TY - JOUR T1 - Is periconceptional opioid use safe? JF - Canadian Family Physician JO - Can Fam Physician SP - 431 LP - 433 VL - 61 IS - 5 AU - Felix Chan AU - Gideon Koren Y1 - 2015/05/01 UR - http://www.cfp.ca/content/61/5/431.abstract N2 - Question A patient in my practice who takes buprenorphine for chronic pain would like to conceive. Is it safe for her to continue taking her medication? Answer The literature regarding periconceptional opioid use is conflicted as to whether opioids pose an elevated risk of birth defects. Confounding factors such as socioeconomic status, stress, and alcohol consumption might play a role. The first trimester of pregnancy is the critical period of development for many organ systems in the embryo. A chemical or environmental insult is more likely to produce major congenital malformations such as neural tube defects or mental retardation if it occurs within this window. Medical practitioners should judiciously consider a risk-benefit analysis before making their decisions. ER -