© 1999 Evidence-Based Mental Health
Slow release morphine did not reduce neonatal abstinence syndrome more than methadone
Fischer G, Jagsch R, Eder H, et al. Comparison of methadone and slow-release morphine maintenance in pregnant addicts. Addiction 1999 Feb;94:231–9.[Medline]
Question In pregnant women who are opioid dependent or polysubstance abusers, does slow release morphine (SRM) with an intermediate half life (16 h) reduce neonatal abstinence syndrome (NAS) in their newborn infants more than methadone?
Randomised, unblinded, controlled trial with a {mean follow up of 15 weeks}*
A drug addiction outpatient clinic at a university hospital in Vienna, Austria.
48 pregnant women (mean age 26 y, mean gestation 22 wks) who were dependent on opioids or abused polysubstances (mean duration 61 mo) and were willing to follow the maintenance programme and avoid using illegal drugs. Follow up was complete.
Women were allocated to oral SRM tablets given twice daily (n=24) or an oral methadone solution given once daily (n=24). A flexible dose regimen was used, and the mean dose at delivery was 53 mg for methadone and 300 mg for SRM. All women received psychosocial counselling twice weekly and group psychotherapy once weekly.
NAS was assessed every 6 hours using the Finngegan score. Other outcomes were illegal drug consumption (assessed by urinanalysis and new injection sites), nicotine dependence (Fagerström questionnaire), and fetal distress.
Neonatal infants
The Chinese University of Hong Kong Shatin, New Territories, Hong Kong
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