What is the preferred medication for treating opioid use disorder during pregnancy?

Buprenorphine is the preferred medication for treating opioid use disorder during pregnancy due to its safety profile and efficacy. It is a partial agonist at the mu-opioid receptor, which means it activates the receptor but to a lesser degree than full agonists like methadone. This property helps to reduce withdrawal symptoms and cravings while minimizing the risk of overdose, making it a safer option for both the mother and the developing fetus.

Buprenorphine also has a lower risk of neonatal withdrawal syndrome compared to other options. This is particularly important as the management of opioid use disorder in pregnant individuals aims to protect both maternal health and fetal development. Methadone, while effective, is associated with a higher potential for causing withdrawal symptoms in the newborn and necessitates a more intensive monitoring process.

Other options, such as bupropion, are not indicated for opioid use disorder and naloxone, though critical for opioid overdose prevention, does not treat opioid use disorder itself. Therefore, buprenorphine stands out as the first-line treatment in this context, aligning with clinical guidelines and research supporting its use in pregnant women with opioid use disorder.