Postpartum Plan for Opioid-Agonist Medication

  • Current evidence does not indicate that immediate dose decreases of methadone or buprenorphine are needed postpartum. Importantly, rapid dose reduction should be avoided due to the risk of relapse. Special attention for drowsiness is warranted.
  • Pay special attention to the potential for women to relapse and return to illicit drug use, especially following breastfeeding cessation and at 3-6 months postpartum. Anecdotal evidence suggests that 3-6 months postpartum is a particularly vulnerable time for a woman in recovery, and a period of high risk for return to use. Encourage mothers at this stage to continue participating in home-visiting programs to receive parenting support and other recovery support services (or make a referral to a home-visiting if the woman has not been referred previously or declined an initial referral).
  • Ensure each woman has a follow-up appointment with BOTH her medication provider and substance-use disorder counselor.