Advances in Obstetric AnesthesiaPeripartum Anesthetic Management of the Opioid-tolerant or Buprenorphine/Suboxone-dependent PatientPAN, AILEEN MD*,†; ZAKOWSKI, MARK MD*Author Information *Department Anesthesiology, Section of Obstetric Anesthesiology, Cedars-Sinai Medical Center †Anesthesiology, Adjunct, Charles Drew University of Medicine and Science, Los Angeles, California The authors declare that they have nothing to disclose. Correspondence: Mark Zakowski, MD, Department Anesthesiology, Section of Obstetric Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd #8211, Los Angeles, CA. E-mail: firstname.lastname@example.org Clinical Obstetrics and Gynecology: June 2017 - Volume 60 - Issue 2 - p 447-458 doi: 10.1097/GRF.0000000000000288 Buy Metrics Abstract Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed. The effects of maternal management on neonatal abstinence syndrome are also reviewed. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.