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Substance Use Disorder Treatment

Image of mother happily holding her infant child.

There are a variety of definitions of treatment. The American Society of Addiction Medicine (ASAM) defines the treatment of addiction as follows:

"The use of any planned, intentional intervention in the health, behavior, personal, and/or family life of an individual suffering from alcohol use disorder or from another drug addiction, and which is designed to facilitate the affected individual to achieve and maintain sobriety, physical, spiritual, and mental health, and a maximum functional ability."

Pregnancy is a unique opportunity for women to engage in substance use disorder treatment, typically they have additional motivations to get needed help. In North Carolina, a range of treatment levels are available to pregnant women, from outpatient to long-term residential treatment. A comprehensive clinical substance use disorder assessment is completed by a licensed professional, and is necessary to determine the best level of treatment for an individual woman to effectively begin her path to recovery.

Women who are pregnant and are in substance use disorder treatment should be provided information about what to expect at the time of delivery if her infant is determined to be “substance affected,” and what the Plan of Safe Care is (see POSC FAQ Prenatal Care handout).

Women who are pregnant, and are in treatment for an opioid use disorder, are recommended to have medication assisted treatment (MAT) as a part of their comprehensive substance use disorder treatment. Research has demonstrated that people with opioid use disorders are more likely to enter long term recovery with MAT as a part of treatment. Research has also demonstrated that birth outcomes are better for women with opioid use disorders when MAT is part of their treatment during pregnancy. MAT for opioid use disorders includes the use of methadone or buprenorphine. 

"Buprenorphine and methadone have both been shown to be safe and effective treatments for opioid use disorder during pregnancy."
- National Institute on Drug Abuse, July 2017

The timing of entry into treatment and aspects of a woman's treatment plan varies and can impact what occurs at the time of delivery. The sooner a woman enters treatment the better birth outcomes and recovery outcomes she is likely to have.