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CASE REPORT
A woman's experience of tapering from buprenorphine during pregnancy
  1. Gabrielle Katrine Welle-Strand1,2,
  2. Odd Kvamme3,
  3. Andreas Andreassen4,
  4. Edle Ravndal1
  1. 1Norwegian Centre for Addiction Research (Seraf), University of Oslo, Oslo, Norway
  2. 2Department of Psychiatry and Substance Use, Norwegian Directorate of Health, Oslo, Norway
  3. 3Leirvik legekontor, Leirvik, Norway
  4. 4Department of Pediatrics, Helse Fonna, Haugesund, Norway
  1. Correspondence to Dr Gabrielle Katrine Welle-Strand, gwe{at}helsedir.no

Summary

Although opioid maintenance treatment (OMT) is the treatment of choice for pregnant opioid-dependent patients, some professionals argue that tapering the medication dose will reduce the severity of neonatal abstinence syndrome (NAS). This case description is based on the patient's detailed blog, and medical records from her general practitioner and the hospital. The patient is an employed, 32-year-old drug-abstinent woman in OMT. Her taper from 24 mg of buprenorphine started at 14 weeks’ gestation and is slow, with withdrawal symptoms increasing gradually. In pregnancy week 31, she is off buprenorphine but she has severe withdrawal symptoms. She chose to go back on 4 mg of buprenorphine. The patient's son was born in pregnancy week 38+3, weighs 2950 g and does not require pharmacological treatment for NAS. The fetus most probably did experience fetal stress during the patient's tapering. It was the right decision by the patient to go back on buprenorphine.

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