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Lund IO, Fitzsimons H, Tuten M, et al. Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes. Subst Abuse Rehabil. 2012;3:17-25doi: 10.2147/SAR.S26288.
Lund, I. O., Fitzsimons, H., Tuten, M., Chisolm, M. S., O'Grady, K. E., & Jones, H. E. (2012). Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes. Substance abuse and rehabilitation, 317-25. https://doi.org/10.2147/SAR.S26288
Lund, Ingunn O, et al. "Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes." Substance abuse and rehabilitation vol. 3 (2012): 17-25. doi: https://doi.org/10.2147/SAR.S26288
Lund IO, Fitzsimons H, Tuten M, Chisolm MS, O'Grady KE, Jones HE. Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes. Subst Abuse Rehabil. 2012 Feb 01;3:17-25. doi: 10.2147/SAR.S26288. eCollection 2012. PMID: 24474873; PMCID: PMC3889178.
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Subst Abuse Rehabil. 2012 Feb 01;3:17-25. doi: 10.2147/SAR.S26288. eCollection 2012.

Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes.

Substance abuse and rehabilitation

Ingunn O Lund, Heather Fitzsimons, Michelle Tuten, Margaret S Chisolm, Kevin E O'Grady, Hendrée E Jones

Affiliations

  1. SERAF-Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
  3. Department of Psychology, University of Maryland, College Park, MD.
  4. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD ; Substance Abuse Treatment evaluations and interventions Research Program, RTI International, Research Triangle Park, NC, USA.

PMID: 24474873 PMCID: PMC3889178 DOI: 10.2147/SAR.S26288

Abstract

Pregnancy can motivate opioid-dependent women to seek substance abuse treatment. Research has demonstrated that although prenatal exposure to buprenorphine results in less severe neonatal abstinence syndrome (NAS) relative to prenatal methadone exposure, the maternal and other neonatal outcomes are similar for the two medications. Maternal and neonatal outcomes for opioid-dependent pregnant women receiving these medications have not been systematically ompared with methadone-assisted withdrawal. The present study provides an initial assessment of the relative efficacy of both methadone and buprenorphine maintenance versus methadone-assisted withdrawal in terms of neonatal and maternal delivery outcomes. Data were derived from (1) the MOTHER (Maternal Opioid Treatment: Human Experimental Research) study at the Johns Hopkins University Bayview Medical Center (JHBMC), or (2) retrospective records review of women who underwent methadone-assisted withdrawal at the JHBMC during the time period in which participants were enrolled in the MOTHER study. Compared with the methadone maintenance group, the methadone-assisted withdrawal group had a significantly lower mean NAS peak score (Means = 13.7 vs 7.0; P = 0.002), required a significantly lower mean amount of morphine to treat NAS (Means = 82.8 vs 0.2; P < 0.001), had significantly fewer days medicated for NAS (Means = 31.5 vs 3.9; P < 0.001), and remained in the hospital for a significantly fewer number of days, on average (Means = 24.2 vs 7.0; P < 0.019). Compared with the buprenorphine maintenance group, the methadone-assisted withdrawal group required a significantly lower mean amount of morphine to treat NAS (Means = 8.2 vs 0.2; P < 0.001) and significantly fewer days medicated for NAS (Means = 12.0 vs 3.9; P = 0.008). Findings suggest that it is possible for some opioid-dependent pregnant women to succeed with methadone-assisted withdrawal. Future research needs to more fully evaluate the potential benefits and risks of methadone-assisted withdrawal for the maternal-fetal dyad.

Keywords: buprenorphine; detoxification; methadone; neonates; pregnancy; women

References

  1. J Pharmacol Toxicol Methods. 1999 Oct;42(2):61-6 - PubMed
  2. Am J Addict. 2008 Sep-Oct;17(5):372-86 - PubMed
  3. J Subst Abuse Treat. 1996 Jul-Aug;13(4):321-9 - PubMed
  4. Early Hum Dev. 2009 Apr;85(4):271-2 - PubMed
  5. Neurotoxicol Teratol. 2011 Mar-Apr;33(2):240-3 - PubMed
  6. Addiction. 2012 Nov;107 Suppl 1:36-44 - PubMed
  7. J Nerv Ment Dis. 1993 Aug;181(8):509-13 - PubMed
  8. Drug Alcohol Depend. 2005 Jul;79(1):1-10 - PubMed
  9. J Pharmacol Exp Ther. 1988 Oct;247(1):47-53 - PubMed
  10. N Engl J Med. 2010 Dec 9;363(24):2320-31 - PubMed
  11. Addiction. 2012 Nov;107 Suppl 1:28-35 - PubMed
  12. Drug Alcohol Depend. 2008 Jul 1;96(1-2):69-78 - PubMed
  13. J Psychoactive Drugs. 2002 Oct-Dec;34(4):339-46 - PubMed
  14. Curr Opin Psychiatry. 2008 May;21(3):255-9 - PubMed
  15. Pediatrics. 2004 Jun;113(6):1677-85 - PubMed
  16. Addiction. 2008 Sep;103(9):1429-40 - PubMed
  17. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006318 - PubMed
  18. J Nerv Ment Dis. 2006 Nov;194(11):826-32 - PubMed
  19. Subst Use Misuse. 2007;42(6):961-74 - PubMed
  20. Addiction. 2007 Feb;102(2):264-70 - PubMed
  21. J Subst Abuse Treat. 2003 Jun;24(4):363-7 - PubMed
  22. Drug Alcohol Depend. 1997 Oct 25;48(1):33-41 - PubMed
  23. J Subst Abuse Treat. 2004 Jul;27(1):31-8 - PubMed
  24. J Psychoactive Drugs. 1991 Apr-Jun;23(2):165-76 - PubMed
  25. Drug Alcohol Depend. 2006 May 20;82(3):250-7 - PubMed
  26. Arch Dis Child. 1988 Jan;63(1):81-3 - PubMed
  27. J Addict Dis. 2010 Apr;29(2):217-30 - PubMed
  28. Addiction. 1997 Nov;92(11):1571-9 - PubMed
  29. CNS Drug Rev. 2002 Winter;8(4):377-90 - PubMed
  30. Brain Res Dev Brain Res. 1998 Sep 10;110(1):61-7 - PubMed
  31. Child Neuropsychol. 2011;17(5):495-519 - PubMed
  32. Obstet Gynecol Clin North Am. 1998 Mar;25(1):139-51 - PubMed
  33. Obstet Gynecol. 1998 Nov;92(5):854-8 - PubMed
  34. J Perinat Med. 1990;18(2):111-8 - PubMed
  35. Res Publ Assoc Res Nerv Ment Dis. 1992;70:253-82 - PubMed
  36. Curr Neuropharmacol. 2008 Jun;6(2):125-50 - PubMed

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