The prevalence of opioid use disorder in the United States continues to rise and is a public health crisis. Because of this, it is increasingly important that providers are educated on opioid prescribing and that patients have access to accurate information and appropriate treatment.

Here are some key resources to help providers and patients, including pregnant women, together carefully weigh the risks and benefits when making decisions to initiate opioid treatment:

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Resources for Providers
Resources for Women and Families
Advocacy Overview and Resources
ACOG Opioid and Addiction Medicine Expert Work Group Other Resources

Resources for Providers

Practice Advisory: FDA Boxed Warning on Immediate-Release Opioid Medications and All Prescription Opioids (March 2016)

Opioid Use, Dependency, and Addiction in Pregnancy (Committee Opinion No. 524, May 2012, Reaffirmed 2014)

Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and Gynecologic Practice (Committee Opinion No. 633, June 2015)

Substance Abuse Reporting and Pregnancy: The Role of the Obstetrician-Gynecologist (Committee Opinion No. 473, January 2011, Reaffirmed 2014)

Guidelines for Perinatal Care, 7th Edition (2012, page 127-130)

Nonmedical Use of Prescription Drugs (Committee Opinion No. 538, October 2012, Reaffirmed 2014)

Resources for Women and Families

Important Information About Opioid Use Disorder and Pregnancy (PFS012, June 2016)

Tobacco, Alcohol, Drugs, and Pregnancy (FAQ 170, December 2013)

Childbirth, Breastfeeding and Infant Care: Methadone and Buprenorphine (ASAM Pamphlet)

Pregnancy: Methadone and Buprenorphine (ASAM Pamphlet)

Advocacy Overview and Resources

In ACOG’s 2016 Legislative Priorities, ACOG has committed to supporting appropriate efforts to reduce maternal opioid dependence by:

  • Promoting public health efforts to reduce maternal opioid dependence and neonatal abstinence syndrome (NAS).

  • Opposing punitive legislation against women with opioid use disorders and babies born with NAS.

ACOG is committed to leading national efforts to develop and disseminate evidence-based recommendations on opioids. This includes strengthening partnerships with policy makers, federal agencies, and peer organizations to support regulations and clinical recommendations that are evidence-based, increase access to appropriate treatment, and improve outcomes for women. This includes participation in:

  • The American Medical Association’s (AMA) Task Force to Reduce Opioid Use. Read ACOG's Statement on Opioid Abuse (July 2015)Learn more about AMA’s Task Force

  • The Substance Abuse and Mental Health Services Administration’s Advisory Committee for Women’s Service. Learn more

  • Centers for Disease Control and Prevention’s (CDC’s) expert panel on substance abuse and pregnancy. This is a multiagency panel charged with enhancing screening, brief intervention, and treatment.

  • CDC’s Stakeholder Review Group for the development of their Guidance for Opioids for Chronic Pain, 2016.

  • US Food and Drug Administration’s (FDA’s)Risk Communication Advisory Committee public comment hearing regarding appropriate labeling of opioid use during pregnancy. Read ACOG’s Statement on Opioid Use During Pregnancy (May 2016)Read FDA’s Opioid Action Plan

  • The US Department of Health and Human Services’ (HHS’) Provider Opioid Partnership. Learn more about HHS’ response to the epidemic.

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development – ACOG - American Academy of Pediatrics – Society for Maternal-Fetal Medicine – CDC – March of Dimes Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes Workshop. The workshop is expected to result in evidence-based consensus guidelines. (Forthcoming)

ACOG Opioid and Addiction Medicine Expert Work Group

In November 2015, ACOG founded the Opioid and Addiction Medicine Expert Work Group (OAMEWG) to assist ACOG in its opioid-related efforts. This includes guiding and representing ACOG in national committees and other advocacy opportunities. It also includes developing and reviewing clinical guidance, patient education materials, clinical training materials, clinical comments, and other educational tools for providers and patients at all levels of the community. The OAMEWG is comprised of noted obstetrician-gynecologists with expertise and experience in opioid use and addiction, use of drugs in pregnancy, substance use and evidence-based medicine.

Other Resources

Buprenorphine Treatment Physician Locator (SAMHSA) is an interactive map that helps providers and patients find physicians who are authorized to treat opioid dependency with buprenorphine by state.

myTopCare is a website dedicated to practicing physicians, pharmacists and other clinical professionals who care for patients with chronic pain using opioid medications.

National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use (ASAM) and a corresponding Promotional Toolkit

Project Nurture: Two Approaches to Integrating Perinatal Care with Substance Use Treatment is a resource from the Institute for Healthcare Improvement designed to help providers integrate substance use management into their practice.

Providers’ Clinical Support System for Medication Assisted Treatment is a national training and mentoring project that aims to make available the most effective medication-assisted treatments to serve patients in a variety of settings.

State Policies on Substance Abuse During Pregnancy (Guttmacher Institute) offers a summary of state laws regarding substance abuse, reporting, testing, and treatment.

MMWR: CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

American Congress of Obstetricians and Gynecologists
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