Methadone has been used to treat opioid use disorder during pregnancy for decades and is considered a standard-of-care option, alongside buprenorphine.
Why medication treatment is recommended over stopping opioids: Untreated withdrawal during pregnancy carries real risk to the pregnancy — medication treatment provides steady, monitored levels instead of the instability of withdrawal or unregulated use.
Neonatal opioid withdrawal syndrome (NOWS): Some infants exposed to methadone during pregnancy experience withdrawal symptoms after birth — a recognized, generally manageable condition that hospital staff monitor and treat directly. This is not a reason to avoid treatment; it’s a known, prepared-for outcome that reflects the medication working, not failing.
Dosing during pregnancy: Methadone requirements often increase as pregnancy progresses due to physiological changes affecting how the body processes the medication — this is normal and expected, not a sign that the original dose was wrong.
Postpartum considerations: Dose needs typically shift again after delivery — close monitoring during this transition is standard practice.
Breastfeeding: Methadone is generally considered compatible with breastfeeding at most doses, though this should be confirmed with your specific care team.
Medically reviewed by [pending]. Sources: ACOG and ASAM joint guidance on opioid use disorder in pregnancy.