Treating Pregnant and Parenting Women with Opioid Use Disorder

CE Course Description

The nation’s opioid epidemic continues to compromise the health and well-being of individuals, families, and communities. The purpose of this intermediate continuing education course, developed using information from the Substance Abuse and Mental Health Services Administration, is to provide an overview of clinical guidance for treating pregnant and parenting women with opioid use disorder (OUD) and their infants. The information, based on recommendations of experts reviewing the limited evidence available for this population, summarizes characteristics of individuals with OUD, pharmacotherapy for pregnant women with OUD, and clinically appropriate actions for particular circumstances facing the mother and infant.  In addition, treatment barriers, comorbid behavioral health disorders, management of Neonatal Abstinence Syndrome (NAS), and maternal postnatal care for mothers with OUD are discussed.

Author: Substance Abuse and Mental Health Services Administration

CE Course Objectives

1. Summarize the characteristics of opioid use disorder (OUD), its epidemiology, and barriers to treatment for pregnant and parenting women with OUD.
2. Discuss screening and assessment considerations for pregnant women with OUD.
3. Evaluate the benefits and uses of medication-assisted treatment (MAT) and evidence-based behavioral interventions for OUD among pregnant and parenting women.
4. Identify comorbid behavioral health disorders that occur among women with OUD and considerations related to polysubstance use during pregnancy.
5. Outline factors that contribute to Neonatal Abstinence Syndrome (NAS) and discuss screening/assessment and management of NAS.
6. Describe recommendations for maternal postpartum care for mothers with OUD including pharmacotherapy dose adjustment, discharge planning, and risk evaluation for returning to substance misuse.
7. Determine steps that can be taken at the clinic, community, and stakeholder level to stay engaged in the treatment process for pregnant and parenting women with OUD.

CE Course Outline

Part A - 1 hour, 15 minutes

1. Background - 5 minutes
2. Epidemiology - 5 minutes
3. Barriers to Treatment - 5 minutes
4. Effective Interventions and Guidelines - 10 minutes
5. Definition of Terms - 10 minutes
6. Creation of the Guide - 10 minutes
7. RAM Methodology - 10 minutes
8. Limitations to the RAM Process and Gaps Identified in the Research - 10 minutes
9. How to Use the Clinical Guide - 10 minutes
10. Introduction Web Resource - 5 minutes
11. References - 5 minutes

Part B: Factsheets - 4 hours, 10 minutes

1. Section I: Prenatal Care - 1 hour, 45 minutes
   1. Factsheet #1: Prenatal Screenings and Assessments - 10 minutes
   2. Factsheet #2: Initiating Pharmacotherapy for Opioid Use Disorder - 10 minutes
   3. Factsheet #3: Changing Pharmacotherapy During Pregnancy - 10 minutes
   4. Factsheet #4: Managing Pharmacotherapy Over the Course of Pregnancy - 10 minutes
   5. Factsheet #5: Pregnant Women with Opioid Use Disorder and Comorbid Behavioral Health Disorders - 10 minutes
   6. Factsheet #6: Addressing Polysubstance Use During Pregnancy - 10 minutes
   7. Factsheet #7: Planning Prior to Labor and Delivery - 10 minutes
   8. Factsheet #8: Peripartum Pain Relief - 10 minutes
   9. Section I References - 5 minutes
2. Section II: Infant Care - 1 hour, 10 minutes
   1. Factsheet #9: Screening and Assessment for Neonatal Abstinence Syndrome - 10 minutes
   2. Factsheet #10: Management of Neonatal Abstinence Syndrome - 10 minutes
   3. Factsheet #11: Breastfeeding Considerations for Infants at Risk for Neonatal Abstinence Syndrome - 10 minutes
   4. Factsheet #12: Infant Discharge Planning - 10 minutes
   5. Factsheet #13: Early Intervention Strategies and Developmental Assessments - 10 minutes
   6. Section II References - 10 minutes
3. Section III: Maternal Postnatal Care - 1 hour, 15 minutes
   1. Factsheet #14: Adjusting Pharmacotherapy Dose Postpartum - 10 minutes
   2. Factsheet #15: Maternal Discharge Planning - 10 minutes
   3. Factsheet #16: Maternal Return to Substance Use - 10 minutes
   4. Section III References - 5 minutes

Part C: Conclusion - 35 minutes

1. Conclusion - 20 minutes
2. Appendices - 15 minutes
1. Appendix A: Suitable Development Assessments for Opioid-Exposed Infants and Children - 10 minutes
2. Appendix B: Glossary and Acronyms - 5 minutes