ASAM COVID-19 TASK FORCE RECOMMENDATIONS
TREATING PREGNANT PEOPLE WITH OPIOID USE DISORDER
A guide for addiction treatment clinicians and programs working to treat patients with substance use disorders safely and effectively during the COVID-19 pandemic1.
For additional recommendations for the Ongoing Management of the Continuum of Addiction Care during COVID-19, please click here.
Purpose of the document
To provide guidance to addiction treatment clinicians and programs on the treatment of pregnant people with addiction during the COVID-19 pandemic. In March 2020, ASAM released a focused update to the National Practice Guideline for the Treatment of Opioid Use Disorder. The COVID-19 crisis is likely to require adjustments in care for this population to balance the risks from both addiction and COVID-19. The purpose of this document is to provide guidance on adjusting that care in the current crisis, with a particular focus on Opioid Use Disorder (OUD).
Treating Pregnant People With Opioid Use Disorder
1This resource was developed by a Task Force appointed by ASAM’s Executive Council. To enable more rapid development and dissemination it was not developed through ASAM’s normal process for clinical guidance development that is overseen by the ASAM Quality Improvement Council.2 https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html (accessed 4/24/2020)
3 Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection: A Systematic Review. Huntley BJF, Huntley ES, Di Mascio D, Chen T, Berghella V, Chauhan SP Obstet Gynecol. 2020.
4 https://www.cdc.gov/mmwr/volumes/69/wr/mm6925a1.html (accessed 7-19-20)
5 https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf (accessed 4/23/2020).6
6Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2 Infection: A Systematic Review. Huntley BJF, Huntley ES, Di Mascio D, Chen T, Berghella V, Chauhan SP Obstet Gynecol. 2020
7 Transplacental transmission of SARS-CoV-2 infection. Alexandre J. Vivanti, Christelle Vauloup-Fellous, Sophie Prevot, Veronique Zupan, Cecile Suffee, Jeremy Do Cao, Alexandra Benachi & Daniele De Luca Nature Communications volume 11, Article number: 3572 (2020). https://www.nature.com/articles/s41467-020-17436-6
10 https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html (accessed 4/24/2020).
This Clinical Guidance (“Guidance”) is provided for informational and educational purposes only. It is intended to provide practical clinical guidance to ad- diction medicine physicians and others caring for individuals with substance use disorders during the COVID-19 pandemic as it unfolds. Adherence to any recommendations included in this Guidance will not ensure successful treatment in every situation. Furthermore, the recommendations contained in this Guidance should not be interpreted as setting a standard of care or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results.
The ultimate judgment regarding the propriety of any specific therapy must be made by the physician and the patient in light of all the circumstances pre- sented by the individual patient, and the known variability and biological behavior of the medical condition.
This Guidance and its conclusions and recommendations reflect the best available information at the time the Guidance was prepared. The results of future studies may require revisions to the recommendations in this Guidance to reflect new data. ASAM does not warrant the accuracy or completeness of the Guidance and assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this Guidance or for any errors or omissions.
If you are a patient or family member or friend in need of immediate assistance:
- Disaster Distress Helpline
Call 1-800-985-5990 or text TalkWithUs to 66746
- National Suicide Prevention Lifeline
Call 800-273-8255 or Chat with Lifeline
About COVID-19 Taskforce Members
If you have questions related to the guidance in this document or suggestions for additional topics, please email COVID@asam.org