Pregnancy and substance dependency

Substance dependency in pregnancy leads to severe health risks for the expe cting mother and for the foetus and the new-born. The problem of substance dependent pregnant women lies not only in the use of illegal substances but also to a high degree in the use of legal substances such as alcohol and n icotine. in contrast to most other substances of abuse, opioids do not show cytotoxic or teratogenic characteristics. The primary goal should be the s tabilisation of the patient and a reduction of additional illicit consumpti on. The ideal goal of abstinence is difficult to reach and often puts the w omen under enhanced risks. Detoxification after week 32 should not be under taken in order to avoid preterm delivery. It should be standardised that a multiprofessional and interdisciplinary th erapeutical care leads to a stabilisation in opioid dependent pregnant addi cts and therefore improves the outcome for neonates. Special awareness need s to be addressed towards the diversification of opioid maintenance therapy . Based on the positive results in opioid maintenance therapy in pregnant opi oid dependent women, it will be required to establish standards. Furthermor e there is a need to establish consistent guidelines for the treatment of t he neonatal abstinence syndrome.