Observational study of the safety of buprenorphine+naloxone in pregnancy in a rural and remote population

Jumah, Naana Afua; Edwards, Craig; Balfour-Boehm, Jazmyn; Loewen, Kassandra; Dooley, Joseph; Finn, Lianne Gerber; Kelly, Len

doi:10.1136/bmjopen-2016-011774

Cited by 38 publications

(64 citation statements)

References 13 publications

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“…During pregnancy, dosing with buprenorphine alone is recommended, although no maternal or neonatal adverse effects have been observed with use of the combination products. (60–63)…”

Section: Medication-assisted Therapymentioning

confidence: 99%

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Reddy¹,

Davis²,

Ren³

et al. 2017

Obstetrics &Amp; Gynecology

215

101

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In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children. Workshop participants identified key scientific opportunities to advance the understanding of opioid use disorders in pregnancy and to improve outcomes for affected women, their children, and their families. This article provides a summary of the workshop presentations and discussions.

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“…During pregnancy, dosing with buprenorphine alone is recommended, although no maternal or neonatal adverse effects have been observed with use of the combination products. (60–63)…”

Section: Medication-assisted Therapymentioning

confidence: 99%

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Reddy¹,

Davis²,

Ren³

et al. 2017

Obstetrics &Amp; Gynecology

215

101

View full text Add to dashboard Cite

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“…5 At Sioux Lookout Meno Ya Win Health Centre, which had approximately 450 births in 2014, 4 the prevalence of opioid use in pregnancy has risen from 8% in 2009 to 18% in 2011, and to 28% in 2014. [6][7][8][9] A similar pattern was seen at the Thunder Bay Regional Health Sciences Centre, which has approximately 1500 births annually. 4,10 Recent data on the pattern of use has shown that just under half of opioid-using pregnant women are now daily users of opioids and the most common opioid remains long-acting oxycodone.…”

mentioning

confidence: 62%

Opioid use in pregnancy and parenting: An Indigenous-based, collaborative framework for Northwestern Ontario

Jumah

Bishop

Franklyn

et al. 2017

Can J Public Health

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Opioid use affects up to 30% of pregnancies in Northwestern Ontario. Health care providers in Northwestern Ontario have varying comfort levels providing care to substance-involved pregnant women. Furthermore, health care practitioners, social service agencies and community groups in Northwestern Ontario often work in isolation with little multidisciplinary communication and collaboration. This article describes two workshops that brought together health and social service providers, community organizations, as well as academic institutions and professional organizations involved in the care of substance-involved pregnant and parenting women. The initial workshop presented best practices and local experience in the management of opioid dependence in pregnancy while the second workshop asked participants to apply a local Indigenous worldview to the implementation of clinical, research and program priorities that were identified in the first workshop. Consensus statements developed by workshop participants identified improved transitions in care, facilitated access to buprenorphine treatment, stable funding models for addiction programs and a focus on Indigenous-led programming. Participants identified a critical need for a national strategy to address the effects of opioid use in pregnancy from a culturally safe, trauma-informed perspective that takes into account the health and well-being of the woman, her infant, her family and her community.KEY WORDS: Opiate dependence; pregnancy; Indigenous health services; rural population La traduction du résumé se trouve à la fin de l'article.

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“…The combination buprenorphine/naloxone products are used almost exclusively, including among pregnant patients, to reduce misuse and diversion (Lowfall & Walsh, 2014). The combination product has been shown to be safe for pregnant women and their neonates (Jumah et al, 2016;Lund et al, 2013;Nguyen et al, 2018). Individual appointments with a therapist are scheduled on a monthly basis or more frequently as necessary.…”

Section: Comprehensive Opioid Addiction Treatment Model (Coat)mentioning

confidence: 99%

West Virginia's model of buprenorphine expansion: Preliminary results

Winstanley

Lander

Berry

et al. 2020

Journal of Substance Abuse Treatment

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West Virginia (WV) is situated at the epicenter of the opioid epidemic with the highest rates of overdose deaths and some of the lowest rates of access to life saving evidence-based medication assisted treatment (MAT) for patients with opioid use disorder (OUD). WV used a modified hub-and-spoke model to build organizational capacity for facilities to use buprenorphine to treat patients with OUD and to provide ongoing case consultation. The purpose of this study is to 1) describe the groupbase model of buprenorphine treatment and the model used to build organizational capacity, 2) to describe the preliminary results of buprenorphine expansion in WV and 3) to report preliminary data describing and comparing the characteristics of the patients served across five hubs. A single Coordinating Center uses video conferencing to train hubs and provide ongoing case consultation, as well as clinical support. Hubs were trained to deliver a buprenorphine treatment model that is multidisciplinary and includes group-based medication management and psychosocial therapy. Five regional hubs independently treat patients and are leading MAT expansion in their local areas by training and mentoring spokes (n = 13). As a result of the WV STR funding, 14 health care facilities have started to use buprenorphine, 56 health professionals were trained and 196 patients with OUD have been treated. There were few sociodemographic characteristic differences across patients treated at the five hubs, while there were differences in self-reported alcohol and drug use in the 30 days prior to intake. Additional research is needed to determine whether the WV modified hub-and-spoke model resulted in statistically significant improvements in buprenorphine treatment capacity; there is a need to address MAT stigma and regulatory barriers in order to ensure the long-term sustainability of the buprenorphine expansion.

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Observational study of the safety of buprenorphine+naloxone in pregnancy in a rural and remote population

Cited by 38 publications

References 13 publications

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Opioid use in pregnancy and parenting: An Indigenous-based, collaborative framework for Northwestern Ontario

West Virginia's model of buprenorphine expansion: Preliminary results

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