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Heroin Addiction and Related Clinical Problems: 2000, 02, 1 (pages: 1 - 8)

Women, pregnancy and methadone

Finnegan L. P.

Summary: The abuse of psychoactive drugs by women of childbearing age has placed an untoward burden on the fetus, new-born and child. This included: marijuana-2.9%; cocaine-1.1%; with lesser percentages of other illicit drugs. Effective methadone maintenance prevents the onset of opioid abstinence syndrome for 24-36 hours, reduces or eliminates drug craving, and blocks the euphoric effects of illicit narcotics. Because of the extremely high risk environment of the pregnant drug-dependent woman, her infant is predisposed to a host of neonatal problems. Infants exposed to methadone in-utero, with mothers receiving prenatal care, generally have higher birth weights and a decreased incidence of premature birth and other medical complications. Infant medical complications are usually influenced by maternal prenatal care, incidence of maternal complications, and multiple drug use by the mother causing an unstable intrauterine milieu complicated by withdrawal and overdose. Infants exposed to methadone generally have a higher incidence and a longer duration of abstinence. The majority of this increased cost has stemmed from drug-affected infants born with significant/major medical needs and premature delivery related to maternal drug abuse. Over three-fourths (77%) of drug-affected infants have had significant/major medical needs compared with 27% of all new-borns. Seventeen per cent of drug-affected infants were born prematurely, compared with 6% of all new-borns. The total cost in 1997 for longer, specialised, and more intensive medical care for Florida's drug-affected infants is estimated at $ 6.7 million.