Medication-assisted treatment vs. detoxification for women who misuse opioids in pregnancy: Associations with dropout, relapse, neonatal opioid withdrawal syndrome (NOWS), and childhood sexual abuse
| Autor: | Stephanie Kors, Gretchen Kurdziel-Adams, Andrea M. Gorrondona, Gregory L. Stuart, Craig V. Towers, Samantha K. Noose, Bharathi J. Zvara, Jenny Macfie, Kimberly B. Fortner, Chloe T. Cohen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Social pathology. Social and public welfare. Criminology Research paper lcsh:BF1-990 education lcsh:HV1-9960 Medication-assisted treatment Pregnancy Detoxification Medicine Prospective cohort study health care economics and organizations business.industry Obstetrics Random assignment Sexual abuse Obstetrics and Gynecology Opioid use disorder General Medicine medicine.disease Psychiatry and Mental health Neonatal Opioid Withdrawal Syndrome Opioid use lcsh:Psychology Opioid business medicine.drug |
| Zdroj: | Addictive Behaviors Reports Addictive Behaviors Reports, Vol 12, Iss, Pp 100315-(2020) |
| ISSN: | 2352-8532 |
| Popis: | Highlights • A professional organization does not recommend opioid detoxification in pregnancy. • Medically-assisted treatment (MAT) is recommended to reduce relapse and dropout. • We sampled 55 pregnant women who misused opioids who chose detoxification or MAT. • There was no dropout in either group and more relapse with MAT than detoxification. • Replication and follow-up are needed to assess relative rates of relapse postpartum. The American College of Obstetricians and Gynecologists recommends medication-assisted treatment (MAT) for pregnant women who misuse opioids rather than detoxification because of possible relapse and dropout from treatment (ACOG, 2017). In a prospective study, fifty-five pregnant women with an opioid use disorder were offered a choice of MAT or detoxification. Ethical concerns precluded random assignment. We assessed dropout, treatment outcome, relapse, other illicit drug use, infant neonatal opioid withdrawal syndrome (NOWS), and childhood sexual abuse. Of 55 women, 13 initially chose MAT and 42 women chose detoxification. All women received behavioral support. No one dropped out of treatment prior to delivery. All women who chose MAT initially remained on MAT. Of women who chose detoxification, 23% switched to MAT, 30% tapered below initial MAT doses, and 45% fully detoxified by delivery. There was a significant difference in opioid relapse between women on MAT (26%) and those who detoxified (0%), but no differences for other illicit drug use. Infants of women on MAT were more likely to have neonatal NOWS (91%) than infants of women who tapered below initial MAT doses but did not fully detoxify (62%). Infants of mothers who tapered (62%) were more likely to have NOWS than infants of women who fully detoxified (0%). Women on MAT reported significantly lower sexual abuse severity than did women who tapered or detoxified. It is critical to replicate the current findings and to follow up with mothers and their infants postpartum to ascertain the long-term impact of tapering or detoxification during pregnancy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|