The American Academy of Pediatrics (AAP) has a long-standing recommendation against breastfeeding if the maternal methadone dose is above 20 mg/day. In 2001, the AAP lifted the dose restriction of maternal methadone allowing methadone-maintained mothers to breastfeed. The allowance of breastfeeding among mothers taking methadone has been met with opposition due to the uncertainty that exists related to methadone exposure of the suckling infant. Methadone-maintained mothers are at higher risk for abuse, concomitant psychiatric disorders, limited access to healthcare, and financial hardship. Breastfeeding rates among methadone-maintained women tend to be low compared to the national average. This manuscript will discuss the implications for healthcare practitioners caring for methadone-maintained mothers and infants and associated risks and benefits of breastfeeding. This population of mothers and infants stands to obtain particular benefits from the various well-known advantages of breastfeeding.
Suboxone and Pregnancy
My Eldrige” is a 33-year-old woman with a medical history of opioid use disorder (OUD), depression, anxiety, hearing loss with cochlear implant, intrauterine pregnancy at 21 weeks and 1 day, by 11-week ultrasound, who presented to a hospital in Tennessee for treatment of opioid withdrawal during pregnancy. She reported a history of misusing medications from her job as a veterinary technician, which included oxycodone, propofol, and benzodiazepines. She also reported previous heroin and methamphetamine use and said she had used substances for over a decade. She said that her substance use would help her to escape from her anxiety. She reported inconsistent engagement with mental health services, including hospitalization for a suicide attempt by cutting in 2020. She said that when she found out she was pregnant, she attempted to discontinue use of all substances, in order to “keep my baby safe.” She said she was able to abstain from substance use with the exception of opioids, saying that she would have “psychological withdrawals.” Through her own internet research, she read that buprenorphine was the safest opioid to take during pregnancy and she started using intravenous buprenorphine from her veterinary clinic. She reported using about 0.3mg intravenous buprenorphine daily, with her last use the day prior to hospital admission
In summary, the current literature suggests that pregnant women undergoing treatment for OUD with buprenorphine-naloxone do not experience significantly different pregnancy outcomes than women undergoing treatment with other forms of MAT. The number and quality of these studies are limited; however, as the opioid crisis continues, it is expected that more women of reproductive age will conceive while taking buprenorphine-naloxone, and providers can use these results to reassure patients
Suboxone and Tooth decay
This patient’s experience of a sudden decline in her oral health without any changes in her dental hygiene practices or sugary food/beverage consumption raises the possibility that chronic use of sublingual buprenorphine/naloxone may have played a role. Possible mechanisms include buprenorphine/naloxone-induced xerostomia and immunosuppression. Therefore, clinicians may need to encourage patients on buprenorphine/naloxone maintenance to practice good dental hygiene and get regular dental checkups, and to rinse their mouths with water immediately after tablet dissolution. Further research is needed to confirm if there indeed is any association between buprenorphine/naloxone treatment and dental caries, and explore methods to minimize the risk of this important treatment option for patients with opioid dependence
Can suboxone be used for pain
Buprenorphine demonstrates unique pharmacological properties that make it an attractive medication for chronic pain patients who require opioid medications. Buprenorphine displays a partial agonist at the mu-opioid receptor, allowing potent analgesia with a better safety profile. Additionally, the medication is a Schedule III opioid with less abuse potential than traditional Schedule II opioids typically used for chronic pain. Practitioners should be aware that this medication is associated with a high proportion of side effects such as nausea, vomiting, and constipation. It is also associated with QTc prolongation, especially at higher doses. However, given the ongoing opioid crisis in the United States, buprenorphine is a valuable tool for treating chronic pain.
Can you drive on suboxone
Suboxone is a central nervous system depressant, and it can slow your reflexes and reaction times. This impact is most pronounced in people who have never taken the drug before.
In studies, researchers found that people experimenting with drugs like Suboxone had an impaired ability to drive. But people who had used the drug before at appropriate doses didn’t have the same problem.In all states, you can legally drive while using a medication like Suboxone so long as you have a valid prescription for this medication.
Your doctor should tell you when it’s safe for you to start driving once you start the medication.
Does suboxone cause constipation
Opioids induce constipation primarily by suppressing neuronal excitability in the enteric system. The circular contractile muscles have primarily inhibitory input. Opioid suppression of inhibitory neurons results in increased contractility, thereby increasing transit time. Longitudinal muscles, on the other hand, primarily receive excitatory input; opioids’ action on longitudinal muscles reduce contractility, exacerbating the constipating effects. As opposed to other side effects of opioids, the constipating effects on GI motility typically do not improve over time.10,11 With the rise of analgesic and illicit opioid use in the United States, it is important to appropriately respond to complaints of constipation by decreasing medications that may cause constipation, recommending increased intake of fiber and water, and treating with laxatives, opioid antagonists, or other medications.2 Only half of the patients on opioids experience constipation. Treatment of all patients receiving opioids would result in overtreatment; however, physician awareness of opioid-induced constipation symptoms would allow for prophylactic treatment with laxatives.
Can suboxone help with Alcohol withdrawal
The short answer is no, provided the individual is only dependent on alcohol and has not been exposed to opioids. Suboxone will not do any good for alcohol withdrawal because it is a combination of buprenorphine and naloxone, both used to treat opioid addiction.
Buprenorphine, which helps lessen the symptoms of opioid dependence, and naloxone, which reverses the effects of opioids. These two combinations are designed to prevent misuse and reduce cravings and withdrawal symptoms associated with opioid addiction.
Doctors typically do not prescribe Suboxone for alcohol withdrawal. The main treatments for alcohol withdrawal include other types of medications, like benzodiazepines, which are proven to be effective in managing withdrawal symptoms. However, if a patient has a dual diagnosis of opioid and alcohol dependency, a doctor might prescribe Suboxone to address the opioid addiction, which could indirectly influence the treatment plan for alcohol withdrawal