Low-dose Induction of Buprenorphine in Pregnancy: A Case Series

J Addict Med. 2024 Jan-Feb;18(1):62-64. doi: 10.1097/ADM.0000000000001233. Epub 2023 Oct 20.

Abstract

Background: Because of a risk of precipitated withdrawal occurring from buprenorphine induction in people who use fentanyl, low-dose inductions are becoming increasingly common. However, little evidence exists on the use of this method in pregnant people.

Methods: We conducted a case series of all pregnant people treated for opioid use disorder with low-dose buprenorphine induction at the University of Maryland Medical Center between January 1, 2021, and August 22, 2022. Primary outcome was completion of induction regimen. Secondary outcomes were self-report of withdrawal, continuation of buprenorphine until delivery, and return to or continuation of illicit opioid use.

Results: Six pregnant people were prescribed a total of 10 buprenorphine inductions. Five of the 6 pregnant people (83.3%) completed at least 1 induction, none of whom experienced precipitated withdrawal. Two of 6 (33.3%) continued buprenorphine until the time of delivery, and 1 of 6 (16.7%) abstained from illicit opioid use.

Conclusions: The low-dose buprenorphine induction regimen described was successful in 5 of 6 pregnant individuals. Further research, particularly regarding continuation rates, is needed.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Buprenorphine* / adverse effects
  • Female
  • Fentanyl / adverse effects
  • Humans
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders* / drug therapy
  • Pregnancy

Substances

  • Buprenorphine
  • Analgesics, Opioid
  • Fentanyl