Maternal and neonatal complications of substance abuse in Iranian pregnant women.

Filed under: Methadone Clinics

Acta Med Iran. 2012 Jun; 50(6): 411-6
Saleh Gargari S, Fallahian M, Haghighi L, Hosseinnezhad-Yazdi M, Dashti E, Dolan K

There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals). Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines). The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.
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Methadone and oral care.

Filed under: Methadone Clinics

Br Dent J. 2012; 213(2): 47-8
Isherwood G

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Drug- and Alcohol-Related Deaths at a Pediatric Institution in the United Kingdom.

Filed under: Methadone Clinics

Am J Forensic Med Pathol. 2012 Jul 25;
Morley SR, Becker J, Al-Adnani M, Cohen MC

AIM: The study aimed to identify the incidence, clinical presentation, and demographic features of drug- and alcohol-related deaths diagnosed at a pediatric pathology department between 2004 and 2010. MATERIAL AND METHODS: Databases of the histopathology and toxicology departments were searched. Three groups were defined as follows: (1) cause of death is toxicologically related; (2) drugs present are consistent with therapeutic range use; and (3) a drug was detected, but the contribution of this drug to the mechanism of death was not clear. RESULTS: Fifty-five cases (36 males, 19 females; mean, 4.8 years; range, 2 hours to 17 years) were identified. This corresponded to 3.3% (55/1669) of all postmortems. Ten cases were group 1, 42 cases were group 2, and 3 cases were group 3. The results in group 1 were methadone (n = 2); methadone, alcohol, and dothiepin (n = 1); diazepam (n = 1); dothiepin (n = 1); carbon monoxide (n = 2); tramadol (n = 1); codeine and paracetamol (n = 1); and dihydrocodeine, citalopram, amitriptyline, and paracetamol (n = 1). The types of death were considered accidental (n = 2), suicide (n = 2), and undetermined (n = 6). CONCLUSIONS: The presence of a toxin in lethal concentration was found in 10 (0.6%) of 1669 of any kind of postmortem examinations. This increased to 2.2% when the analysis was restricted to “sudden deaths.” These results demonstrate the need to conduct toxicological screening in all postmortems of this sort.
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The perioperative combination of methadone and ketamine reduces post-operative opioid usage compared with methadone alone.

Filed under: Methadone Clinics

Acta Anaesthesiol Scand. 2012 Jul 26;
Pacreu S, Fernández Candil J, Moltó L, Carazo J, Fernández Galinski S

BACKGROUND: A synergy between ketamine and methadone (ME) to produce antinociception has been demonstrated in experimental neuropathy. We wanted to compare post-operative opioid requirements in patients undergoing multilevel lumbar arthrodesis after the administration combined ME-ketamine (MK) or ME alone. METHODS: This was a randomised double-blind study. During sevoflurane-remifentanil anaesthesia, 11 patients in each group received the following: ketamine bolus (0.5?mg/kg) after tracheal intubation, followed by an infusion of 2.5??g/kg/min in the MK or saline bolus plus infusion in the ME group. Post-operative analgesia – during 48?h – was provided by patient-controlled analgesia (PCA), delivering bolus containing the following: ME 0.25?mg plus ketamine 0.5?mg in the MK group or ME 0.5?mg in the ME group. Lockout was 10?min, maximum of 3 boluses/h in both groups. Before closing the wound, all the patients received intravenous (i.v.) ME 0.1?mg/kg, dexketoprophen and paracetamol. Pain intensity was evaluated by a numerical rating scale (NRS), on arrival at recovery room (RR) and 24 and 48?h after surgery. In the RR, i.v. ME was administered until NRS was 3 when PCA was started. Dexketoprophen and paracetamol were administered 48?h. RESULTS: Remifentanil requirements were higher in the MK group (P?=?0.004). Patients in the MK group received 70% less ME by PCA at 24?h (MK vs. ME group, median and interquartile range) – 3.43?mg (1.9-6.5) vs. 15?mg (9.65-17.38) (P Source

Paging Harm Reduction Activists: It's Time to Take Our Destiny Into Our Own …

Filed under: Methadone Clinics

She was the first person in Russia to file a lawsuit demanding access to substitution treatment. About a year ago when Irina was crossing the border into Russia from Ukraine, the customs officers found a methadone pill in her luggage. The local Federal …
Read more on RH Reality Check (blog)

Methadone clinic application coming

Filed under: Methadone Clinics

TORRINGTON — City Planner Martin Connor said Thursday his office has received a call from methadone clinic owner Hartford Dispensary inquiring about fee schedules they need to follow when they apply to bring a new clinic to the city. Connor said he …
Read more on Waterbury Republican American

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