Meconium drug testing reveals maternal misuse of medicinal opioids among addicted mothers

Abstract

Meconium drug testing is a non-invasive method to detect prenatal drug exposure, which can cause severe problems for the infant, indicating the need for follow-up measures to ensure the welfare of the child. Meconium samples for drug testing were collected from 143 infants as part of routine clinical work among addicted mothers. The drug testing findings were combined with medical records including clinical background and follow-up data. The substances screened for included medicinal opioids, 6-monoacetylmorphine (a metabolite of heroin), amphetamines and tetrahydrocannabinolic acid. At least one of the 13 target drugs was detected in 57 (40%) meconium samples. In 21 cases, the findings were unexpected on the basis of clinical data or denied by the mother. Medicinal opioids, especially the opioid substitution treatment drugs buprenorphine and methadone, comprised the majority of the findings of both admitted and unexpected drug misuse. Meconium drug testing methods should target not just traditional illicit drugs but also prescription drugs with misuse potential.

Retrospective analysis of the diagnostic yield of newborn drug testing

“…Recent studies using meconium drug testing have documented misuse of prescription pain medication among pregnant women [27, 28]. The incidence of non-medical use of prescription opiates identified via meconium drug testing was 0.5% (n = 40) in this study.…”

“…The study institution includes a neonatal intensive care unit which cares for many premature infants. Many premature infants receive medications prior to the passage of meconium, which may be delayed until the ninth day of life [28]. Morphine, lorazepam, and phenobarbital administered to newborns prior to meconium collection accounted for 96.5% of the 283 samples whose meconium findings were completely explained by prescribed medications.…”

Clinical Applications of Hair Analysis

“…NAS symptoms typically peak by 48À72 h after birth with a mean onset time of 33 h, although onset may be delayed as much as several weeks [39]. The results revealed misuse of medicinal opioids among drug-dependent mothers, suggesting that licit drugs with substance abuse potential should be routinely tested in meconium [40]. Launiainen et al estimated the frequency at which meconium samples test positive for opioids, amphetamines (APs), and cannabis based on suspected or reported drug use and to relate these findings to neonatal outcome [40,41].…”

“…NAS is medically manageable with clinical guidelines readily available in most jurisdictions [38]. Launiainen et al estimated the frequency at which meconium samples test positive for opioids, amphetamines (APs), and cannabis based on suspected or reported drug use and to relate these findings to neonatal outcome [40,41]. This could be problematic in infants with undetected chronic opioid or benzodiazepine exposures that are discharged from hospital within 24À36 h postpartum.…”

Effects of Methadone Exposure during Development on Avian Brain and Blood Cells

“…In theory, maintenance improves psychosocial circumstances for mothers and increases medical compliance among pregnant patients [1]; but, in fact, many at-risk women abuse medical opioids during pregnancy [2]. Substitution therapy frequently leads to the newborn suffering through neonatal abstinence syndrome [3].…”