Breastfeeding and Substance Abuse.

Clin Obstet Gynecol. 2013 Jan 18;
D’Apolito K

Breastfeeding is the recommended feeding method for infants. The decision to allow women to breastfeed while consuming alcohol and other drugs postpartum presents a problem for the health care provider. This article discusses the biochemical properties of various drugs as they relate to breastfeeding. Women in a methadone treatment program should be allowed to breast feed; however, more research is needed to determine the efficacy of breastfeeding when women are receiving buprenorphine. Breastfeeding should not be recommended in women who abuse heroin recreationally until more information is known about the actual amount of morphine present in the breast milk.
HubMed – Methadone

Management of the Pregnant Substance Abusing Woman.

Clin Obstet Gynecol. 2013 Jan 18;
Sheehan M, Sheehan MG

Operation PAR has been involved in prevention and treatment service development for drug-dependent women for nearly 40 years. Management starts with prevention programs. For opiate-addicted pregnant women, methadone is the treatment of choice and should be maintained throughout pregnancy, despite the manageable problem of neonatal opiate withdrawal. Women are actively engaged in innovative educational and therapeutic activities to help moms build skills to enhance their personal health and develop recovery orientation and drug refusal skills. Specific parenting skills are modeled and taught both on an outpatient and inpatient basis as appropriate.
HubMed – Methadone

[Characteristics of heroin dependent patients admitted to a methadone treatment program.]

Med Clin (Barc). 2013 Jan 18;
Sanvisens A, Rivas I, Faure E, Muñoz T, Rubio M, Fuster D, Tor J, Muga R

BACKGROUND AND OBJETIVE: Methadone is largely used as the primary opioid substitution therapy for the treatment of heroin addiction; the objective of the study was to describe the clinical characteristics of heroin abusers admitted into a methadone maintenance program (MMP) in metropolitan Barcelona. METHOD: Cross-sectional study in patients enrolled in MMP since its introduction in 1992 through December 2010. Socio-demographic data, drug use characteristics, prevalence of blood-borne infections (human immunodeficiency virus [HIV], and hepatitis B [HBV] and C [HCV]) and psychiatric co-morbidity were assessed at entry. RESULTS: One thousand and six hundred seventy eight patients (82.8% male). A total of 608 (36.2%) patients were admitted during 1992-1996, 566 (33.7%) between 1997-2001, 305 (18.2%) between 2002-2006 and 199 (11.9%) in the last period. Age at admission to methadone increased significantly (28 years in period 1992-1996 vs. 37 years in the last period [P<.005]). The percentage of patients with a history of intravenous drug use decreased significantly (89.5% in first period vs. 56.4% in period 2007-2010 [P<.05]). Prevalence of HIV, HCV and HBV (HBcAb+) was 53.7, 73.6 and 61.3%, respectively. The prevalence of HIV decreased over time from 66.2% in first period to 43.5% in 2007-2010 (P<.05); the prevalence of HCV decreased significantly from 82.8% in 1992-1996 to 69.8% in last period (P<.05). Twenty five percent of patients had psychiatric co-morbidity at admission and the prevalence of psychiatric co-morbidity increased over time (21% in 1992-1996 and 32% in 2007-2010; P<.05). CONCLUSION: Age at first opioid substitution therapy is increasing over time, as well as the proportion of patients with psychiatric co-morbidity. There were significant reductions in blood-borne infections. HubMed – Methadone

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