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The last high-quality head-to-head comparison of buprenorphine and methadone during pregnancy was the MOTHER trial, which was published nearly 15 years ago. Here, researchers revisited the question of which medication is better to use in pregnancy in this large, carefully done, retrospective study. The results make a compelling case for buprenorphine. 

Methadone treatment for OUD typically comes with a high level of supervision whereas buprenorphine is often flexibly dosed and taken at home. Here researchers wanted to know how patients of a closely supervised methadone clinic compared with those taking buprenorphine prescribed in an office setting. The findings might surprise you.

The process of starting a patient on buprenorphine, called an induction, can be a bit tricky and puts a patient at risk of a precipitated opioid withdrawal. In this article, we discuss the three most common buprenorphine induction approaches, review the pros and cons of each, and include straightforward guidance that will help you perform a successful buprenorphine induction for your patients.

Ketamine and esketamine represent some of the most powerful rapid-acting agents in our armamentarium of treatments for depression. However, ketamine is also an addictive substance, and there is emerging evidence that the widespread use of ketamine may be causing more patient harms than we were previously aware of. Here, Dr. Trujillo discusses how to use ketamine safely in clinical practice.

As the overall prevalence of opioid use disorder has increased, so to has the prevalence of opioid use during pregnancy. Opioid use during pregnancy can put both your patient and the baby at risk, making proper treatment with MOUD essential. In this article, we outline the special considerations for the treatment of OUD during pregnancy and discuss how to prescribe MOUD safely.