Management of Opioid Dependence in Pregnancy: A Review of the Evidence

Young, Dykes M

doi:10.1007/s11469-007-9054-z

Cited by 1 publication

(1 citation statement)

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“…Opioid detoxification has been contra-indicated in both the first trimester of pregnancy because of the risk of miscarriage and in the last trimester because of the possibility of precipitating pre-term labour, fetal distress, and even stillbirth (Department of Health (England) and the devolved administrations, 2007). However, Young (Young, 2007) revealed that the underlying evidence was tentative at best and based on two case studies that had low scientific power (n = 1) and no controls (Rementeria & Nunag, 1973;Zuspan, Gumpel, Mejia-Zelaya, Madden, & Davis, 1975). The Royal College of General Practitioners', using evidence from a comparison of two self-selected Scottish groups (Hepburn, 1997), suggest that methadone detoxification can be carried out 'at any speed and at any stage' during pregnancy (Ford et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

A National Survey Investigating Methadone Treatment for Pregnant Opioid Dependent Women in England and Wales

Perez-Montejano

Finch

Wolff

2013

Int J Ment Health Addiction

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We investigated the management and treatment of pregnant opioid users by Drug Treatment Services by region across England and Wales. A postal survey was conducted among 223 Community Drug Treatment Services (CDTS) across England and Wales. Sixtysix percent CDTS responded (n=154/233) to the survey. Over half CDTS (55.3%) provided a maintenance methadone dose lower than that recommended for non-pregnant drug users.There were significant variations across regions and how professionals approached the management of pregnant opioid users. CDTS with an addiction specialist were significantly more likely (p<.01) to advocate high doses of methadone whereas those with a midwife, obstetrician or social worker involved were more likely (p<.05) to suggest low dose methadone and/or detoxification. Service provision for pregnant opioid users is reliable and comprehensive but there is still variability in some aspects of the treatment received and the way in which methadone is prescribed is not always optimal.

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Section: Discussionmentioning

confidence: 99%