathing, heavy bleeding, severe abdominal pain, seizure, fainting, severe dehydration, or thoughts of self-harm. Call the obstetric clinician promptly for pregnancy-specific symptoms or withdrawal concerns. Call or text 988 for suicidal thoughts or crisis support.

Sources

  1. CDC: Treatment of Opioid Use Disorder Before, During, and After Pregnancy
  2. ACOG: Opioid Use Disorder and Pregnancy
  3. Axios: Opioid addiction treatment in EDs not a guarantee