2026-2027 | On-Demand Session | Pregnancy and Women's SUD: Focus on OUD Treatment Strategies | August 2026-Pregnancy and Women's SUD: Focus on OUD Treatment Strategies Recording

Video Transcription

Video Summary

Dr. Tipu Khan presented a comprehensive talk on pregnancy and women’s substance use disorders, emphasizing opioid use disorder treatment and the importance of caring for both the pregnant parent and infant as a dyad. He highlighted that overdose is now the leading cause of maternal death in the U.S., making routine screening and treatment in prenatal care essential.<br /><br />The session reviewed how pregnancy changes drug metabolism, often requiring higher or more frequent dosing of medications for opioid use disorder (MOUD), especially methadone and buprenorphine. He stressed that both buprenorphine and methadone are appropriate in pregnancy, and that buprenorphine often leads to less severe neonatal opioid withdrawal. He also noted that the buprenorphine/naloxone combination product is safe to continue during pregnancy.<br /><br />A major focus was fentanyl-era induction strategies. Because fentanyl is lipophilic and can cause prolonged tissue release, standard induction is often less effective. Dr. Khan discussed low-dose induction, high-dose/macro induction, direct-to-inject approaches, and inpatient rapid methadone starts, emphasizing the need for individualized care and close monitoring, especially in pregnancy.<br /><br />He also reviewed management of labor, delivery, and postpartum care: continue MOUD during labor, use early epidural analgesia, avoid mixed agonist-antagonists like nalbuphine, and do not reflexively taper MOUD after delivery. He stressed postpartum relapse risk and the importance of contraception, harm reduction, and depression screening.<br /><br />For newborns, he recommended Eat, Sleep, Console as standard care for neonatal opioid withdrawal syndrome, with pharmacologic treatment only when needed. Overall, the talk centered on reducing stigma, using evidence-based care, and supporting long-term family stability.

Keywords

pregnancy

women's substance use disorders

opioid use disorder

maternal death

prenatal screening

medication for opioid use disorder

methadone

buprenorphine

neonatal opioid withdrawal syndrome

fentanyl-era induction

low-dose induction

high-dose induction

labor and delivery care

postpartum relapse prevention

Eat Sleep Console