A 25-year-old woman, gravida 3 para 2 at 12 weeks of gestation, with two prior cesarean deliveries, presents for prenatal care. She is in treatment for opioid use disorder on extended-release naltrexone injection, with a history of opioid overdose, relapse, and poor treatment adherence on methadone and buprenorphine. She asks, “Is it safe for my baby if I continue on this medication? How will you manage my postoperative pain?”
Naltrexone, an opioid antagonist used for the treatment of opioid use disorder, is not well- studied in pregnancy and may pose challenges for analgesia and anesthesia surrounding delivery.
Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, Minneapolis, Minnesota; and Virginia Commonwealth University, Richmond, Virginia.
Corresponding author: Cresta W. Jones, MD, Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, 606 24th Avenue, S, #401, Minneapolis, MN 55455; email: email@example.com.
Financial Disclosure The authors did not report any potential conflicts of interest.
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