Methadone Moms Face Catch-22

By Chrisanne Grise 09/04/12

New moms on methadone treatment are often trapped between Dr.'s orders and child-welfare workers who report them for still using opiates.

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A lose-lose situation. Photo via

Doctors often prescribe recovering addicts methadone to help wean them off of opiates, but as painkiller abuse rates skyrocket, this treatment is increasingly causing problems for pregnant women. More and more parents are being charged with child abuse or are having their children taken away, even when the mother was following her doctor’s orders. In fact, the methadone may actually save a fetus’s life, as going cold turkey can cause premature birth or even a miscarriage. “Mothers on methadone maintenance stop getting high, they tend to lead more stable lives, get better prenatal care, and are rarely born premature,” says Barry Lester, the director of the Center for the Study of Children at Risk at Brown Alpert Medical School's Women and Infants Hospital. But because methadone is an opiate, many child welfare workers and judges view it as an addiction. Lester explains that there is little research on the long-term risks to children exposed to methadone in utero, and methadone has never been approved by the Federal Drug Administration. In addition, exposed babies often experience symptoms of withdrawal for up to several weeks after birth, giving child-protective workers a reason to take the infants from their mothers.

Despite the lack of research, advocates say scaring pregnant women away from methadone treatment is not the solution. “There are definitely situations where reporting is appropriate in order to keep children safe,” says Maureen Phipps, immediate past chair of American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women. “But whenever possible, that ought to be done after doctors have been able to establish a relationship with their patients. When women are too afraid of the consequences of being honest with their doctors, that can be a very risky situation for the mother and for the fetus.” Experts suggest there is also a double standard, as caseworkers do not remove children from mothers who smoke, despite the fact that much more is known about the negative effects of tobacco exposure, making it seem as though these parents are being punished for seeking treatment. “These are not pregnant women using methadone,” says Robert Newman, a doctor who established some of the first methadone-maintenance clinics in the country. “These are pregnant women receiving medical treatment from licensed trained physicians, approved by the federal government and by state governments. To penalize them because they are compliant with a medical regimen is hard to understand.”

 

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Chrisanne Grise is a multimedia journalist specializing in health/fitness, lifestyle, travel, bridal, and music. Her work has appeared in print and online for publications such as Martha Stewart Weddings, Parents, FitnessMagazine, Fisher Price, Bridal Guide, Scholastic's Choices, AbsolutePunk.net, Chorus.fm, and more. She is the Senior Editor at The New York Times Upfront. Follow her on Linkedin and Twitter.

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