A 29-year-old pregnant woman is referred to the psychiatric-mental health nurse practitioner for medication-assisted treatment (MAT) for opioid use disorder (OUD). Which of the following will the PMHNP prescribe?

Choice A reason: Naloxone is used for emergency reversal of opioid overdose, not for maintenance therapy. It is not appropriate for MAT in pregnancy and does not address withdrawal or cravings. Choice B reason: Naltrexone is contraindicated in pregnancy due to limited safety data and the risk of precipitating withdrawal. It requires complete detoxification before initiation, which is not feasible or safe during pregnancy. Choice C reason: Buprenorphine is a partial opioid agonist and is considered safe and effective for use during pregnancy. It reduces cravings and withdrawal symptoms and is preferred over methadone in many cases due to lower risk of neonatal abstinence syndrome and better maternal outcomes. Choice D reason: Buprenorphine/Naloxone combination is generally avoided during pregnancy because naloxone can precipitate withdrawal in the fetus. Monotherapy with buprenorphine is the recommended approach for pregnant women with OUD.