Clinical |

IHS and ACOG release clinical recommendations to improve care of American Indian, Alaska Native women with opioid use disorder

Indian Health Service


Contact: (301) 443-3593, [email protected]

Today, the Indian Health Service and the American College of Obstetricians and Gynecologists are announcing new clinical recommendations for healthcare providers treating American Indian and Alaska Native pregnant women and women of childbearing age with opioid use disorder.


“These new recommendations are part of our comprehensive strategy to address the opioid epidemic in partnership with American Indian and Alaska Native tribes and communities,” said IHS Chief Medical Officer Rear Adm. Michael Toedt, M.D. “American Indian and Alaska Native women of childbearing age receive enhanced treatment and care when clinicians are culturally responsive to each patient.”

The recommendations will support the efforts of tribes and tribal health organizations in rural and urban Indian communities in addressing the needs of pregnant women with opioid use disorders, their infants, and families, and improving the health among tribal communities. The recommendations will also assist health care providers in improving maternal engagement in early prenatal care and promote active participation in recovery strategies.

“American Indian and Alaska Native women have the highest risk of dying from a prescription opioid overdose and obstetrician-gynecologists are among those on the frontlines caring for these women,” said Dr. Barbara Levy, ACOG vice president of health policy. “ACOG is proud to partner with IHS to provide the most appropriate and effective treatment for women and ensure the best maternal and neonatal outcomes.”

The new recommendations establish a unified pathway for opioid use disorder treatment in pregnant and reproductive-age women, as well as those who are at risk for developing an opioid use disorder. They focus on universal screening, medication-assisted treatment, prenatal and postpartum care, and recovery. These recommendations support the U.S. Department of Health and Human Services 5-Point Strategy to Combat the Opioids Crisis. Specifically, the recommendations seek to provide better addiction prevention, treatment, and recovery services.

The recommendations were developed in partnership with tribes and ACOG’s Committee on American Indian and Alaska Native Women’s Health based on critical feedback IHS received on the importance of perinatal opioid exposure in opioid listening sessions and tribal consultations throughout the past year. This report was also funded, in part, by the Department of Health and Human Services Office on Women's Health.

Combatting the opioid epidemic remains a top priority at IHS and HHS. Leading IHS efforts is the IHS National Committee on Heroin, Opioids and Pain Efforts, which exists to promote appropriate and effective pain management, reduce overdose deaths from heroin and prescription opioid misuse, and improve access to culturally appropriate treatment.

The IHS, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.6 million American Indians and Alaska Natives. Our mission is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level. Follow the agency via social media on Facebook and Twitter.

The American College of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists (ACOG) is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.

The recommendations are available here.