Treating opioid use disorders during pregnancy: historical, current, and future directions

The historical and current contexts of opioid use disorders during pregnancy are reviewed. There has been a long history of use of opioids by women in the United States, including by prescription prior to 1919. Neonatal abstinence syndrome was first identified coincident with this use. Methadone and more recently buprenorphine have proven to be successful pharmacotherapeutic agents in the treatment of opioid use disorder in pregnant women. However, these medications should be seen as only one ingredient of a comprehensive treatment approach for this population. The 21st century needs to witness a heightened emphasis on the myriad factors that lead to opioid use in women, and a broader education of those professionals who may come in contact with pregnant women with opioid use disorder.