A 27-year-old primigravid with a history of opioid use disorder, on buprenorphine, presented to the OB suite in active labor. She underwent an emergent cesarean section under a spinal anesthetic due to persistent late decelerations. Her operative course was uneventful. Postoperatively, she complains of unrelenting pain around the incision site.

Opioid use disorder is defined as a chronic disease characterized by tolerance, craving, inability to control use, and continued use despite adverse consequences. This condition results in significant impairment and disability in daily activities at home and at work (asamonitor.pub/3ywlSdb). Opioid use in pregnancy poses a paramount public health concern for the pregnant patient and the fetus. There has been an escalation in opioid use in pregnancy, paralleling the increase seen in the nonpregnant population during the opioid epidemic.

According to the Centers for Disease Control and Prevention, the national prevalence of opioid use disorder in the...

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