Many pregnant women in recovery from opioid use disorder hear the same worry: if you stay on your medication, your baby will have a harder withdrawal after birth. A new study says cutting the dose does not fix that problem, and it can put the mother at risk.
What happened
On 10/29, researchers led by the University of Maryland School of Medicine published a research letter in JAMA Network Open looking at 92 pregnancies and 94 newborns. Every mother had taken methadone or buprenorphine for at least 30 days before delivery.
The team measured the medications directly in umbilical cord tissue at birth. Neither the mother’s dose nor the drug levels in the cord tissue were linked to how severe the baby’s withdrawal was, according to the JAMA Network summary.
Severe newborn withdrawal happened in about 44 percent of babies in the study. It was more common with methadone than with buprenorphine, but dose still did not predict it. “Cutting the dose doesn’t give the baby an easier withdrawal. It only puts the mother at risk,” lead author Dr. Courtney Townsel said in the University of Maryland announcement.
The study is small, and the authors note limited racial and ethnic diversity. It shows no link between dose and withdrawal severity. It does not prove medication has no effect on newborns, and babies exposed to opioids still need monitoring and care.
What this means for Las Vegas and Nevada
This matters here. In 2022, Clark County had 295 hospital admissions for neonatal abstinence syndrome, a rate of 11.9 per 1,000 live births and the highest in ten years of data, according to the Nevada Department of Health and Human Services 2024 Clark County profile. That count covers exposure to many substances, not only treatment medications.
The bigger danger is to mothers. The University of Maryland release notes that opioid use disorder is a leading cause of death during pregnancy and the months after birth. Lowering or stopping medication raises the risk of relapse and overdose, while fentanyl and dangerous drug mixtures remain in the local supply, as we covered in our recent look at local overdose trends.
How Vegas Stronger helps
Vegas Stronger treats opioid use disorder with medication-assisted treatment combined with counseling. Our detox and MAT services include buprenorphine (Suboxone, Subutex) and naltrexone options, with prescribers on staff to address co-occurring mental health conditions.
If you are trying to understand the difference between the two medications in this study, our guide on Suboxone vs. methadone explains how each one works. Medication decisions in pregnancy should always be made with both your prescriber and your OB.
Recovery also depends on stable housing and practical support. Our list of support resources for women in Las Vegas includes local programs for pregnant and parenting women.
Staying in treatment protects the mother, and a healthy, stable mother is one of the best things a newborn can have.
If you or a loved one is affected
If you are pregnant and taking methadone or buprenorphine, do not lower or stop your dose on your own. Talk with your prescriber and OB together, and ask how your baby will be monitored after birth.
If you are a partner, parent or friend, the most useful thing you can do is help her stay in care. Offer rides to appointments, help with insurance calls and keep judgment out of the conversation. Our article on family involvement in treatment has more ideas.
If someone is not yet in treatment, our guide to same-day opioid addiction help in Las Vegas walks through first steps. You can also call Vegas Stronger at (702) 202-6647, visit us at 916 N. Main St., or contact us online.
For a mental health crisis, call or text 988. For free, confidential treatment referrals any time, call the SAMHSA National Helpline at 1-800-662-4357.
Frequently asked questions
Does a higher methadone or buprenorphine dose cause worse withdrawal in newborns?
In this 94-baby study, no. Neither the mother’s dose nor cord tissue drug levels were linked to withdrawal severity.
Should I lower my dose while pregnant?
Do not change your dose without your prescriber. The researchers say doses should be set to treat the mother’s opioid use disorder, not lowered to try to prevent newborn withdrawal.
Is buprenorphine or methadone better in pregnancy?
Severe withdrawal was more common with methadone in this study, but both are standard treatments. The right choice depends on the person, so decide with your care team.
