Buprenorphine with, or without, Naloxone for Pregnant Women?–Review of Current Evidence and Practice in Massachusetts

Opioid use disorder has reached the level of an epidemic. Potential complications of unsafe injections, lifestyle, overdose and withdrawal are particularly concerning in pregnant women as the risk therein extends also to the foetus. The main medications in treatment of opioid use disorder are methadone, naltrexone and buprenorphine products. Naloxone (pregnancy class: B) was carefully selected to be a part of Suboxone® in 4:1 ratio to buprenorphine (pregnancy class: C) as a deterrent for intravenous use. Naloxone's bioavailability, delivered sublingually, is minimal (