Study Shows Buprenorphine Beats Methadone For Pregnancy Maintenance Treatment

An article in the December 9th issue of the New England Journal of Medicine (not available online) refers to a Johns Hopkins study regarding maintenance treatment for opiate addiction in pregnant women.

First, we need to mention that, when a woman who is currently addicted to opiates gives birth, the baby is addicted as well. The child’s detox symptoms are known as neonatal abstinence syndrome (NAS).

The Johns Hopkins study revealed that babies born to women who were maintained on buprenorphine (Subutex) during pregnancy, rather than methadone, required 89% less morphine to relieve the symptoms of NAS than those whose mothers had methadone. Furthermore, hospital stays for the babies were reduced by an average of 43% (10 days versus 17.5 days).  The reason for this is not clear, but it is likely related to the long life of methadone metabolites, some of which are also opioids.

photo: Martin LaBar/Flickr

The study’s authors reported that “Although there were no significant differences in overall rates [of NAS] … the benefits of buprenorphine in reducing the severity of neonatal abstinence syndrome … suggest that it should be considered a first-line treatment option in pregnancy.”

It is important to note that the study involved buprenorphine in the form of Subutex rather than Suboxone which, in addition to buprenophine, contains the narcotic antagonist naloxone.  Unborn babies should not be exposed to naloxone. Any mothers or doctors considering this form of maintenance should be very clear on this point.

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