Methadone treatment during pregnancy

Abstract

Objective: To review the literature on methadone use by pregnant women.

Data sources: A search was conducted on CINAHL, MEDLINE, and PSYCHINFO under "pregnancy" and "methadone."

Study selection: Articles published between 1988-1998 were reviewed and chosen based upon relevance to the objective.

Data extraction: Data were extracted and organized under the following headings: effects of methadone on pregnancy outcome, management of the pregnant woman on methadone, and implications of social and political policies for pregnant women who use opiates.

Data synthesis: Methadone treatment is most effective for pregnant women who receive care in a comprehensive service center. Few systematic investigations exist concerning methadone maintenance during pregnancy, thus no formal guidelines for management exist. Changes in federal policies for drug treatment and welfare regulations will challenge health care professionals who provide treatment for opiate-dependent pregnant women.

Conclusions: Treatment with methadone is the standard of care for the opiate-using pregnant woman, despite findings challenging its benefits and efficacy in women who continue to use illicit drugs.