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Russell", "lastName": "Lyman" }, { "creatorType": "author", "firstName": "Leslie B.", "lastName": "Montejano" }, { "creatorType": "author", "firstName": "Richard H.", "lastName": "Dougherty" }, { "creatorType": "author", "firstName": "Allen S.", "lastName": "Daniels" }, { "creatorType": "author", "firstName": "Sushmita Shoma", "lastName": "Ghose" }, { "creatorType": "author", "firstName": "Miriam E.", "lastName": "Delphin-Rittmon" } ], "abstractNote": "Five decades after its introduction, methadone maintenance treatment (MMT) for opioid addiction remains in high demand as a more effective alternative to abstinence-based treatments. The authors of this literature review describe a significant body of research supporting MMT’s positive impact on treatment retention and suppression of heroin use, particularly at higher doses. Efforts should be made to increase access to MMT for all individuals who struggle with opioid use disorders, they said.", "publicationTitle": "Psychiatric Services", "publisher": "", "place": "", "date": "February 1, 2014", "volume": "65", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "146-157", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "PS", "DOI": "10.1176/appi.ps.201300235", "citationKey": "", "url": "http://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201300235", "accessDate": "2016-01-31T23:11:03Z", "PMID": "", "PMCID": "", "ISSN": "1075-2730", "archive": "", "archiveLocation": "", "shortTitle": "Medication-Assisted Treatment With Methadone", "language": "", "libraryCatalog": "ps.psychiatryonline.org (Atypon)", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2016-01-31T23:11:03Z", "dateModified": "2016-01-31T23:11:03Z" } }, { "key": "HS3QTRPP", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/HS3QTRPP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/HS3QTRPP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "HS3QTRPP", "version": 35, "itemType": "attachment", "linkMode": "imported_url", "title": "PS201300235 146..157 - appi.ps.201300235", "accessDate": "2016-01-31T23:10:51Z", "url": "http://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201300235", "note": "", "contentType": "application/pdf", "charset": "utf-8", "filename": "appi.ps.pdf", "md5": null, "mtime": null, "tags": [], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T23:10:51Z", "dateModified": "2016-01-31T23:10:53Z" } }, { "key": "44IKAXQ9", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/44IKAXQ9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/44IKAXQ9", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/RHPHF4SZ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "44IKAXQ9", "version": 35, "parentItem": "RHPHF4SZ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-31T22:45:29Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15592269", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-31T22:45:29Z", "dateModified": "2016-01-31T22:45:29Z" } }, { "key": "RHPHF4SZ", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/RHPHF4SZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/RHPHF4SZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Rayburn and Bogenschutz", "parsedDate": "2004-12", "numChildren": 1 }, "data": { "key": "RHPHF4SZ", "version": 35, "itemType": "journalArticle", "title": "Pharmacotherapy for pregnant women with addictions", "creators": [ { "creatorType": "author", "firstName": "William F.", "lastName": "Rayburn" }, { "creatorType": "author", "firstName": "Michael P.", "lastName": "Bogenschutz" } ], "abstractNote": "OBJECTIVE: Dependence on alcohol, nicotine, or illicit drugs during pregnancy continues to be a problem of major medical, social, and fetal consequences. The purpose of this systematic review was to summarize current experience that pertains to pharmacotherapy for pregnant women with specific chemical addictions.\nSTUDY DESIGN: Studies were identified through Medline and HealthSTAR (1979-2003) that linked specific pharmacotherapy with pregnancy. This article reviews the English language literature for clinical studies that link the 2 conditions. In addition, reference lists of all articles that were obtained were evaluated for other potential citations.\nRESULTS: Pregnant women are excluded systematically from almost all drug trials. Most knowledge about the fetal effects from maternal substance and medication use comes from animal data and from case reports and small clinical series. With the exception of methadone and nicotine replacement, clinical experience with antiaddictive medications in pregnant women is either very limited (alcohol, stimulants) or nonexistent (cannabis, hallucinogens).\nCONCLUSION: Antiaddiction medications are important in the treatment of pregnant women with opioid and nicotine dependence and are of growing importance in the treatment of alcohol and stimulant dependence. Future directions will be toward increasing knowledge about current drug therapy and in developing new antiaddiction medications.", "publicationTitle": "American Journal of Obstetrics and Gynecology", "publisher": "", "place": "", "date": "Dec 2004", "volume": "191", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "1885-1897", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am. J. Obstet. Gynecol.", "DOI": "10.1016/j.ajog.2004.06.082", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0002-9378", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15592269", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Behavior, Addictive", "type": 1 }, { "tag": "Cocaine-Related Disorders", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Gestational Age", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Maternal-Fetal Exchange", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Narcotic Antagonists", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pharmaceutical Preparations", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Outcome", "type": 1 }, { "tag": "Pregnancy, High-Risk", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Substance-Related Disorders", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T22:45:29Z", "dateModified": "2016-01-31T22:45:29Z" } }, { "key": "8EHDNRKN", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/8EHDNRKN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/8EHDNRKN", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/9KU2GK83", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "8EHDNRKN", "version": 35, "parentItem": "9KU2GK83", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-31T17:45:54Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24845488", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-31T17:45:54Z", "dateModified": "2016-01-31T17:45:54Z" } }, { "key": "9KU2GK83", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/9KU2GK83", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/9KU2GK83", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Mozurkewich and Rayburn", "parsedDate": "2014-06", "numChildren": 1 }, "data": { "key": "9KU2GK83", "version": 35, "itemType": "journalArticle", "title": "Buprenorphine and methadone for opioid addiction during pregnancy", "creators": [ { "creatorType": "author", "firstName": "Ellen L.", "lastName": "Mozurkewich" }, { "creatorType": "author", "firstName": "William F.", "lastName": "Rayburn" } ], "abstractNote": "Buprenorphine and methadone are opioid-receptor agonists used as opioid substitution therapy during pregnancy to limit exposure of the fetus to cycles of opioid withdrawal and reduce the risk of infectious comorbidities of illicit opioid use. As part of a comprehensive care plan, such therapy may result in improved access to prenatal care, reduced illicit drug use, reduced exposure to infections associated with intravenous drug use, and improved maternal nutrition and infant birth weight. This article describes differences in patient selection between the two drugs, their relative safety during pregnancy, and changes in daily doses as a guide for prescribing clinicians.", "publicationTitle": "Obstetrics and Gynecology Clinics of North America", "publisher": "", "place": "", "date": "Jun 2014", "volume": "41", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "241-253", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Obstet. Gynecol. Clin. North Am.", "DOI": "10.1016/j.ogc.2014.02.005", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1558-0474", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24845488", "tags": [ { "tag": "Abstinence", "type": 1 }, { "tag": "Analgesics, Opioid", "type": 1 }, { "tag": "Buprenorphine", "type": 1 }, { "tag": "Drug Administration Schedule", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Neonatal", "type": 1 }, { "tag": "Neonatal Abstinence Syndrome", "type": 1 }, { "tag": "Opiate Substitution Treatment", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Practice Guidelines as Topic", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Pregnancy opioid addiction", "type": 1 }, { "tag": "Pregnant Women", "type": 1 }, { "tag": "Prenatal Exposure Delayed Effects", "type": 1 }, { "tag": "Substance-Related Disorders", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T17:45:54Z", "dateModified": "2016-01-31T17:45:54Z" } }, { "key": "798CWFRE", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/798CWFRE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/798CWFRE", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/XGJRJK6Z", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "798CWFRE", "version": 35, "parentItem": "XGJRJK6Z", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-31T03:04:19Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24494118", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-31T03:04:19Z", "dateModified": "2016-01-31T03:04:19Z" } }, { "key": "XGJRJK6Z", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/XGJRJK6Z", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/XGJRJK6Z", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Rahi et al.", "parsedDate": "2011", "numChildren": 1 }, "data": { "key": "XGJRJK6Z", "version": 35, "itemType": "journalArticle", "title": "A Comparison between APGAR Scores and Birth Weight in Infants of Addicted and Non-Addicted Mothers", "creators": [ { "creatorType": "author", "firstName": "Esmat", "lastName": "Rahi" }, { "creatorType": "author", "firstName": "Mohammad Reza", "lastName": "Baneshi" }, { "creatorType": "author", "firstName": "Ehsan", "lastName": "Mirkamandar" }, { "creatorType": "author", "firstName": "Saiedeh", "lastName": "Haji Maghsoudi" }, { "creatorType": "author", "firstName": "Azam", "lastName": "Rastegari" } ], "abstractNote": "BACKGROUND: Addiction in pregnant women causes complications such as abortion, asphyxia and cerebral and physical problems. APGAR score assesses vital signs and birth weight and represents the physical and brain growth of newborns. In this study, the effects of opium addiction in mothers on birth weight and APGAR scores of neonates were discussed.\nMETHODS: This study analytic, descriptive study was conducted on 49 pregnant women addicted to oral consumption of opium (0.5-0.8 grams daily) and 49 non-addicted women who referred to Afzalipour Hospital associated with Kerman University of Medical Sciences. Information including various personal characteristics, history of addiction and drug consumption, and the possibility of taking other drugs was collected by a researcher and recorded confidentially in a checklist. Birth weight and APGAR score t first, fifth and tenth minutes were also recorded. Statistical analysis was performed using Pearson correlation test, independent t-test, and repeated measure to evaluate the APGAR scores and other characteristics of the two groups of infants.\nFINDINGS: Average birth weight of infants with addicted mothers was 2255 grams which had a significant difference with infants born by non-addicted mothers (P < 0.0001). Average APGAR scores at the first minute were 7.6 ± 1.1 and 8.6 ± 1.1 among infants from addicted and non-addicted mothers, respectively. Average APGAR scores over time (at minutes 1, 5 and 10) had a significant difference (P < 0.0001) where an ascending trend was seen. This difference was significant in both groups (P = 0.003).\nCONCLUSION: Drug addiction in mothers decreases the APGAR score and birth weight of infants.", "publicationTitle": "Addiction & Health", "publisher": "", "place": "", "date": "2011 Winter-Spring", "volume": "3", "issue": "1-2", "section": "", "partNumber": "", "partTitle": "", "pages": "61-67", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Addict Health", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "2008-4633", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24494118\nPMCID: PMC3905520", "tags": [ { "tag": "Addicted mother", "type": 1 }, { "tag": "Apgar Score", "type": 1 }, { "tag": "Birth Weight", "type": 1 }, { "tag": "Opiate", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T03:04:19Z", "dateModified": "2016-01-31T03:04:19Z" } }, { "key": "RHCHJBXB", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/RHCHJBXB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/RHCHJBXB", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/ZE3IJACJ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "RHCHJBXB", "version": 35, "parentItem": "ZE3IJACJ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-31T03:03:42Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15282000", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2016-01-31T03:03:42Z", "dateModified": "2016-01-31T03:03:42Z" } }, { "key": "ZE3IJACJ", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/ZE3IJACJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/ZE3IJACJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Ludlow et al.", "parsedDate": "2004-08", "numChildren": 1 }, "data": { "key": "ZE3IJACJ", "version": 35, "itemType": "journalArticle", "title": "Obstetric and perinatal outcomes in pregnancies associated with illicit substance abuse", "creators": [ { "creatorType": "author", "firstName": "Joanne P.", "lastName": "Ludlow" }, { "creatorType": "author", "firstName": "Sharon F.", "lastName": "Evans" }, { "creatorType": "author", "firstName": "Gary", "lastName": "Hulse" } ], "abstractNote": "OBJECTIVE: To determine the obstetric and perinatal outcomes of women using illicit drugs during pregnancy by substance group.\nMETHOD: A retrospective audit of obstetric and perinatal outcomes in women who used opiates or amphetamines during their pregnancy and delivered at King Edward Memorial Hospital (KEMH), Perth, Australia between December 1997 and April 2000 was performed. Maternal, fetal and neonatal parameters were assessed. These were compared with obstetric and perinatal data recorded by the Health Department of Western Australia (HDWA) for the 25,291 deliveries of 25,677 infants in 1998.\nRESULTS: Between December 1997 and April 2000 91 opiate-using and 50 amphetamine-using women were identified and included in the analysis. Both groups of drug-using women were younger (opiates P = 0.001, amphetamines P = 0.001) than the general population. There was a higher incidence of aboriginality (P = 0.001) in the amphetamine group. In the opiate-using group multiparity (P = 0.0001) and anaemia (P = 0.0001) were higher. Illicit drug-using women had a higher incidence of hepatitis C (opiates P = 0.001, amphetamines P = 0.003), and a greater need for pharmacological analgesia for labour and delivery (opiates P = 0.007, amphetamines P = 0.042). Their infants were significantly more likely to deliver at less than 37 weeks' gestation (opiates P = 0.0001, amphetamines P = 0.001), to have a birthweight of less than 2.5 kg (P = 0.0001), be small for gestational age and require admission to the special care nursery (P = 0.0001). Infants born to women in the amphetamine group were more likely to have an Apgar score < 7 (P = 0.0001) recorded. Infants of women in the opiate group required more resuscitation (P = 0.05).\nCONCLUSION: Women who use illicit drugs are more likely to experience adverse obstetric and perinatal outcomes than women in the general population. Differences are seen depending on the type of illicit drug used. These findings need to be replicated in a larger prospective cohort to highlight management requirements of these women and their infants. Further information is required about the effects of amphetamines in pregnancy.", "publicationTitle": "The Australian & New Zealand Journal of Obstetrics & Gynaecology", "publisher": "", "place": "", "date": "Aug 2004", "volume": "44", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "302-306", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Aust N Z J Obstet Gynaecol", "DOI": "10.1111/j.1479-828X.2004.00221.x", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0004-8666", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15282000", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Apgar Score", "type": 1 }, { "tag": "Birth Weight", "type": 1 }, { "tag": "Cohort Studies", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Gestational Age", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Maternal Exposure", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Pregnancy Outcome", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Street Drugs", "type": 1 }, { "tag": "Substance-Related Disorders", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T03:03:42Z", "dateModified": "2016-01-31T03:03:42Z" } }, { "key": "7H3JERFZ", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/7H3JERFZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/7H3JERFZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Minozzi et al.", "parsedDate": "2013", "numChildren": 1 }, "data": { "key": "7H3JERFZ", "version": 35, "itemType": "journalArticle", "title": "Maintenance agonist treatments for opiate-dependent pregnant women", "creators": [ { "creatorType": "author", "firstName": "Silvia", "lastName": "Minozzi" }, { "creatorType": "author", "firstName": "Laura", "lastName": "Amato" }, { "creatorType": "author", "firstName": "Cristina", "lastName": "Bellisario" }, { "creatorType": "author", "firstName": "Marica", "lastName": "Ferri" }, { "creatorType": "author", "firstName": "Marina", "lastName": "Davoli" } ], "abstractNote": "BACKGROUND: The prevalence of opiate use among pregnant women can range from 1% to 2% to as high as 21%. Heroin crosses the placenta and pregnant, opiate-dependent women experience a six-fold increase in maternal obstetric complications such as low birth weight, toxaemia, third trimester bleeding, malpresentation, puerperal morbidity, fetal distress and meconium aspiration. Neonatal complications include narcotic withdrawal, postnatal growth deficiency, microcephaly, neuro-behavioural problems, increased neonatal mortality and a 74-fold increase in sudden infant death syndrome.\nOBJECTIVES: To assess the effectiveness of any maintenance treatment alone or in combination with psychosocial intervention compared to no intervention, other pharmacological intervention or psychosocial interventions for child health status, neonatal mortality, retaining pregnant women in treatment and reducing the use of substances.\nSEARCH METHODS: We searched the Cochrane Drugs and Alcohol Group Trials Register (September 2013), PubMed (1966 to September 2013), CINAHL (1982 to September 2013), reference lists of relevant papers, sources of ongoing trials, conference proceedings and national focal points for drug research. We contacted authors of included studies and experts in the field.\nSELECTION CRITERIA: Randomised controlled trials assessing the efficacy of any maintenance pharmacological treatment for opiate-dependent pregnant women.\nDATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by The Cochrane Collaboration.\nMAIN RESULTS: We found four trials with 271 pregnant women. Three compared methadone with buprenorphine and one methadone with oral slow-release morphine. Three out of four studies had adequate allocation concealment and were double-blind. The major flaw in the included studies was attrition bias: three out of four had a high drop-out rate (30% to 40%) and this was unbalanced between groups.Methadone versus buprenorphine: the drop-out rate from treatment was lower in the methadone group (risk ratio (RR) 0.64, 95% confidence interval (CI) 0.41 to 1.01, three studies, 223 participants). There was no statistically significant difference in the use of primary substance between methadone and buprenorphine (RR 1.81, 95% CI 0.70 to 4.69, two studies, 151 participants). For both, we judged the quality of evidence as low. Birth weight was higher in the buprenorphine group in the two trials that could be pooled (mean difference (MD) -365.45 g (95% CI -673.84 to -57.07), two studies, 150 participants). The third study reported that there was no statistically significant difference. For APGAR score neither of the studies which compared methadone with buprenorphine found a significant difference. For both, we judged the quality of evidence as low. Many measures were used in the studies to assess neonatal abstinence syndrome. The number of newborns treated for neonatal abstinence syndrome, which is the most critical outcome, did not differ significantly between groups. We judged the quality of evidence as very low.Methadone versus slow-release morphine: there was no drop-out in either treatment group. Oral slow-release morphine seemed superior to methadone for abstinence from heroin use during pregnancy (RR 2.40, 95% CI 1.00 to 5.77, one study, 48 participants). We judged the quality of evidence as moderate.Only one study which compared methadone with buprenorphine reported side effects. For the mother there was no statistically significant difference; for the newborns in the buprenorphine group there were significantly fewer serious side effects.In the comparison between methadone and slow-release morphine no side effects were reported for the mother, whereas one child in the methadone group had central apnoea and one child in the morphine group had obstructive apnoea.\nAUTHORS' CONCLUSIONS: We did not find sufficient significant differences between methadone and buprenorphine or slow-release morphineto allow us to conclude that one treatment is superior to another for all relevant outcomes. While methadone seems superior in terms of retaining patients in treatment, buprenorphine seems to lead to less severe neonatal abstinence syndrome. Additionally, even though a multi-centre, international trial with 175 pregnant women has recently been completed and its results published and included in this review, the body of evidence is still too small to draw firm conclusions about the equivalence of the treatments compared. There is still a need for randomised controlled trials of adequate sample size comparing different maintenance treatments.", "publicationTitle": "The Cochrane Database of Systematic Reviews", "publisher": "", "place": "", "date": "2013", "volume": "12", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "CD006318", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD006318.pub3", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24366859", "tags": [ { "tag": "Birth Weight", "type": 1 }, { "tag": "Buprenorphine", "type": 1 }, { "tag": "Delayed-Action Preparations", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Narcotics", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "infant", "type": 1 }, { "tag": "morphine", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": {}, "dateAdded": "2016-01-31T02:13:46Z", "dateModified": "2016-01-31T02:13:46Z" } }, { "key": "3SJ2VQB4", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/3SJ2VQB4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/3SJ2VQB4", "type": "text/html" }, "up": { "href": 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"version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/ZFU7N834", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/ZFU7N834", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/AHKDTDJR", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "ZFU7N834", "version": 35, "parentItem": "AHKDTDJR", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-29T18:30:32Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24247147", 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} } }, "data": { "key": "BUD9PTUD", "version": 35, "parentItem": "NSUFFM98", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-29T18:30:32Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25070299", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/WSF3N87J" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "JF3EP4WF", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/JF3EP4WF", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/JF3EP4WF", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/MKBKHMW5", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "JF3EP4WF", "version": 35, "parentItem": "MKBKHMW5", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-29T18:30:32Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25150272", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/MRDZGEWC" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "X7RBDB5W", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/X7RBDB5W", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/X7RBDB5W", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/359489/items/HVRDDVA2", "type": "application/json" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } } }, "data": { "key": "X7RBDB5W", "version": 35, "parentItem": "HVRDDVA2", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2016-01-29T18:30:32Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/25323126", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/WKV8UGAN" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "PBUC5BWU", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/PBUC5BWU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/PBUC5BWU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Cleary et al.", "parsedDate": "2010-12", "numChildren": 1 }, "data": { "key": "PBUC5BWU", "version": 35, "itemType": "journalArticle", "title": "Methadone dose and neonatal abstinence syndrome-systematic review and meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Brian J.", "lastName": "Cleary" }, { "creatorType": "author", "firstName": "Jean", "lastName": "Donnelly" }, { "creatorType": "author", "firstName": "Judith", "lastName": "Strawbridge" }, { "creatorType": "author", "firstName": "Paul J.", "lastName": "Gallagher" }, { "creatorType": "author", "firstName": "Tom", "lastName": "Fahey" }, { "creatorType": "author", "firstName": "Mike", "lastName": "Clarke" }, { "creatorType": "author", "firstName": "Deirdre J.", "lastName": "Murphy" } ], "abstractNote": "AIM: To determine if there is a relationship between maternal methadone dose in pregnancy and the diagnosis or medical treatment of neonatal abstinence syndrome (NAS).\nMETHODS: PubMed, EMBASE, the Cochrane Library and PsychINFO were searched for studies reporting on methadone use in pregnancy and NAS (1966-2009). The relative risk (RR) of NAS was compared for methadone doses above versus below a range of cut-off points. Summary RRs and 95% confidence intervals (CI) were estimated using random effects meta-analysis. Sensitivity analyses explored the impact of limiting meta-analyses to prospective studies or studies using an objective scoring system to diagnose NAS.\nRESULTS: A total of 67 studies met inclusion criteria for the systematic review; 29 were included in the meta-analysis. Any differences in the incidence of NAS in infants of women on higher compared with lower doses were statistically non-significant in analyses restricted to prospective studies or to those using an objective scoring system to diagnose NAS.\nCONCLUSIONS: Severity of the neonatal abstinence syndrome does not appear to differ according to whether mothers are on high- or low-dose methadone maintenance therapy.", "publicationTitle": "Addiction (Abingdon, England)", "publisher": "", "place": "", "date": "Dec 2010", "volume": "105", "issue": "12", "section": "", "partNumber": "", "partTitle": "", "pages": "2071-2084", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Addiction", "DOI": "10.1111/j.1360-0443.2010.03120.x", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1360-0443", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 20840198", "tags": [ { "tag": "Cohort Studies", "type": 1 }, { "tag": "Databases, Bibliographic", "type": 1 }, { "tag": "Dose-Response Relationship, Drug", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Narcotics", "type": 1 }, { "tag": "Neonatal Abstinence Syndrome", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "Prenatal Exposure Delayed Effects", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Severity of Illness Index", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/M9MCGUD5" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "I3RKP5Z8", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/I3RKP5Z8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/I3RKP5Z8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Jones et al.", "parsedDate": "2010-12-09", "numChildren": 1 }, "data": { "key": "I3RKP5Z8", "version": 35, "itemType": "journalArticle", "title": "Neonatal abstinence syndrome after methadone or buprenorphine exposure", "creators": [ { "creatorType": "author", "firstName": "Hendrée E.", "lastName": "Jones" }, { "creatorType": "author", "firstName": "Karol", "lastName": "Kaltenbach" }, { "creatorType": "author", "firstName": "Sarah H.", "lastName": "Heil" }, { "creatorType": "author", "firstName": "Susan M.", "lastName": "Stine" }, { "creatorType": "author", "firstName": "Mara G.", "lastName": "Coyle" }, { "creatorType": "author", "firstName": "Amelia M.", "lastName": "Arria" }, { "creatorType": "author", "firstName": "Kevin E.", "lastName": "O'Grady" }, { "creatorType": "author", "firstName": "Peter", "lastName": "Selby" }, { "creatorType": "author", "firstName": "Peter R.", "lastName": "Martin" }, { "creatorType": "author", "firstName": "Gabriele", "lastName": "Fischer" } ], "abstractNote": "BACKGROUND: Methadone, a full mu-opioid agonist, is the recommended treatment for opioid dependence during pregnancy. However, prenatal exposure to methadone is associated with a neonatal abstinence syndrome (NAS) characterized by central nervous system hyperirritability and autonomic nervous system dysfunction, which often requires medication and extended hospitalization. Buprenorphine, a partial mu-opioid agonist, is an alternative treatment for opioid dependence but has not been extensively studied in pregnancy.\nMETHODS: We conducted a double-blind, double-dummy, flexible-dosing, randomized, controlled study in which buprenorphine and methadone were compared for use in the comprehensive care of 175 pregnant women with opioid dependency at eight international sites. Primary outcomes were the number of neonates requiring treatment for NAS, the peak NAS score, the total amount of morphine needed to treat NAS, the length of the hospital stay for neonates, and neonatal head circumference.\nRESULTS: Treatment was discontinued by 16 of the 89 women in the methadone group (18%) and 28 of the 86 women in the buprenorphine group (33%). A comparison of the 131 neonates whose mothers were followed to the end of pregnancy according to treatment group (with 58 exposed to buprenorphine and 73 exposed to methadone) showed that the former group required significantly less morphine (mean dose, 1.1 mg vs. 10.4 mg; P<0.0091), had a significantly shorter hospital stay (10.0 days vs. 17.5 days, P<0.0091), and had a significantly shorter duration of treatment for the neonatal abstinence syndrome (4.1 days vs. 9.9 days, P<0.003125) (P values calculated in accordance with prespecified thresholds for significance). There were no significant differences between groups in other primary or secondary outcomes or in the rates of maternal or neonatal adverse events.\nCONCLUSIONS: These results are consistent with the use of buprenorphine as an acceptable treatment for opioid dependence in pregnant women. (Funded by the National Institute on Drug Abuse; ClinicalTrials.gov number, NCT00271219.).", "publicationTitle": "The New England Journal of Medicine", "publisher": "", "place": "", "date": "Dec 9, 2010", "volume": "363", "issue": "24", "section": "", "partNumber": "", "partTitle": "", "pages": "2320-2331", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "N. Engl. J. Med.", "DOI": "10.1056/NEJMoa1005359", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1533-4406", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 21142534\nPMCID: PMC3073631", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Buprenorphine", "type": 1 }, { "tag": "Double-Blind Method", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Head", "type": 1 }, { "tag": "History, Ancient", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Length of Stay", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Narcotics", "type": 1 }, { "tag": "Neonatal Abstinence Syndrome", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 }, { "tag": "morphine", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/45Z4SB65" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "C75ESJC8", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/C75ESJC8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/C75ESJC8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Jones et al.", "parsedDate": "2013-10", "numChildren": 1 }, "data": { "key": "C75ESJC8", "version": 35, "itemType": "journalArticle", "title": "The relationship between maternal methadone dose at delivery and neonatal outcome: methodological and design considerations", "creators": [ { "creatorType": "author", "firstName": "Hendrée E.", "lastName": "Jones" }, { "creatorType": "author", "firstName": "Lauren M.", "lastName": "Jansson" }, { "creatorType": "author", "firstName": "Kevin E.", "lastName": "O'Grady" }, { "creatorType": "author", "firstName": "Karol", "lastName": "Kaltenbach" } ], "abstractNote": "Compared to untreated opioid dependence, methadone maintenance treatment of opioid-dependent pregnant women has been found to be associated with better maternal and neonatal outcomes. Secondary analysis of data from 73 maternal and neonatal participants in the MOTHER study (H. E. Jones et al., New England Journal of Medicine, 2010) found no relationship between maternal methadone dose at delivery and any of 9 neonatal outcomes--peak neonatal abstinence syndrome (NAS) score, total amount of morphine needed to treat NAS, duration of neonatal hospital stay, duration of treatment for NAS, estimated gestational age at delivery, Apgar score at 5 min, and neonatal head circumference, length, and weight at birth. These results are consistent with a recent systematic review and meta-analysis (B. J. Cleary et al., Addiction, 2010) and extend findings to outcomes other than NAS. Methodological and design issues that might have adversely impacted the ability of researchers to establish the existence or non-existence of these relationships are considered.", "publicationTitle": "Neurotoxicology and Teratology", "publisher": "", "place": "", "date": "2013 Sep-Oct", "volume": "39", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "110-115", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Neurotoxicol Teratol", "DOI": "10.1016/j.ntt.2013.05.003", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1872-9738", "archive": "", "archiveLocation": "", "shortTitle": "The relationship between maternal methadone dose at delivery and neonatal outcome", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24099621\nPMCID: PMC3793207", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Apgar Score", "type": 1 }, { "tag": "Body Size", "type": 1 }, { "tag": "Child Development", "type": 1 }, { "tag": "Dose-Response Relationship, Drug", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Gestational Age", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infant, Newborn", "type": 1 }, { "tag": "Length of Stay", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Neonatal Abstinence Syndrome", "type": 1 }, { "tag": "Neonate", "type": 1 }, { "tag": "Opiate Substitution Treatment", "type": 1 }, { "tag": "Opioid dependence", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Prenatal Exposure Delayed Effects", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "morphine", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/FZTFKSSD" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "RZWICFJU", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/RZWICFJU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/RZWICFJU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Nuckols et al.", "parsedDate": "2014-01-07", "numChildren": 1 }, "data": { "key": "RZWICFJU", "version": 35, "itemType": "journalArticle", "title": "Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain", "creators": [ { "creatorType": "author", "firstName": "Teryl K.", "lastName": "Nuckols" }, { "creatorType": "author", "firstName": "Laura", "lastName": "Anderson" }, { "creatorType": "author", "firstName": "Ioana", "lastName": "Popescu" }, { "creatorType": "author", "firstName": "Allison L.", "lastName": "Diamant" }, { "creatorType": "author", "firstName": "Brian", "lastName": "Doyle" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Di Capua" }, { "creatorType": "author", "firstName": "Roger", "lastName": "Chou" } ], "abstractNote": "BACKGROUND: Deaths due to prescription opioid overdoses have increased dramatically. High-quality guidelines could help clinicians mitigate risks associated with opioid therapy.\nPURPOSE: To evaluate the quality and content of guidelines on the use of opioids for chronic pain.\nDATA SOURCES: MEDLINE, National Guideline Clearinghouse, specialty society Web sites, and international guideline clearinghouses (searched in July 2013).\nSTUDY SELECTION: Guidelines published between January 2007 and July 2013 addressing the use of opioids for chronic pain in adults were selected. Guidelines on specific settings, populations, and conditions were excluded.\nDATA EXTRACTION: Guidelines and associated systematic reviews were evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument and A Measurement Tool to Assess Systematic Reviews (AMSTAR), respectively, and recommendations for mitigating opioid-related risks were compared.\nDATA SYNTHESIS: Thirteen guidelines met selection criteria. Overall AGREE II scores were 3.00 to 6.20 (on a scale of 1 to 7). The AMSTAR ratings were poor to fair for 10 guidelines. Two received high AGREE II and AMSTAR scores. Most guidelines recommend that clinicians avoid doses greater than 90 to 200 mg of morphine equivalents per day, have additional knowledge to prescribe methadone, recognize risks of fentanyl patches, titrate cautiously, and reduce doses by at least 25% to 50% when switching opioids. Guidelines also agree that opioid risk assessment tools, written treatment agreements, and urine drug testing can mitigate risks. Most recommendations are supported by observational data or expert consensus.\nLIMITATION: Exclusion of non-English-language guidelines and reliance on published information.\nCONCLUSION: Despite limited evidence and variable development methods, recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug-drug and drug-disease interactions; and use of risk assessment tools, treatment agreements, and urine drug testing. Future research should directly examine the effectiveness of opioid risk mitigation strategies.\nPRIMARY FUNDING SOURCE: California Department of Industrial Relations and California Commission on Health and Safety and Workers' Compensation.", "publicationTitle": "Annals of Internal Medicine", "publisher": "", "place": "", "date": "Jan 7, 2014", "volume": "160", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "38-47", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann. Intern. Med.", "DOI": "10.7326/0003-4819-160-1-201401070-00732", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1539-3704", "archive": "", "archiveLocation": "", "shortTitle": "Opioid prescribing", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24217469", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Analgesics, Opioid", "type": 1 }, { "tag": "Chronic Pain", "type": 1 }, { "tag": "Drug Overdose", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Medication Adherence", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Practice Guidelines as Topic", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "Urinalysis", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/JTB4FPIS" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "AHKDTDJR", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/AHKDTDJR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/AHKDTDJR", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Thomas et al.", "parsedDate": "2014-02-01", "numChildren": 1 }, "data": { "key": "AHKDTDJR", "version": 35, "itemType": "journalArticle", "title": "Medication-assisted treatment with buprenorphine: assessing the evidence", "creators": [ { "creatorType": "author", "firstName": "Cindy Parks", "lastName": "Thomas" }, { "creatorType": "author", "firstName": "Catherine Anne", "lastName": "Fullerton" }, { "creatorType": "author", "firstName": "Meelee", "lastName": "Kim" }, { "creatorType": "author", "firstName": "Leslie", "lastName": "Montejano" }, { "creatorType": "author", "firstName": "D. Russell", "lastName": "Lyman" }, { "creatorType": "author", "firstName": "Richard H.", "lastName": "Dougherty" }, { "creatorType": "author", "firstName": "Allen S.", "lastName": "Daniels" }, { "creatorType": "author", "firstName": "Sushmita Shoma", "lastName": "Ghose" }, { "creatorType": "author", "firstName": "Miriam E.", "lastName": "Delphin-Rittmon" } ], "abstractNote": "OBJECTIVE: Buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) are pharmacological treatment programs for individuals with opioid use disorders. MMT is discussed in a companion article. This article describes BMT and reviews available research on its efficacy.\nMETHODS: Authors reviewed meta-analyses, systematic reviews, and individual studies of BMT from 1995 through 2012. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, and Published International Literature on Traumatic Stress. They chose from three levels of evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness.\nRESULTS: Sixteen adequately designed randomized controlled trials of BMT indicated a high level of evidence for its positive impact on treatment retention and illicit opioid use. Seven reviews or meta-analyses were also included. When the medication was dosed adequately, BMT and MMT showed similar reduction in illicit opioid use, but BMT was associated with less risk of adverse events. Results suggested better treatment retention with MMT. BMT was associated with improved maternal and fetal outcomes in pregnancy, compared with no medication-assisted treatment. Rates of neonatal abstinence syndrome were similar for mothers treated with BMT and MMT during pregnancy, but symptoms were less severe for infants whose mothers were treated with BMT.\nCONCLUSIONS: BMT is associated with improved outcomes compared with placebo for individuals and pregnant women with opioid use disorders. BMT should be considered for inclusion as a covered benefit.", "publicationTitle": "Psychiatric Services (Washington, D.C.)", "publisher": "", "place": "", "date": "Feb 1, 2014", "volume": "65", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "158-170", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Psychiatr Serv", "DOI": "10.1176/appi.ps.201300256", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1557-9700", "archive": "", "archiveLocation": "", "shortTitle": "Medication-assisted treatment with buprenorphine", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24247147", "tags": [ { "tag": "Analgesics, Opioid", "type": 1 }, { "tag": "Buprenorphine", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Opiate Substitution Treatment", "type": 1 }, { "tag": "Opioid-Related Disorders", "type": 1 }, { "tag": "Pregnancy", "type": 1 }, { "tag": "Pregnancy Complications", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/E4HN77AB" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } }, { "key": "Z2ITTCEZ", "version": 35, "library": { "type": "group", "id": 359489, "name": "Methadone safety in pregnancy", "links": { "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/359489/items/Z2ITTCEZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/methadone_safety_in_pregnancy/items/Z2ITTCEZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 136169, "username": "TanyaHill", "name": "Tanya MacLeod", "links": { "alternate": { "href": "https://www.zotero.org/tanyahill", "type": "text/html" } } }, "creatorSummary": "Weimer and Chou", "parsedDate": "2014-04", "numChildren": 1 }, "data": { "key": "Z2ITTCEZ", "version": 35, "itemType": "journalArticle", "title": "Research gaps on methadone harms and comparative harms: findings from a review of the evidence for an American Pain Society and College on Problems of Drug Dependence clinical practice guideline", "creators": [ { "creatorType": "author", "firstName": "Melissa B.", "lastName": "Weimer" }, { "creatorType": "author", "firstName": "Roger", "lastName": "Chou" } ], "abstractNote": "Methadone-associated overdose deaths have dramatically increased. In order to inform an evidence-based clinical practice guideline to improve safety of methadone prescribing, the American Pain Society commissioned a systematic review on various aspects related to methadone safety. We searched Ovid MEDLINE, Cochrane Library, and PsycINFO databases through July 2012 to identify studies that addressed 1 or more of 17 Key Questions related to methadone safety; an update search was performed in 2014 for new studies related to methadone-related overdose and risks related to cardiac arrhythmias. A total of 168 studies met inclusion criteria for the review. The purpose of this article is to highlight critical research gaps in the literature related to methadone safety. These include lack of evidence on risk factors associated with methadone-overdose deaths and adverse events, limited evidence to evaluate the comparative mortality of methadone versus other opioids, insufficient evidence to fully understand the harms associated with methadone use during pregnancy, and insufficient evidence to determine effects of risk mitigation strategies such as electrocardiogram monitoring, strategies for managing patients with prolonged QTc intervals on screening, urine drug testing, alternative dosing regimens for initiation and titration of therapy, and timing of follow-up. Therefore, most guideline recommendations are based on weak evidence. More research is needed to guide safe methadone prescribing practices and decrease the adverse events associated with methadone.\nPERSPECTIVE: This article summarizes critical research gaps in the literature related to methadone safety, based on a systematic review commissioned by the American Pain Society. Critical research gaps were identified in a number of areas, highlighting the need for additional research to guide safer prescribing and risk mitigation strategies.", "publicationTitle": "The Journal of Pain: Official Journal of the American Pain Society", "publisher": "", "place": "", "date": "Apr 2014", "volume": "15", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "366-376", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Pain", "DOI": "10.1016/j.jpain.2014.01.496", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1528-8447", "archive": "", "archiveLocation": "", "shortTitle": "Research gaps on methadone harms and comparative harms", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24685460", "tags": [ { "tag": "Analgesics, Opioid", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Methadone", "type": 1 }, { "tag": "Practice Guidelines as Topic", "type": 1 }, { "tag": "harms", "type": 1 }, { "tag": "research gaps", "type": 1 }, { "tag": "systematic review", "type": 1 } ], "collections": [ "IBB4EAPF" ], "relations": { "owl:sameAs": "http://zotero.org/groups/361204/items/PQAMUWJQ" }, "dateAdded": "2016-01-29T22:59:39Z", "dateModified": "2016-01-29T22:59:39Z" } } ]