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Heroin Addiction and Related Clinical Problems: 2020, 22, N1 (pages: 17 - 22)

Stigma against pregnant women addicted to opioids with a case report

Mehić-Basara N., Marjanović-Lisac S., and Grabovica M.

Summary: Background: Opiate addicts are often stigmatized; this applies especially to pregnant women addicted to opiates, due both to stigma expressed by the general population and also by health professionals working in other fields of medicine. Methods: The study is epidemiological and retrospective. The sample included 45 pregnant addicted women on agonist opioid therapy (AOT). The study used medical records: the Pompidou form, medical histories, discharge letters, treatment protocols, and therapy follow-up lists. Results: Of the total sample, 42 pregnant women were on methadone and 3 on buprenorphine treatment, 69% were in AOT before pregnancy, and 31% started AOT after they found out that they were pregnant. A majority (77.8%) had a partner who was also an addict, and as many as 20% had some other mental disorder in addition to diagnosis F11.2. From baseline, 57.8% of respondents remained stably in the AOT programme during pregnancy. All pregnancies ended in childbirth, mostly with premature delivery. E.K. gave birth prematurely after bleeding and pain, but was discharged by the Gynaecological Clinic staff only two hours after delivery. The patient walked 1.5 km and, in an extremely exhausted condition, reached the addiction centre. In the period before birth, due to various subjective problems, the gynaecologist sought the opinion of an internist, pulmonologist, haematologist, cardiologist, infectologist and nephrologist. Conclusions: The use of agonist opioid therapy during pregnancy allows for continuous professional monitoring of the pregnant woman and a better pregnancy outcome, but not the reduction of stigma, which lives on in the minds both of the general population and many healthcare professionals.