Methadone is frequently prescribed to expecting mothers as a substitute for illegal drugs such as heroin that carry high risks for both the mother and baby, according to the National Institute on Drug Abuse. The risks attached to methadone are considered to be lower than the risk associated with the use of these illegal drugs. Detoxing from methadone is not recommended during the first trimester since it can increase the risk for miscarriage. Detoxing during the last trimester is not recommended either, since the mother’s withdrawal symptoms may cause stress and lack of oxygen in the baby. Although using methadone during pregnancy may be better than using illegal opioids, it can cause serious side-effects and complications in the fetus and newborn 1.
The National Institute on Drug Abuse estimates that approximately 60 to 80 percent of the infants show at least some immediate side effects following the methadone exposure. Among the most common side effects are pinpoint pupils, confusion, nausea and vomiting, low blood pressure, decreased heart rate, dry mouth, eyes or nose, and raised pressure inside the skull.
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Babies exposed to methadone often suffer from decreased fetal growth, low birth weight and height, as well as small head circumference, according to the Drugs.com 1. Luckily, these deficits do not seem to persist into later childhood. Children born to women treated with methadone commonly demonstrate mild but persistent deficits in their psychometric and behavioral tests, even years after birth.
According to the National Institute on Drug Abuse, neonatal opiate abstinence syndrome is a generalized disorder characterized by autonomic nervous system, central nervous system, gastrointestinal tract and respiratory system dysfunctions. Usually these symptoms first appear 48 to 72 hours after the birth, but they may also appear later because methadone is stored in fetal tissue. In addition to the classic methadone side effect symptoms, infants may also develop jaundice and have an increased risk of sudden infant death syndrome. Dr. C. Dryden and colleagues showed in a study published in the “British Journal of Obstetrics and Gynecology” in October 2008 that if the mother continues taking methadone after the baby is born, breastfeeding may help ease some of the withdrawal signs in the neonate 2.
- According to the National Institute on Drug Abuse, neonatal opiate abstinence syndrome is a generalized disorder characterized by autonomic nervous system, central nervous system, gastrointestinal tract and respiratory system dysfunctions.
- Usually these symptoms first appear 48 to 72 hours after the birth, but they may also appear later because methadone is stored in fetal tissue.
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- eMedtv.com: Methadone and Pregnancy
- “British Journal of Obstetrics and Gynecology”; Maternal methadone use in pregnancy: factors associated with the development of neonatal abstinence syndrome and implications for healthcare resources; Dryden C, Young D, Hepburn M, Mactier H.; Oct 2008.
- Netdoctor.co.uk: Methadone
- Bell J. Pharmacological maintenance treatments of opiate addiction. Br J Clin Pharmacol. 2014;77(2):253-263. doi:10.1111/bcp.12051
- Grissinger M. Keeping Patients Safe From Methadone Overdoses. P T. 2011;36(8):462-466.
- U.S. Food & Drug Administration. Roxane Laboratories, Inc. Methadone Hydrochloride Cl Tablets USP 5mg, 10mg. (Dolophine HCl CII). Updated October 2006.
- MedlinePlus. Methadone. Updated September 28, 2020.
- Sameed M, Teague H. Use of nebulized naloxone to reverse methadone overdose - A case report and review of literature. J Community Hosp Intern Med Perspect. 2019;9(5):422-424. doi:10.1080/20009666.2019.1659664
- American College of Medical Toxicology. ACMT Position Statement: The Use of Methadone as an Analgesic. J Med Toxicol. 2016;12(2):213-215. doi:10.1007/s13181-015-0532-6
- Modesto-lowe V, Brooks D, Petry N. Methadone Deaths: Risk Factors in Pain and Addicted Populations. J Gen Intern Med. 2010;25(4):305-309. doi:10.1007/s11606-009-1225-0
- Centers for Disease Control and Prevention. Vital Signs: Risk for Overdose from Methadone Used for Pain Relief — United States, 1999–2010. Morbidity and Mortality Weekly Report (MMWR). 2012;61(26);493-497.
- Kharasch ED. Current Concepts in Methadone Metabolism and Transport. Clin Pharmacol Drug Dev. 2017;6(2):125-134. doi:10.1002/cpdd.326
- American Addiction Centers. How Long Does Methadone Stay in Your System? Updated June 10, 2019.
- Center for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2006.
Marie Cheour had her first article published in 1995, and she has since published more than 40 articles in peer-reviewed publications such as "Nature" and "Nature Neuroscience." She has worked as a college professor in Europe and in the United States. Cheour has a Ph.D. in cognitive psychology from the University of Helsinki.