Extended-Release Buprenorphine for Treatment of Opioid Use Disorder During Pregnancy and Postpartum

Buprenorphine use in pregnancy and postpartum for individuals with opioid use disorder (OUD) decreases maternal and fetal morbidity and mortality. Extended-release buprenorphine overcomes barriers to sublingual buprenorphine, but very limited data are available regarding use in the perinatal period. We aimed to describe extended-release buprenorphine uptake and associated recovery and pregnancy outcomes in a case series of 15 pregnant and postpartum individuals with OUD. Reasons for extended-release buprenorphine initiation included nausea, burdensome multiple daily dosing of sublingual buprenorphine, and persistent cravings. Postinitiation, all patients demonstrated increased buprenorphine adherence, total cessation of nonprescribed opioids, and a reduction in other substance use. There were no identified maternal or neonatal side effects. Our data provide early evidence for safety, adherence, and reduced substance use among perinatal patients with OUD treated with extended-release buprenorphine.