Opioid detoxification in pregnancy

Dashe, Jodi S.; Jackson, Gregory L.; Olscher, Debora A.; ZANE, ELIZABETH H.; Wendel, George D.

doi:10.1016/s0029-7844(98)00312-3

Cited by 75 publications

(65 citation statements)

References 8 publications

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“…NAS occurred in 63% of neonates, and was less frequent after methadone detox. Opioid detoxification in pregnancy Dashe et al [9] Obstetrics and Gynaecology, 1998 34 pregnant opiate-dependent women offered methadone detoxification. 59% were successfully detoxified with no adverse pregnancy outcomes, or relapse to illicit substances.…”

Section: Systematic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Heroin detoxification during pregnancy: A systematic review and retrospective study of the management of heroin addiction in pregnancy

Gilfillan¹,

Dannatt

Stein

et al. 2018

S Afr Med J

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Background. There is general consensus that methadone maintenance is the gold standard in the management of pregnant heroin users. However, in South African state hospitals, methadone withdrawal is the routine procedure offered to these patients, as methadone maintenance programmes are unavailable in the public sector. Objectives. To conduct a systematic review of the literature on heroin detoxification in pregnancy, and to document pregnancy outcomes in heroin users detoxified with methadone at Groote Schuur Hospital (GSH), Cape Town, from 2006 to 2010. Methods. A literature search was undertaken to identify key publications on the management of heroin addiction in pregnancy. Patients for the study were identified from the GSH methadone registry, and data were collected from the clinical files. Results. A total of 20 relevant publications were identified and reviewed. Early case reports described an increased risk of stillbirths and fetal distress after methadone detoxification, but more recent case series involving larger numbers of patients showed positive outcomes. In our study, six pregnant patients received methadone withdrawal over a 5-year period at GSH, and all the neonates had good Apgar scores and were discharged home within 3 days of delivery. Conclusions. There is limited evidence on the management of heroin addiction during pregnancy, and the only two guidelines identified suggest that methadone maintenance is preferable to methadone withdrawal. The favourable pregnancy outcomes in this small sample of patients managed with methadone withdrawal suggest that it may be safe and deserves further study.

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Section: Systematic Reviewmentioning

confidence: 99%

“…Similarly, Dashe et al [9] conducted a prospective study in which 35 opioid-addicted pregnant patients were offered inpatient opiate detoxification with methadone; 59% of them successfully completed heroin detoxification, did not relapse, and had no adverse pregnancy outcomes.…”

Section: Researchmentioning

confidence: 99%

Heroin detoxification during pregnancy: A systematic review and retrospective study of the management of heroin addiction in pregnancy

Gilfillan¹,

Dannatt

Stein

et al. 2018

S Afr Med J

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“…39 Among the five retrospective case series involving women with heroin addiction, there is no consensus on the rate of methadone taper or the superiority of inpatient versus outpatient detoxification (Box 4). [40][41][42][43][44] Although the literature cites concerns for increased rates of miscarriage with detoxification during the first trimester and increased rates of preterm labour with detoxification during the third trimester, 45,46 this effect was not shown. 40,43 Neonatal outcomes, when reported, were inconsistent.…”

Section: Is There a Role For Detoxification In Pregnancy?mentioning

confidence: 99%

The management of opioid dependence during pregnancy in rural and remote settings

Jumah

Graves

2014

CMAJ

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• Nonmedical use of prescription opioids during pregnancy is becoming more common, and members of Canada's Aboriginal population are disproportionately affected.• Methadone maintenance therapy has logistic limitations in rural and remote settings, but buprenorphine and slow-release morphine maintenance therapies are feasible alternatives.• Opioid detoxification in pregnancy is associated with high rates of relapse and should only be offered if a comprehensive rehabilitation program is available.• Treatment of opioid dependence and rehabilitation services should be provided to all women during pregnancy and the postpartum period.

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“…It was recommended at the time to avoid detoxification until more data became available to monitor fetal homeostasis [8]. Since that time, methadone has been being used for maintenance and detoxification from illicit opiate use [9].…”

Section: Introductionmentioning

confidence: 99%

Risks of Methadone use as Substitute Therapy for Opioid Addiction during Pregnancy and use of Clonidine as a Plausible Alternative

Munim¹,

Iqbal²,

Stowe³

2016

J Addict Med Ther Sci

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Opioid detoxification in pregnancy

Abstract: In selected patients, opioid detoxification can be accomplished safely during pregnancy.

Cited by 75 publications

References 8 publications

Heroin detoxification during pregnancy: A systematic review and retrospective study of the management of heroin addiction in pregnancy

Heroin detoxification during pregnancy: A systematic review and retrospective study of the management of heroin addiction in pregnancy

The management of opioid dependence during pregnancy in rural and remote settings

Risks of Methadone use as Substitute Therapy for Opioid Addiction during Pregnancy and use of Clonidine as a Plausible Alternative

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