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:

Jump to

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

Guidance and Resources for Providers

Webinar recording: ASAM:ACOG Buprenorphine Waiver Training Information Session




Webinar recording: 

Opioid Use and Opioid Use Disorder in Pregnancy (Committee Opinion No. 711, August 2017)

Postpartum Pain Management  (Committee Opinion No. 742, July 2018 and Resource Overview)

Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic 

Removing Barriers to Medication-Assisted Treatment (MAT) for Substance Use Disorder (2018, ACOG and AMA)

Caring for Pregnant and Breastfeeding Women with Opioid Use Disorder Webinar

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

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)

Coding for Substance Use: Opioid Use, Alcohol Use, Tobacco Use

Screening Tools, Behavioral Therapy, and Medications for Substance Use and Opioid Use Disorder

Guidelines for Perinatal Care, 8th Edition (2017)

Viral Hepatitis in Pregnancy (Practice Bulletin No. 86, October 2007, Reaffirmed 2016)

Resources for Women and Families

Opioid Use Disorder and Pregnancy (Infographic, September 2018)

Opioid Use Disorder and Pregnancy Frequently Asked Questions (open access) (FAQ 506, September 2018)

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

Tobacco, Alcohol, Drugs, and Pregnancy

Frequently Asked Questions (open access) (FAQ 170, December 2017) 
Patient Education Pamphlet for purchase
Spanish Patient Education Pamphlet (open access)

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

Pregnancy: Methadone and Buprenorphine (ASAM Pamphlet)

Protecting Yourself Against Hepatitis B and Hepatitis C (AP125, October 2016)

Hepatitis B and Hepatitis C in Pregnancy (AP093, November 2013)

Advocacy Overview and Resources

In ACOG’s 2018 Legislative Priorities, ACOG has committed to supporting appropriate efforts to reduce maternal opioid dependence by:

  • Promoting public health efforts to reduce maternal opioid use disorder and neonatal abstinence syndrome (NAS)
  • Opposing punitive legislation against women with opioid use disorder and babies born with NAS
  • Supporting implementation of laws to ensure access to appropriate care for women with opioid use disorder and babies born with NAS
  • Protecting against mandatory testing and reporting to law enforcement or child protective services; maintain protections for women undergoing medically assisted treatment (MAT)

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:

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

A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare and Collaborating Service Providers (SAMHSA, ACF) provides best practices for states, tribes, and local communities in addressing the needs of pregnant women with opioid use disorders and their infants and families.

A Public Health Response to Opioid Use in Pregnancy Policy Statement (American Academy of Pediatrics) issues recommendations for a public health response, rather than a punitive approach, to the opioid epidemic and substance use during pregnancy. ACOG supported, December 2016.

American Academy of Addiction Medicine’s Public Policy Statement on the Use of Naloxone for the Prevention of Opioid Overdose Deaths outlines ASAM’s recommendations.

CDC Guideline for Prescribing Opioids for Chronic Pain provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. Please note that CDC issued a letter to the American Society of Addiction Medicine clarifying that “the dosage thresholds in the Guideline were not meant to and should not apply to dosing of opioid agonists/partial agonists used for the treatment of opioid use disorder.” CDC also offers clinical tools to support providers, as well as a corresponding Opioid Guideline Mobile App that helps providers apply the recommendations of the guideline into clinical practice. It includes the entire guideline, tools, and resources. In addition, CDC’s March 2018 issue of Vital Signs reports data on emergency department visits for opioid overdoses. 

Hepatitis C Virus Infection Among Women Giving Birth — Tennessee and United States, 2009–2014 is an MMWR published in 2017, in which researchers used U.S. birth certificate data to analyze trends and geographic variations in rates of HCV infection among women giving birth during 2009–2014.

Medication-Assisted Treatment for Opioid Use Disorder Playbook from the US Agency for Healthcare Research and Quality includes information on treatment of pregnant and postpartum women with OUD.

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

National Institute on Drug Abuse offers a quick screen for drug abuse, a research report on heroin, and a number of other resources on opioids

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

Obstetric Care for Women with Opioid Use Disorder Patient Safety Bundle from the Council on Patient Safety in Women’s Health Care provides a broad framework for incorporating OUD screening, intervention, treatment, and follow up into maternity care practice across health care settings. ACOG District II offers provider education for assistance with implementing this bundle

Prescription Drug Monitoring Program Training and Technical Assistance Center at Brandeis University compiles informational profiles for each state’s PDMP.

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.

Remove the Risk Outreach Toolkit from the US Food and Drug Administration includes free materials, such as public service announcements, social media images and posts, and fact sheets for talking with others about safe opioid disposal.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. 

Substance Abuse and Mental Health Services Administration (SAMHSA) offers numerous resources on medication-assisted treatment. Their Buprenorphine Treatment Physician Locator is an interactive map that helps providers and patients find physicians who are authorized to treat opioid dependency with buprenorphine by state. MATx Mobile App is free app that supports practitioners in providing medication-assisted treatment for opioid use disorder. It includes a guide for becoming certified to prescribe buprenorphine, information on medications, clinical support tools, and access to critical helplines and SAMHSA’s treatment locators. 

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

University of California, San Francisco, Clinician Consultation Center offers peer-to-peer consultation from physicians, clinical pharmacists, and nurses with special expertise in substance use evaluation and management, including opioid use disorder.

The CRAFFT Screening Tool consists of a series of six questions developed to screen adolescents for high risk alcohol and other drug use disorders.