Methadone for Treatment of Pregnant Opiate Addicted Women: Is There a Safer Alternative? A Review of Literature

Methadone is commonly used for the treatment of pregnant opiate-addicts. But, it can have severe effects on the neonate including Neonatal Abstinence Syndrome, increased length of stay in the neonatal intensive care unit, and intrauterine growth retardation. Neonatal Abstinence Syndrome includes neurological excitability, gastrointestinal dysfunction, and autonomic signs. Because of these adverse effects, studies have been conducted to determine what can help reduce the severe complications caused by methadone. Varied dosages of methadone and alternative medications, such as buprenorphine, slow-release morphine, and others have been studied. Most of the alternative medications, especially buprenorphine, are gaining popularity in Europe where there is a growing problem of opiate use during pregnancy. In the studies comparing methadone and buprenorphine, a slight decline in symptoms of Neonatal Abstinence Syndrome as well as shorter hospital stays for the neonates exposed to buprenorphine was noted. Studies of different dosages of methadone were conducted to determine the lowest methadone dose that is both effective for the mother and safe for the neonate. All of the studies have provided information that is helping in the search for the safest and most effective treatment for opiate addiction. What is known is that helping the mother overcome the addiction is very important. So far, the data collected are not strong enough to make a conclusion on the best choice for treatment. Further research is indicated for methadone itself and also for all its possible alternatives.