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Re: Methadone in pregnancy From: Robert J. Carpenter, Jr. MD (zygote@icsi.net) Thu Oct 30 16:19:54 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman: "perinatal contracts" Previous message: DoctorJoe@aol.com: "Re: Methadone in pregnancy" In reply to: DoctorJoe@aol.com: "Re: Methadone in pregnancy" Having practiced 25 years ago and being at a hospital with methadone dependent patients. Methadone was frequently decreased to 20MG dosage and some women with appropriate supervision were able to get off meds. That latter event requires great dedication and support. The state is being abitrary and caprious in its stand and appropriate medical intervention is required and actually demanded. You will need an activist MD (MFM or not) to plead your case! On 30 Oct 2003 at 16:31, DoctorJoe@aol.com wrote: > > In a message dated 10/30/03 12:35:01, jescnm@icehouse.net writes: > > > I'm having similar problems with the methadone clinic in our > > community, I have a 24 y/o woman, g4 p3 with a hx of previous > > prescription pain med addiction, she was court ordered into this > > program and now that she is pregnant wants to wean so that she will > > be metadone free to breastfeed, she's currently first trimester. > > > > I consulted with an MFM who supported her attempting a slow > > withdrawl to be down to 20mg per day by 3rd trimester. Sent the > > metadone clinic the notes and plan which they are refusing to carry > > out. > > > > The methadone folks are threatening to report failure to comply to > > Child Protective services and the court if the mom refuses to take > > their prescribed dosage and are trying to increase the now 60mg/day > > dose. > > > > They are reciting 25 y/o studies which show higher SAB rates, > > abruptio etc. The current literature is lacking. So what to do? > > > > This is REALLY a job for a lawyer who is familiar with this sort of > stuff. When they get the courts involved and have the power they have > (i.e. Child Protective Services, etc.), you CANNOT afford to miss a > beat or make a mistake. They'll swoop her baby up at birth quick as > you can bat an eye. If they want to INCREASE her dose, against medical > advice, you need to be aggressive and go after them and advocate for > your patient/client. > > I would advise the MFM and you and the lawyer put your heads together > and go for it, if you think the mom is sincerce, etc., etc. > > Joe P. > -- Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 St. Luke's Medical Tower Houston,TX 77030-2339 713-795-4600 Next message: Dean Huffman: "perinatal contracts" Previous message: DoctorJoe@aol.com: "Re: Methadone in pregnancy" In reply to: DoctorJoe@aol.com: "Re: Methadone in pregnancy"

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