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An Alternative Approach to Low-Dose Buprenorphine Induction in Pregnancy and Postpartum
Kathleen Koenigs1, Jessica Gray1, Evan Gale1
1Department of Obstetrics, Gynecology, and Reproductive Biology and the Department of Medicine, Massachusetts General Hospital, and the Division of General Academic Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts.
Abstract:
Low-dose buprenorphine induction, unlike traditional methods, does not require that individuals experience at least moderate withdrawal before initiation. This technique has been widely used and studied in the general population; however, research in pregnancy is limited. We aimed to evaluate obstetric and neonatal outcomes after low-dose buprenorphine induction. In this retrospective case series, we reviewed all cases of low-dose induction during pregnancy or within 6 weeks postpartum at an urban academic medical center over a 3-year period. Nine patients started buprenorphine using this method, and all but one completed induction. There was a high rate of treatment retention and no apparent associated adverse neonatal events. Four individuals are in sustained remission and currently parenting. Though further research is needed, low-dose buprenorphine induction appears effective in the obstetric population.
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