Comparison of methadone and slow-release morphine maintenance in pregnant addicts

Aims. To investigate whether the neonatal abstinence syndrome (NAS) is diff erent in children born to women,maintained on slow-release morphine, compar ed with those maintained on methadone, and to compare additional drug consu mption in these groups of women. Design, Setting and Participants. An open, randomized trial was conducted in an established clinic. Forty-eight pregn ant women who presented to the clinic as opiate or polysubstance abusers we re enrolled and maintained on either methadone (24 women) or slow-release,m orphine (24 women) up to and following delivery. The programme included psy chosocial therapy and support for their opiate-addicted partners. Measureme nts. Standard urinalysis methods were used to measure consumption of cocain e and benzodiazepines during pregnancy. Injection sites were monitored to i ndicate additional opiate use. NAS was measured according to Finnegan score and the amount of phenobarbiturates prescribed to alleviate the symptoms. Findings. No difference was found in the number of days that NAS was experi enced by neonates born to methadone or morphine maintained mothers (mean = 16 and 21 days, respectively). All children were born healthy and no seriou s complications arose. Fewer benzodiazepines (p < 0.05) and fewer additiona l opiates (p < 0.05) were consumed by the morphine-maintained women compare d with those who took methadone, but no difference was seen in cocaine cons umption. Nicotine consumption was reduced significantly in both groups duri ng pregnancy (p < 0.02). Conclusions. Both methadone and morphine are suita ble maintenance agents for pregnant opiate addicts. Maintenance agents that result in a less prolonged NAS should be studied in further trials.