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Methadone in pregnancyFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Wed Oct 29 17:45:14 2003
I've seen more patients in the last couple of years on methadone maintenance than I recall in previous years. My impression is that the methadone clinics only incentive is to increase the number of patients they treat and increase the amount of methadone they dispense. These patients are told by the clinic that they cannot stop methadone during pregnancy because they will miscarry. Rather than attempting to detox patients during the second trimester or taper them down to a workable level of 20-40 mg by the third trimester, most of these patients have been increased to 120 mg or greater. It is frustrating because the clinic gives no feedback and I've even had the experience of patients not even informing me until late in their pregnancies that they are on methadone - to "avoid stigmatization." I've tried to enter into a dialogue with the physician who is in charge of the clinic, I've sent several faxed notes about specific patients as well as my general concerns but get no response. If you read the literature on methadone in pregnancy, this is far from ideal! How is it working in other's experience and areas?
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