Module 20: Treating Women for Opioid Use Disorder during Pregnancy: Clinical Challenges

Note: Following this module’s development, we were given approval to change the term “Medication Assisted Treatment (MAT)” to “Medications for Addiction Treatment (MAT)” or “Medications for Opioid Use Disorder (MOUD). ” We support this change and have begun to implement throughout our educational trainings, resources and website as we move forward.

Presenter: Hendrée E. Jones, PhD | Executive Director, UNC Horizons;  Professor, Department of Obstetrics and Gynecology University of North Carolina

Cost:  No Fee

Target Audience:  Physicians, nurses, and healthcare teams who are treating patients with substance use disorder (SUD).

Core Competencies as a result of participating in this activity:   
Interpersonal Skills and Communication
Medical Knowledge
Patient Care

Module Description: Opioid use disorder (OUD) among women who become pregnant is increasing in prevalence in clinical settings. The standard of care is to provide buprenorphine or methadone as a part of a complete treatment approach during pregnancy and beyond the postpartum period. This module reviews the historical and current context of opioid use among women and during pregnancy. It compares pharmacological treatment options for women who become pregnant with an OUD and also discusses the issues with detoxification or medically assisted withdrawal from opioids during pregnancy.  Issues related to the treatment of OUD during pregnancy and in the postpartum period for the mother, fetus and child will also be discussed (e.g., induction, dosing, pain management, neonatal withdrawal syndrome and how to reduce its severity).  

Educational Objectives  
At the conclusion of this activity participants should be able to:

• Compare and contrast the risks and benefits of medication assisted treatment vs. medication assisted withdrawal for the effective treatment of women with OUD during pregnancy and the post-partum period
• Compare and contrast the risks and benefits of methadone and buprenorphine treatment during pregnancy for mother, fetus and child
• Identify at least three factors that are associated with reducing neonatal abstinence syndrome (NAS) severity among babies that are prenatally exposed to methadone or buprenorphine

Method of participating in the learning process 

In order to receive maximum credit, learners must: 

1. Review the materials provided in this module.
2. Earn a minimum cumulative score of 80% on the post-test. 
3. Complete an evaluation to assess satisfaction and plans for individual and/or team practice change.
4. Follow instructions at the end of the course regarding how to retrieve a certificate.* 

*Credit will not be awarded unless all components of the program are completed.  Partial credit will not be awarded.

Accreditation and Certification of this activity:

Joint Accreditation Statement

In support of improving patient care, American Academy of Addiction Psychiatry is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

In 2019, AAAP also added accreditation from The American Academy of PAs (AAPA), American Psychological Association (APA) and Association for Social Work Boards (ASWB).

Release Date: July 26, 2019                               Date of Expiration: July 26, 2022

Interprofessional Continuing Education (IPCE) Designation Statement 

This activity was planned by and for the healthcare team, and learners will receive 1.25 Interprofessional Continuing Education credit for learning and change.

Physician Designation Statement

American Academy of Addiction Psychiatry designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Nursing Designation Statement

American Academy of Addiction Psychiatry is an approved provider of nursing continuing education through AAAP's Joint Accreditation provider #4008192. This program is approved for up to 1.25 Nursing Contact Hours.

Disclosures:

AAAP's interprofessional continuing education program aims to provide educational information that is balanced, independent, objective and free of bias and based on evidence. During the planning process, anyone that is involved in the content is required to disclose to AAAP and our learners any real or potential conflict of interest related to the educational activity. The following individuals have no relevant financial relationships with an ACCME defined commercial interest to disclose: Thomas Penders, MD, Michael Goedde, MD, Nitigna Desai, MD, Karen Oliver, PhD, John Renner, Jr, MD, Kevin Sevarino, MD, PhD, Kathryn Cates-Wessel, Miriam Giles, Carol Johnson, Jennifer Lundstrom, and Justina Pereira.  PCSS Clinical Expert Committee members and content reviewers David Fiellin, MD, Michelle Lofwall, MD, Larissa Mooney, MD, and Colleen LaBelle, MSN, RN-BC, CARN, have nothing relevant to the content of this module to disclose. Content Developer Hendrée E. Jones, PhD, has nothing to disclose. 

Faculty have been advised that any recommendations involving clinical medicine must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in the presentation must conform to the generally accepted standards of experimental design, data collection, and analysis. Learners are advised that this activity may contain references to unlabeled uses of US FDA-approved products or to products not approved by the FDA for use in the United States. In these instances, participants will be made aware of such usage and discussions regarding either non–FDA-approved or investigational use of products/devices.

ADA Accommodation Statement 

AAAP encourage persons with disabilities to participate in our programs and activities. If you anticipate needing any type of accommodation or have questions about this activity, please email pcss@aaap.org.

Privacy and Confidentiality Policy 

AAAP values your privacy and confidentiality of the information you choose to share with us. Personal information collected from evaluations will not be shared with third parties. 

Disclaimer: The views, opinions, and content expressed herein do not necessarily reflect the views or policies of AAAP, CSAT, SAMHSA, or HHS. No official support of or endorsement by AAAP, CSAT, SAMHSA, or HHS for these opinions or for particular instruments, software, or resources is intended or should be inferred.

Support for the Program: 

Funding for this initiative was made possible (in part) by grant no. 5U79TI026556 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.