Methadone During Pregnancy: Is it Safe?

While there are still many unknowns in the treatment of opioid-addicted pregnant women, one aspect that’s abundantly clear is that current opioid medication-assisted therapies are better than heroin for both mother and child.
pregnant woman with hands on belly

Methadone and buprenorphine (commonly known by the brand name, Suboxone) are categorized as category C pregnancy drugs by the FDA, which means there is not yet enough research to deem them completely safe. They should be prescribed when the benefits outweigh the risks, such as in cases of heroin addiction. Existing research concludes that while drugs like methadone and Suboxone have much better outcomes than heroin for the fetus and newborn when managed by a medical professional, more studies on the use of these drugs for detox during pregnancy are needed. Here’s what’s known right now based on the limited data:

Is methadone harmful during pregnancy?

Methadone is currently the standard treatment for opioid-addicted pregnant women in the U.S.  The consensus among most researchers and healthcare providers is that the benefits of taking methadone during pregnancy to treat heroin addiction outweigh the risks.

This is because heroin use during pregnancy comes with these potential adverse effects to the fetus/child:

  • Withdrawal that leads to uterine contractions, which can result in miscarriage or preterm birth
  • Low birth rate
  • Developmental delays
  • Increased risk for infectious diseases through needle sharing
  • Poor feeding
  • Difficulty breathing /respiratory distress
  • Bleeding of the brain

While methadone also comes with some of these  risks, with medical oversight,  the chances of perinatal or neonatal death due to miscarriage or preterm birth are minimized as well as the possibility of diseases contracted through shared needles.

Can a baby be born addicted to methadone?

Babies are not born addicted to methadone, but may experience some withdrawal symptoms in the first 48 hours, according to information from the Substance Abuse and Mental Health Services Administration. This condition is neonatal abstinence syndrome (NAS), which is the name for the withdrawal symptoms newborns experience upon birth from mothers who’ve abused drugs.

Methadone NAS withdrawal in babies include:

  • Fever
  • Diarrhea
  • Excessive crying
  • Tremors
  • Low birth rate

One small study (n=20) found long-term symptoms may potentially include:

  • Lower IQ scores
  • Anxiety
  • Aggression
  • Rejection
  • Behavior problems

What are the side effects of methadone?

Potential side effects of methadone for the mother may include:

  • Lethargy
  • Respiratory issues
  • Mood swings
  • Slow reaction time
  • Nausea
  • Dry mouth
  • Pulmonary problems
  • Pupil contraction
  • Drowsiness
  • Risk for dependence/abuse of drug

Is it safe to take Suboxone while pregnant?

Suboxone as an alternative to methadone is a relatively recent heroin treatment intervention. Research on the effectiveness and safety of its use is still in its infancy. One study found that while withdrawal symptoms were similar in newborns whose mothers were treated with Suboxone or methadone during pregnancy, NAS symptoms were less severe in those treated with Suboxone for detox during pregnancy.

Posted on November 9th, 2017

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