Maternal Buprenorphine-naloxone Treatment and the Infant

Inclusion Criteria: * Current opioid use disorder (OUD) as defined by DSM V criteria * singleton pregnancies, generally uncomplicated by conditions that jeopardize pregnancy outcome * Gestation less than 24 weeks Exclusion Criteria: * Complications of pregnancy, including gestational diabetes, polyhydramnios, hypertension, placenta previa or significant risk of preterm delivery; * Evidence of fetal malformation detected by prenatal ultrasound; * Significant general maternal health problems that can affect fetal functioning, including Type I or gestational diabetes, alterations in thyroid functioning, HIV infection or hypertension; * Significant maternal psychopathology that would preclude informed consent; * Alcohol use disorder per DSM V criteria (see ascertainment methods below) * Women stable on methadone maintenance (defined as more than 3 consecutive days of dosing) * Women coming to treatment reporting "street" methadone use (for more than 3 consecutive days * Women not planning to receive obstetric care at the Center for Addiction and Pregnancy; - Women not planning to deliver their infants at Johns Hopkins Bayview Medical center * Women planning for adoption of their infant.