Comparison of methadone and slow‐release morphine maintenance in pregnant addicts

Fischer, Gabriele; Jagsch, Reinhold; Eder, Harald; Gombas, Wolfgang; Etzersdorfer, P.; Schmidl-Mohl, K.; Schatten, Christian; Weninger, M.; Aschauer, Harald

doi:10.1046/j.1360-0443.1999.9422317.x

Cited by 91 publications

(44 citation statements)

References 24 publications

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“…Oral slow-release morphine has also been used safely and successfully during pregnancy. 83 Where no form of maintenance treatment is available, advocates should press for its introduction.…”

Section: Provide Gender-sensitive Drug Treatmentmentioning

confidence: 99%

Women, Harm Reduction and HIV

Pinkham¹,

Malinowska-Sempruch²

2008

Reproductive Health Matters

110

117

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Section: Provide Gender-sensitive Drug Treatmentmentioning

confidence: 99%

Women, Harm Reduction and HIV

Pinkham¹,

Malinowska-Sempruch²

2008

Reproductive Health Matters

110

117

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“…In a RCT comparing methadone with SROM there was no difference in maternal or neonatal outcomes for methadone and SROM except reduced maternal heroin use in the third trimester with morphine (Fischer et al, 1999) …”

Section: (1b)mentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

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The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short-and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. KeywordsSubstance misuse, addiction, guidelines, pharmacotherapy, comorbidity 1 Imperial College London, CNWL NHS Foundation Trust, London, UK 2 Gether NHS Foundation Trust, Gloucester, UK 3 Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UKOther invited participants at the consensus meeting who contributed to the discussion and commented on the guidelines were Drummond C, Farrell M, Gilvarry E, Strang J. John, a user representative, read and commented on the written guidelines. Prof W van den Brink reviewed the written guidelines.

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“…Des études concordent sur la tendance à d'autres consommations en plus de la méthadone en Australie (Fischer, 1999) et ainsi qu'à la diminution d'opiacés Boer (1994) aux Pays-Bas, Batey (1993) en Australie. Leur impact sur la grossesse est plutôt décrit sur un plan clinique qu'épidémiologique (Guyon, 2003).…”

Section: Discussionunclassified

“…L'augmentation la plus nette concerne l'alcool, utilisé par 38% des sujets et les benzodiazépines utilisées par 50%, comme pour l'ensemble des toxicomanes traités à la méthadone. (Fischer, 1999); la diminution d'opiacés est signalée par Boer (1994) aux Pays-Bas, Batey (1993) L'origine des ressources indique une amélioration de la situation, 10% toutefois restent sans ressource. Une grande précarité de logement concerne 3% des cas.…”

Section: Evolution Des Femmes Enceintes Au Niveau Des Usages De Produitsunclassified

Embarazo y tratamiento con metadona

2003

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RESUMENSe analizan las necesidades específicas de las mujeres toxicómanas embarazadas al principio y durante el tratamiento con metadona partiendo de una muestra de 119 mujeres que solicitan tratamiento, dentro de un estudio nacional hecho en Francia sobre el conjunto de toxicómanos en tratamiento. El 66% de la muestra son adictas a la heroí-na y el 15% a la buprenorfina. Durante el tratamiento se pudo constatar un aumento de las dosis medias prescritas de metadona, lo cual ha favorecido una mejora de la situación general y una disminución de las consultas necesarias.Los estudios internacionales tanto con mujeres cocainómanas como con heroinó-manas indican, como en nuestro estudio, como tanto la demanda de tratamiento como el seguimiento del tratamiento con metadona viene facilitado si el equipo de tratamiento aporta apoyo psicoeducativo, en conexión con el ambiente familiar cuando sea posible, para facilitar que exista un proyecto para el futuro niño.Nuestro estudio muestra como las mujeres embarazadas piden ayuda a los centros especializados, pero que en ocasiones las dificultades que surgen al poner en marcha el tratamiento llevan a abandonos precoces.El embarazo debe considerarse un momento privilegiado para abordar los problemas de abuso de drogas y un momento en que es más fácil motivar para la inclusión en tratamiento. Debería mejorar la articulación entre los equipos de toxicomanías y los de ginecología y pediatría. Palabras clave: toxicomanía, mujeresembarazo, Metadona, epidemiología. ABSTRACTAnalysis of the specific needs of pregnant drug-dependent women at the commencement of and during treatment with methadone, on the basis of a sample of 119 women who requested treatment, in a national study in France on drug addicts undergoing treatment. 66% of the sample were addicted to heroin and 15% to buprenorphine. During treatment, it could be seen that there was an increase in the average prescribed doses of methadone, which favoured an improvement in the general situation and a reduction in the necessary consultations.In line with our study, international studies with both women cocaine dependents and heroin dependents also indicate how both the demand for treatment and the continuance of the treatment with methadone was easier if the treatment team provided psychoeducational support, in connection with the family environment, wherever possible, to facilitate the existence of a project for the future child.Our study shows that pregnant women do ask for assistance from specialist centres but, on occasion, the difficulties that arise when undergoing treatment leads them to abandon it early.Pregnancy should be considered to be a privileged moment to approach the problems of drug abuse and as a moment during which it is easier to motivate women to take treatment. The articulation between the drug dependency, gynaecological and paediatric teams must be improved. Key words: drug dependency, women,pregnancy, methadone, epidemiology. RÉSUMÉLes besoins spécifiques des femmes toxicomanes en période de grossesse sont...

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Comparison of methadone and slow‐release morphine maintenance in pregnant addicts

Abstract: Both methadone and morphine are suitable maintenance agents for pregnant opiate addicts. Maintenance agents that result in a less prolonged NAS should be studied in further trials.

Cited by 91 publications

References 24 publications

Women, Harm Reduction and HIV

Women, Harm Reduction and HIV

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Embarazo y tratamiento con metadona

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