New treatment guidelines to support pregnant women with opioid addiction
published on June 1, 2018
New guidelines released today aim to address the misconceptions, stigma and barriers to treatment experienced by pregnant women who use opioids.
The guidelines, developed by the BC Centre on Substance Use (BCCSU) and Perinatal Services BC (PSBC), a part of the Provincial Health Services Authority, provide treatment recommendations and care principles for pregnant women with an opioid addiction. Left untreated, pregnant women with opioid addiction are not only at risk of overdose and injection-related infections, but also face an increased likelihood of adverse outcomes for the baby including poor fetal growth, increased mortality risk, and neonatal opioid withdrawal symptoms.
“Every day we see that stigma around substance use, especially among pregnant mothers and new parents, continues to be a tremendous barrier for people seeking treatment and recovery,” said Judy Darcy, Minister of Mental Health and Addictions. “These new guidelines will help to break down these barriers and establish a standard of care that makes sure both mother and child have the best possible health outcomes.”
The guideline recommends a comprehensive integrated care plan for pregnant women that goes beyond substance-focused approaches and includes collaboration with relevant supports and resources that address patients’ social determinants of health, such as adequate nutrition, safe housing, and other psychosocial supports.
The new guidelines make eight recommendations and offer five care principles including: screening for substance use during prenatal assessment; offering the full scope of harm reduction supplies and services; making the full continuum of care of medications known as opioid agonist treatment (OAT) available; encouraging breastfeeding; and ending the practice of separating the mother from her newborn child immediately after birth.
“Evidence and trauma-informed practice should be at the core of our care principles,” said Tamil Kendall, Interim Provincial Executive Director at PSBC. “Supporting women with appropriate treatment and supports, and keeping mothers and babies together after birth promotes health and well-being for both.”
The new guideline is a supplement to the provincial guidelines for treating opioid addiction developed by the BCCSU and Ministry of Health, released in June 2017. While those guidelines laid out the recommended treatments for opioid addiction, including buprenorphine/naloxone as the preferred first-line treatment, the complexities of treating pregnant women called for detailed recommendations to support this population.
“Providing care during pregnancy is complex, even more so for pregnant women with an opioid addiction,” said Cheyenne Johnson, Director of Clinical Activities and Development at BCCSU. “However, a lack of knowledge regarding evidence-based, safe and effective treatment options for this population has frequently been cited as a barrier to both providing and seeking treatment. These new guidelines will fill that gap and ensure everyone has access to the same high quality and compassionate treatment and care.”
“These new guidelines are the result of a collaborative push to improve the standard of care for pregnant women living with opioid addiction and their babies,” said Dr. Eric Cattoni, medical lead at FIR Square, a BC Women’s Hospital unit that provides specialized services for women with substance use issues. “The goal of our combined care unit is to provide woman-centred, trauma-informed care that aims to keep mother and baby together. These guidelines help get us there.”
The guidelines were released in advance of a two-day visioning forum convened by Provincial Health Services Authority leaders and clinicians with PSBC and BC Women’s Hospital and Health Centre. The forum brings together health care providers, community organizations and policy makers to focus on actions to improve services and supports for pregnant and newly parenting women with substance use challenges across the province.
For the new guideline, Treating Opioid Use Disorder During Pregnancy: Guideline Supplement, visit: http://www.bccsu.ca/oud-pregnancy
To learn more about the BC Centre on Substance Use (BCCSU), visit: http://www.bccsu.ca
To learn more about Perinatal Services BC (PSBC), visit: http://www.perinatalservicesbc.ca/
For more about preventing overdoses, visit: https://www.health.gov.bc.ca/stopoverdosebc/
Ministry of Mental Health and Addictions
BC Centre on Substance Use
Kevin Hollett, Communications Lead
Perinatal Services BC
Provincial Health Services Authority
Media line: 778-867-7472