PURPOSE OF REVIEW: This article addresses the question of 'best treatment options', which clinicians face when treating pregnant women with alcohol and opioid dependence. RECENT FINDINGS: Studies show that alcohol consumption is associated with fetal abnormalities and long-term cognitive problems depending on the amount consumed, drinking pattern, and time of gestation. Screening and evaluation of specific interventions are important to reduce alcohol consumption during pregnancy and associated problems in infants. Opioid detoxification is only recommended beyond the first trimester and only in those pregnant women who refuse opioid maintenance therapy. Methadone is the most established treatment of pregnant opioid-dependent women, though recent results indicate some advantages of buprenorphine, slow-release oral methadone and diamorphine compared with methadone. SUMMARY: Benzodiazepines seem to be the most recommendable option for managing alcohol withdrawal, and psychosocial interventions succeed in reducing alcohol consumption or in maintaining abstinence in alcohol-dependent pregnant women. Regarding opioid dependence, current results suggest that factors like the health status of the mother, the need for additional medications (e.g. treatment for HIV), comorbid drug dependence, and concurrent drug use need to be considered in order to find the 'best opioid substitute'.
PURPOSE OF REVIEW: This article addresses the question of 'best treatment options', which clinicians face when treating pregnant women with alcohol and opioid dependence. RECENT FINDINGS: Studies show that alcohol consumption is associated with fetal abnormalities and long-term cognitive problems depending on the amount consumed, drinking pattern, and time of gestation. Screening and evaluation of specific interventions are important to reduce alcohol consumption during pregnancy and associated problems in infants. Opioid detoxification is only recommended beyond the first trimester and only in those pregnant women who refuse opioid maintenance therapy. Methadone is the most established treatment of pregnant opioid-dependent women, though recent results indicate some advantages of buprenorphine, slow-release oral methadone and diamorphine compared with methadone. SUMMARY:Benzodiazepines seem to be the most recommendable option for managing alcohol withdrawal, and psychosocial interventions succeed in reducing alcohol consumption or in maintaining abstinence in alcohol-dependent pregnant women. Regarding opioid dependence, current results suggest that factors like the health status of the mother, the need for additional medications (e.g. treatment for HIV), comorbid drug dependence, and concurrent drug use need to be considered in order to find the 'best opioid substitute'.
Authors: Grace Chang; Tay K McNamara; E John Orav; Danielle Koby; Alyson Lavigne; Barbara Ludman; Nori Ann Vincitorio; Louise Wilkins-Haug Journal: Obstet Gynecol Date: 2005-05 Impact factor: 7.661
Authors: Janneke Jentink; Maria A Loane; Helen Dolk; Ingeborg Barisic; Ester Garne; Joan K Morris; Lolkje T W de Jong-van den Berg Journal: N Engl J Med Date: 2010-06-10 Impact factor: 91.245
Authors: Hendree E Jones; Peter R Martin; Sarah H Heil; Karol Kaltenbach; Peter Selby; Mara G Coyle; Susan M Stine; Kevin E O'Grady; Amelia M Arria; Gabriele Fischer Journal: J Subst Abuse Treat Date: 2008-01-14
Authors: Amanda P Miller; Steven Shoptaw; Rufaro Mvududu; Nyiko Mashele; Thomas J Coates; Linda-Gail Bekker; Zaynab Essack; Candice Groenewald; Zaino Petersen; Pamina M Gorbach; Landon Myer; Dvora L Joseph Davey Journal: AIDS Behav Date: 2022-06-23
Authors: Valerie E Whiteman; Jason L Salemi; Mulubrhan F Mogos; Mary Ashley Cain; Muktar H Aliyu; Hamisu M Salihu Journal: J Pregnancy Date: 2014-08-28
Authors: Kriti D Gandhi; Kathryn M Schak; Jennifer L Vande; Julia Shekunov; Brian A Lynch; Teresa A Rummans; Jennifer R Geske; Eric R Pease; Mara G Limbeck; Jinal Desai; Paul E Croarkin; Magdalena Romanowicz Journal: Prim Care Companion CNS Disord Date: 2021-06-10