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Heroin Addiction and Related Clinical Problems: 2023, 25, N2 (pages: 23 - 28)

Maternal Methadone Split Dosing in Pregnancy

Flores C., and Riaz U.

Summary: Amid the opioid pandemic, methadone treatment has emerged as the standard of care to facilitate patients with reducing their use of narcotics. The inherent physical properties of the treatment promote a long-sustained release from tissues that extends its half-life and minimizes the need for increased dosing. In pregnant patient populations, physiological changes during gestation decrease the serum concentration of methadone. Current dosing protocols do not address the elevated disposition of pregnant patients to developing early withdrawal symptoms that maladaptively affect mother and child. This calls to question the need for improved dosing protocols tailored towards meeting the needs of this vulnerable population. Recent studies highlight the benefits of using split-dosing to prevent over-medication and achieve longer-lasting serum concentrations. The modified dosing protocol underlines the advantages of utilizing a split-dosing regimen to reduce the need for increased methadone dosing while enhancing healthier outcomes during the post-partum period.