Gabrielle Fischer


Pregnancy and buprenorphine maintenance


Drug addiction in females requires special attention when the woman is pregnant. In opioid dependent females, early intervention during the prenatal period is highly desirable for maintaining the health of the woman, the fetus, and her infant after birth. We performed an analysis of different variables to determine which factors are responsible for stabilizing the
mother so that she could keep the child. Pregnant opioid dependent Women who were seeking treatment in our multiprofessional treatment programmes were investigated. The women were treated during pregnancy and then after delivery for a period of 36 months at the University Drug Addiction Outpatient Clinic. Pregnant women who met DSM-IV criteria for opioid dependence (DSM-IV 304.0) or polysubstance abuse (DSM-IV 304.8) were included. All patients received oral opioid maintenance therapy (methadone, slow-release morphine, buprenorphine) and had access to the same psychosocial and psychotherapeutic treatment. Length of treatment period, duration and type of maintenance therapy as well as attendance
for psychotherapy were used to evaluate which of these parameters are predictors of whether the child can live with its own mother or has to be placed elsewhere. At the end of the investigation period, 59% of the children remained with their mothers. Duration of involvement in a maintenance programme with replacement opioids (p=0.002), as well as early intervention (p=0.003), had a significant influence towards retaining custody of the child. In addition to successful pharmacological treatment, psychosocial and psychological services and attendance at the weekly group psychotherapy sessions contributed significantly to the mother keeping the child (p=0.004). Details regarding the different psychopharmacological therapies during pregnancy will be presented: early intervention and multiprofessional treatment approaches gave a better outcome for this risk population with respect to mothers retaining custody of their children.

 

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