{"id":268386,"date":"2026-09-16T15:24:44","date_gmt":"2026-09-16T19:24:44","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&#038;p=268386"},"modified":"2026-09-18T16:27:34","modified_gmt":"2026-09-18T20:27:34","slug":"professors-receive-3-7-million-nih-grant-to-study-effectiveness-of-higher-dosage-buprenorphine-among-pregnant-women-with-opioid-use-disorder","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2026\/professors-receive-3-7-million-nih-grant-to-study-effectiveness-of-higher-dosage-buprenorphine-among-pregnant-women-with-opioid-use-disorder\/","title":{"rendered":"Professors Receive $3.7 Million NIH Grant to Study Effectiveness of Higher-Dosage Buprenorphine among Pregnant Women with Opioid Use Disorder"},"content":{"rendered":"\t<div class=\"wp-block-editorial-leadin sphnews-block-editorial-leadin is-style-default-alt has-media has-media-focus-center-middle has-light-theme\">\n\t\t<div class=\"container-lockup\">\n\n\t\t\t<div class=\"wp-block-leadin-media\">\n\t\t\t\t\n\t\t\t\t<img width=\"1280\" height=\"800\" src=\"\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine.png\" class=\"\" alt=\"Young-pregnant-woman-taking-medicine\" loading=\"lazy\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine.png 1280w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-636x398.png 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-1024x640.png 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-768x480.png 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-755x472.png 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-900x563.png 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/09\/Young-pregnant-woman-taking-medicine-1200x750.png 1200w\" sizes=\"(max-width: 1280px) 100vw, 1280px\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\n\t\t\t\n\t\t\t\t<div class=\"container-words-outer\">\n\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"container-words-inner\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"wp-prepress-tag\">Featured<\/span>\n\t\t\t\t\t\t\t\t<h1 class=\"head\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>Professors Receive $3.7 Million NIH Grant to Study Effectiveness of Higher-Dosage Buprenorphine among Pregnant Women with Opioid Use Disorder<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"deck\">Jake Morgan (SPH&#8217;17), of the School of Public Health, and Ashley Leech (SPH&#8217;17), of Vanderbilt University School of Medicine, will evaluate the health and economic consequences of subpar buprenorphine dosing among Medicaid-covered pregnant women to guide evidence-based dosing strategies that will improve maternal and infant outcomes.<\/h4>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div>\n\n\t\t\n\t<\/div>\n\n\t\n<div class=\"wp-prepress-component-metabar js-block-editorial-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">September 16, 2026<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t\t\t\t<ul data-credit-type=\"By\">\n\t\t\t\t\t\t<li><a href=\"https:\/\/www.bu.edu\/sph\/news\/authors\/jillian-mckoy\/\">Jillian McKoy<\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t\n\n\n<p>Accidental drug overdose is the <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMc2512078\">leading<\/a> cause of maternal deaths during pregnancy and one year postpartum in many US states, making access to effective opioid use disorder (OUD) medications a critical public health need for this population.&nbsp;<\/p>\n\n\n\n<p>Buprenorphine, one of three drugs approved by the US Food and Drug Administration for long-term treatment of OUD, is one of the most <a href=\"https:\/\/www.samhsa.gov\/substance-use\/treatment\/options\/buprenorphine\">effective<\/a> and accessible medications to treat this disorder. However, pregnancy accelerates the metabolization of buprenorphine, meaning that higher doses are <a href=\"https:\/\/www.ajog.org\/article\/S0002-9378(16)30816-X\/abstract\">often needed<\/a> in order for pregnant patients to avoid withdrawal. Increased doses are often required even for people who are not pregnant, as fentanyl\u2014which is up to <a href=\"https:\/\/www.cdc.gov\/stop-overdose\/caring\/fentanyl-facts.html\">50 times stronger<\/a> than heroin\u2014continues to drive the opioid overdose epidemic in the US.&nbsp;<\/p>\n\n\n\n<p>Despite research <a href=\"https:\/\/www.nih.gov\/news-events\/news-releases\/higher-doses-buprenorphine-may-improve-treatment-outcomes-people-opioid-use-disorder\">supporting<\/a> increased dosages as needed for this medication, buprenorphine treatment during pregnancy is inconsistent and patients often receive inadequate dosages. Researchers at the School of Public Health and Vanderbilt University School of Medicine are addressing this public health issue with a <a href=\"https:\/\/reporter.nih.gov\/search\/991uPIRbhEeXGSWBvO3aPw\/project-details\/11340887#details\">$3.7 million grant<\/a> from the National Institute on Drug Abuse. <a href=\"https:\/\/www.bu.edu\/sph\/profile\/jake-morgan\/\">Jake Morgan<\/a> (SPH&#8217;17), research assistant professor of health law, policy &amp; management at SPH, and <a href=\"https:\/\/www.vumc.org\/health-policy\/person\/ashley-leech-phd-ms\">Ashley Leech<\/a> (SPH&#8217;17), assistant professor of health policy at Vanderbilt, received the five-year award to evaluate the health and economic consequences of suboptimal buprenorphine dosing in pregnancy. Both professors are SPH alums who received their PhD in <a href=\"https:\/\/www.bu.edu\/sph\/education\/degrees-and-programs\/doctor-of-philosophy-phd\/doctor-of-philosophy-in-health-services-and-policy-research\/\">Health Services and Policy Research<\/a> in 2017.<\/p>\n\n\n\n<p>\u201cDespite decades of research on opioid use disorder in pregnancy, clinical guidelines on buprenorphine dosing remain vague and inconsistent, and state Medicaid policies often go even further, capping doses in ways that are not grounded in the evidence,\u201d says Morgan, a health services researcher whose work focuses on the opioid overdose epidemic and how to improve access and retention to OUD medications. \u201cPregnant women generally <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3555224\/\">metabolize<\/a> drugs differently than non-pregnant individuals, due to physical and hormonal changes, and data suggest that up to 90 percent of pregnant women who experience opioid use disorder require higher doses of buprenorphine. Our work aims to better understand whether and to what extent pregnant women benefit from higher doses of buprenorphine, and how this insight can inform dosing strategies and policy changes to improve maternal and infant outcomes.\u201d<\/p>\n\n\n\n<p>Buprenorphine works to <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0306460322003550?via%3Dihub\" target=\"_blank\" rel=\"noreferrer noopener\">reduce<\/a> cravings and ease withdrawal symptoms, lowering the risk of overdose. It is also the first OUD medication that can be distributed in <a href=\"https:\/\/www.npr.org\/2021\/01\/15\/957115368\/trump-administration-will-let-more-doctors-prescribe-drug-to-fight-opioid-addict\" target=\"_blank\" rel=\"noreferrer noopener\">doctor\u2019s offices<\/a> and <a href=\"https:\/\/www.drugtopics.com\/view\/pharmacists-now-authorized-to-independently-prescribe-buprenorphine\" target=\"_blank\" rel=\"noreferrer noopener\">pharmacies<\/a>, following a December 2025 law intended to increase access to this medication, particularly as fentanyl continues to drive the <a href=\"https:\/\/www.dea.gov\/resources\/facts-about-fentanyl\" target=\"_blank\" rel=\"noreferrer noopener\">opioid crisis<\/a> in America. A dose of daily buprenorphine administered under the tongue typically <a href=\"https:\/\/www.healthline.com\/health\/drugs\/buprenorphine-dosage\" target=\"_blank\" rel=\"noreferrer noopener\">begins<\/a> at 2-4 mg, with the standard target dosage <a href=\"https:\/\/www.drugs.com\/dosage\/buprenorphine.html#Usual_Adult_Dose_for_Opioid_Use_Disorder___Maintenance\" target=\"_blank\" rel=\"noreferrer noopener\">reaching<\/a> 16-24 mg, but some people can see benefit up to 32 mg.&nbsp;<\/p>\n\n\n\n<div class=\"wp-block-bu-pullquote sphnews-block-bu-pullquote has-image-focus-center-middle\"><div class=\"wp-block-bu-pullquote-inner\"><figure><\/figure><blockquote><div class=\"container-lockup\"><div class=\"container-icon-outer\"><div class=\"container-icon-inner\"><\/div><\/div><div class=\"container-text\"><hr\/><div class=\"quote-sizing\">We hope to show that increasing buprenorphine dosing during pregnancy is both an ethical and a cost-effective decision that can improve health outcomes for mothers and their babies.<\/div><footer class=\"caption\">Jake Morgan, research assistant professor of health law, policy &amp; management.<\/footer><hr\/><\/div><\/div><\/blockquote><\/div><\/div>\n\n\n\n<p>The team will focus on studying pregnant women who receive Medicaid, as state Medicaid programs <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8339176\/\" target=\"_blank\" rel=\"noreferrer noopener\">cover<\/a> more than 80 percent of pregnant women with OUD in the US. However, many Medicaid programs cap daily dosages of this medication, and many states even discourage physicians from increasing this dosage during a patient\u2019s pregnancy.<\/p>\n\n\n\n<p>\u201cCurrent buprenorphine dosing recommendations for pregnant and postpartum patients provide little guidance on dose adjustment, and therapeutic inertia\u2014a known phenomenon in pregnancy often driven by fetal safety concerns and clinical uncertainty\u2014can lead to dangerous underdosing,\u201d says Leech. \u201cMedicaid pregnancy guidance around buprenorphine dosing in some states includes language that implies dose minimization is the goal, which contradicts decades of evidence demonstrating the clinical needs during pregnancy.\u201d&nbsp;<\/p>\n\n\n\n<p>For the study, Morgan and Leech will collaborate with researchers from Boston Medical Center to first assess national and state-level differences in buprenorphine dosing between pregnant and non-pregnant women with OUD, and will examine how dosing has evolved over time and in response to fentanyl use. The team will also examine the effectiveness of different buprenorphine thresholds and how those dosages advance or inhibit sustained treatment.<\/p>\n\n\n\n<p>Notably, the researchers will also estimate the long-term health and economic consequences of suboptimal buprenorphine dosing by applying a decision analytic model that will be able to project multiple outcomes among pregnant and postpartum women experiencing OUD, including treatment discontinuation, postpartum treatment continuation, overdose, infant outcomes, life expectancy, and healthcare utilization, as well as the cost-effectiveness of restricting or increasing Medicaid dosing.<\/p>\n\n\n\n<p>\u201cBy using decision analytic modeling, we can leverage evidence on dosing effects and quantify outcomes that are infeasible to assess in clinical trials, such as maternal and infant lives lost and the long-term costs of untreated OUD or suboptimal care,\u201d Leech says. \u201cDecision analysis provides a rigorous method for comparing the tradeoffs of different coverage decisions.\u201d&nbsp;<\/p>\n\n\n\n<p>\u201cUltimately, we hope to show that increasing buprenorphine dosing during pregnancy is both an ethical and a cost-effective decision that can improve health outcomes for mothers and their babies,\u201d Morgan says.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Accidental drug overdose is the leading cause of maternal deaths during pregnancy and one year postpartum in many US states, making access to effective opioid use disorder (OUD) medications a critical public health need for this population.&nbsp; Buprenorphine, one of three drugs approved by the US Food and Drug Administration for long-term treatment of OUD, [&hellip;]<\/p>\n","protected":false},"author":15205,"featured_media":268424,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[1894,2136,1841,4751,2137,2157,1781],"bu-publication":[3516],"sphnews-article-category":[3519,3520,3531,3535,3540],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[3221],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/268386"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/15205"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=268386"}],"version-history":[{"count":11,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/268386\/revisions"}],"predecessor-version":[{"id":268527,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/268386\/revisions\/268527"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/268424"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=268386"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=268386"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=268386"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=268386"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=268386"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=268386"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=268386"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=268386"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}