Do Hospitals Test Newborns for Suboxone?

Hospitals do not routinely test newborns for buprenorphine/naloxone (Suboxone).

Newborn drug testing may be performed by a hospital in certain circumstances if medical providers believe the infant’s mother engaged in high-risk behaviors due to a history of drug misuse or substance use disorder, had minimal or no prenatal care, or underwent unexplained obstetric events.

What Is Neonatal Abstinence Syndrome?

‍Neonatal abstinence syndrome (NAS) is a constellation of symptoms in newborns due to maternal drug use during pregnancy. [1] It refers broadly to any drug, but NAS is most often seen in newborns whose mothers were exposed to cocaine, opioids, alcohol, nicotine, or certain psychiatric medications including SSRIs. NAS is generally characterized by irritability, a high-pitched cry, poor sleep, and uncoordinated sucking reflexes that lead to poor feeding.[2] 

The long-term health outcomes for babies with NAS are not completely understood, and this is an active area of research within medicine. However, it is currently believed that the harms of relapse or untreated addiction to the patient and baby far outweigh the harms of NAS, and so women who are in treatment for OUD and who are on MAT (either methadone or Suboxone) are encouraged to continue their treatment during pregnancy. 

OUD Treatment Is Recommended and Crucial During Pregnancy

All major authorities on maternity care, including the American College of Obstetricians & Gynecologists (ACOG) and the American Society of Addiction Medicine (ASAM), agree that untreated opioid use disorder during pregnancy is dangerous. They all universally support continued treatment with MAT for expectant mothers with OUD, and also support the initiation of MAT in pregnant women who have been previously untreated for OUD. 

Many pregnant women are on buprenorphine alone (Subutex) or buprenorphine with naloxone (Suboxone) during pregnancy. While infants can experience mild withdrawal symptoms if their mother is taking buprenorphine during pregnancy, these symptoms are usually self-limited to the first few days of life. Just like in adults, withdrawal symptoms from Suboxone and other opioids can be extremely unpleasant but are almost never life-threatening or dangerous. 

It is generally thought that the risks of relapse during pregnancy are more dangerous than the risks of taking buprenorphine during pregnancy. Thus, most providers strongly recommend the continuation of buprenorphine during pregnancy.

What do I need to Know About The Postpartum Period if I am on Methadone or Suboxone?

While hospitals do not routinely test babies for Suboxone or methadone exposure, doctors will be on the look-out for symptoms of NAS in any newborn whose mother was known to be on these medications during pregnancy. The reason for this is to help monitor and keep babies healthy as they go through either minor or severe withdrawal.

It is important to disclose your medications to your doctors so that they can prepare you and your baby to get the best medical support after delivery. Babies at risk for NAS usually require a few days or even weeks of additional monitoring in the hospital after delivery. Talk openly with your doctor about what you can expect after delivery. The more you are open and honest with them, the better they can help prepare you and your baby for postpartum care.

Sources

1. Neonatal Abstinence Syndrome. Stanford University. https://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387. Accessed July 2022.
2. Opioid Use and Opioid Use Disorder in Pregnancy. The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy. August 2017. Accessed July 2022.