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Re: hello and questionFrom: ainsron (ainsron@sbcglobal.net)Tue May 31 13:05:00 2005
There is a good article in Obstetrics & Gynecology, Dec 2002, V100, #6, P1244-1249, "Relationship between maternal methadone dosage and neonatal withdrawal" By Dashe, et al. 2nd trimester seems to be the best time to taper, so you may already have passed through the window of opportunity. Another good article is "Methadone treatment during pregnancy by Jarvis & Schnoll, Journal of Psychoactive drugs, Apr-Jun 1994, V26(2), p. 155-161. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Rachel Hedin Sent: Tuesday, May 31, 2005 9:59 AM To: Multiple recipients of list OB-GYN-L Subject: hello and question Hi. I'm a family practice nurse practitioner working in women's health...currently also beginning studies for a second master's degree to get my CNM. We have a 32 y/o client at my clinic who just moved from out of state. She is 26 weeks pregnant (G2 P1, had a c. section for FTP in Sept 2004 and is due again Sept 2005) She has struggled with drug addiction in the past, but has been sober for 8 years and currently is maintained on 10 mg of methadone a day. She would like to discontinue the methadone completely but was advised by her previous provider to wait until after the birth. There are no methadone clinics/addictionists nearby for us to refer to. We found out legally that we CAN continue to prescribe for her during her pregnancy, so the group has asked that we do some research into what the best action plan is. Mom is very motivated to get off the methadone as she wants to prevent IUGR, withdrawl syndromes postnatally, etc. If anybody has any experience with this...or suggestions about how to taper mom off (and when) as well as any risks/pitfalls to look out for, I'd appreciate the input. FWIW mom is in a very structured living environment with lots of emotional support right now as she has voluntarily joined a live-in religious program for unwed moms. Thanks! Rachel RN MSN
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