Methadone is an opioid medication often used as a replacement for other opioids in the treatment of opioid use disorder in pregnant women. However, the relationship between methadone and pregnancy is complicated and must be examined from multiple angles to understand whether the drug’s benefits outweigh the risks.
Read on to gain a deeper insight into methadone and pregnancy, the drug’s effect on fertility and breastfeeding, and its impact on fetal and neonatal development.
What Is Methadone?
Methadone is a synthetic opioid medication used primarily to treat opioid use disorder (OUD). As a Schedule II drug, it is a tightly controlled substance with significant potential for addiction and abuse, so it can only be sold as a prescription medication.
Sold under the brand names Dolophine®, Methadose®, and Methadone Intensol®, methadone comes in the form of a tablet, dispersible tablet, concentrate solution, oral liquid, and powder. The onset of its effects occurs approximately 30 minutes after administration, and they can last up to 24 hours with repeated use.
As a long-acting opioid, methadone isn’t suitable for the treatment of mild pain. Instead, it’s administered to patients who need round-the-clock relief from moderate to severe pain.
However, its primary function is that of an opioid agonist used to treat opioid dependence. Methadone binds to the same opioid receptors in the central nervous system (CNS) as other opioids.
As a result, methadone is often used in medication-assisted treatment (MAT), which also encompasses behavioral therapy and counseling. Another opioid, buprenorphine, can be used for this same purpose.
Despite its use in the OUD treatment, methadone is just as addictive as other opioids. Although methadone is used to treat opioid dependence, patients who are taking methadone are dependent on it. If they miss a dose or discontinue it “cold turkey,” they will experience withdrawal symptoms just like with any other opioid.
Side Effects of Using Methadone
Common side effects of methadone include:
- Sweating
- Headache
- Dry mouth
- Weight gain
- Blurry vision
- Stomachache
- Sleep problems
- Trouble urinating
- Changes in appetite
Methadone can also result in side effects that require immediate medical attention, such as:
- Rashes
- Nausea
- Fainting
- Vomiting
- Itchy skin
- Hallucinations
- Rapid heartbeat
- Lightheadedness
- Difficulty swallowing or breathing
Some of these symptoms may indicate a methadone overdose or a potentially life-threatening allergic reaction, so it’s essential to act quickly.
Now that we’ve reviewed the basics let’s examine the essential facts about methadone and pregnancy.
Methadone and Pregnancy: Understanding the Risks & Dangers
The risks and dangers of taking methadone during pregnancy are not entirely clear because research on the drug’s effects is complex and limited. However, the general consensus is that pregnant women should only use methadone if there is no other option and if the potential benefits outweigh the risks.
How Does Methadone Affect Pregnant Women and the Fetus?
Methadone might negatively affect pregnant women and especially the fetus, according to a meta-analysis conducted by researchers from the University of Oslo. Evidence presented in this study shows that using methadone during pregnancy results in worse outcomes in children.
Several studies found that babies born to mothers who took methadone as part of MAT didn’t perform as well in terms of cognitive, behavioral, and executive functioning as those whose mothers didn’t use drugs. Furthermore, some of them experienced vision impairment and may be more likely to develop anxiety and depression later in life.
However, these children still performed better compared to babies born to mothers who weren’t receiving any treatment for their opioid dependence. Prenatal exposure to heroin, for instance, is significantly worse than methadone.
As for the mothers, several studies maintain that methadone is safe to use during pregnancy and causes no significant harm. In fact, using methadone under medical supervision is far preferable to unregulated, illicit opioid use or abrupt cessation, as this may result in premature labor, fetal distress, and even miscarriage caused by withdrawal symptoms.
Using Methadone While Breastfeeding
Using methadone while breastfeeding is generally considered safe for the baby, but it’s important to note that a small dose of the drug can pass into breast milk. That can be harmful to the child, especially if their mother is prescribed a high dose. Either way, it’s best to consult a medical professional if you’re taking methadone and breastfeeding.
If your doctor approves the use of the drug regardless of its potential risks, you should monitor your baby’s behavior carefully.
In case you notice any of the following side effects, seek medical help immediately:
- Limpness
- Drowsiness
- Breathing difficulties
- Inability to gain weight
Furthermore, your baby may experience withdrawal symptoms if you abruptly stop breastfeeding while taking methadone. Thus, weaning them off gradually and following your doctor’s instructions closely is important.
How Does Methadone Affect Fertility?
It’s uncertain how methadone affects fertility, as there is limited research on this drug specifically. However, opioids as a whole have been found to decrease fertility both in men and women, so that is likely the case with methadone, too.
In women, long-term opioid use affects hormone levels and frequently causes amenorrhea, irregular periods, and decreased ovary function. All this can lead to infertility or at least difficulty conceiving.
Opioids similarly affect testosterone production in men, resulting in abnormal semen and potential fertility issues. In particular, a study conducted on 32 heroin and methadone addicts showed that 65% of methadone users experienced fertility issues.
Methadone and the Cause of Neonatal Abstinence Syndrome (NAS)
Methadone is a frequent cause of neonatal abstinence syndrome (NAS), a condition newborns experience when they are exposed to drugs in the womb.
NAS can develop from all drugs the baby receives through the placenta before birth, but the most frequent culprits are opioids. For that reason, this condition is often referred to as neonatal opioid withdrawal syndrome (NOWS).
Essentially, NAS develops because the baby becomes dependent on methadone (or other opioids) in the womb. Upon birth, it no longer receives the drug, which usually results in a range of withdrawal symptoms.
These symptoms commonly include:
- Fever
- Tremors
- Diarrhea
- Vomiting
- Seizures
- Sweating
- Diaper rash
- Rapid breathing
- Excessive crying
- Difficulty sleeping
- Feeding problems
- Hyperactive reflexes
Although these symptoms can be stressful for a new parent, they are treatable and may last between a week and six months. In case they are particularly severe, the baby may be required to stay in the neonatal intensive care unit (NICU) until the worst of it subsides.
Considering that methadone is linked to CNS hyperirritability and autonomic nervous system dysfunction in newborns, a hospital stay is almost unavoidable.
The Importance of Quitting Methadone During Pregnancy
Though the risks of consuming opioids during pregnancy are high, most doctors advise against quitting “cold turkey.” As mentioned before, abrupt quitting may cause severe withdrawal symptoms, which may put excessive strain on the body and result in various complications.
The situation is exactly the same for those who consume methadone. Despite its role in OUD treatments, it is still an opioid and withdrawal once that use stops.
As a solution, some experts suggest tapering off methadone over a long period of time to reduce the risk of severe withdrawal symptoms. However, some withdrawal is still likely to occur, so health professionals tend to disagree over whether this is a good idea, calling for more research before they can decide.
Ultimately, since it’s unsafe to take methadone during pregnancy and to quit it, the ideal course of action would be to address methadone dependence before planning a child, when possible.
ANR Treatment for Methadone Dependence
Accelerated Neuro-Regulation (ANR) is a highly advanced methadone dependence treatment that addresses the root cause of the problem, resulting in a long-lasting recovery.
Unlike other treatment options, ANR acts directly on the endorphin-receptor system, rebalancing it and reversing damage caused by chronic opioid use. At the end of the treatment, you will no longer experience cravings, nor will you be at risk of relapse.
To avoid unpleasant withdrawal symptoms, ANR is carried out while the patient is sedated and monitored by a team of certified anesthesiologists and other medical professionals.
Each treatment is tailored to the patient’s needs, so it is safe even for people who suffer from various chronic conditions. However, the ANR treatment is not administered to pregnant women, prioritizing the safety and well-being of both mother and baby.
The procedure lasts only 4–6 hours, after which the patient wakes up and stays in the hospital for evaluation and monitoring. On average, the total hospital stay does not exceed 36 hours.
So far, ANR has helped approximately 25,000 people in the world to overcome their opioid dependence and addiction. The entire process is quick, painless, and long-lasting, so there is no need to come for follow-up treatments after your brain has been re-regulated.
To learn more about the treatment, contact us for a free, fully confidential consultation.
Key Takeaways
Although we’ve covered the basics of interactions between methadone and pregnancy, you should consult your doctor.
For now, here are the key points you should remember:
- Methadone is an opioid medication used to treat opioid dependence, and it is approved for use during pregnancy. Despite this, methadone use can result in methadone dependence.
- There is evidence that taking methadone during pregnancy can have a negative effect on the development of the fetus, causing visual impairment, potentially lower cognitive and executive functioning, and neonatal abstinence syndrome (NAS).
- Even so, it’s not safe to abruptly quit taking methadone during pregnancy. The resulting withdrawal symptoms may cause complications in the pregnancy, including fetal distress, premature labor, and miscarriage.
Methadone and Pregnancy Q&A
If your baby was exposed to methadone, it may develop dependence and subsequent neonatal abstinence syndrome (NAS). This treatable condition occurs after birth when the baby no longer receives the opioid it was exposed to through the placenta and begins experiencing withdrawal symptoms.
It is unknown whether methadone increases the chances of miscarriage, but many experts believe it is preferable to quitting “cold turkey” during pregnancy. Withdrawal symptoms are hard on the body and may result in numerous complications, including miscarriage.
Taking methadone may increase the chances of congenital anomalies in babies, although it’s difficult to determine whether they occur due to the drug or another factor entirely. Typically, methadone-related congenital anomalies may include vision impairment and lower cognitive and executive functioning.
Methadone generally doesn’t affect natural labor, but it may increase analgesic needs in women who go through C-sections by approximately 70%.
Usually, a painkiller safe to take during pregnancy is acetaminophen (paracetamol), while most others come with certain risks. For instance, non-steroidal anti-inflammatory drugs, like ibuprofen, aren’t recommended in the final trimester, and opioids should be avoided altogether if possible. However, it’s always advisable to consult your doctor before you take anything, including acetaminophen.
Taking methadone can make it harder to get pregnant, as there is some evidence that it affects hormone levels and decreases ovary function. This is also the case with other opioids, to a greater or lesser extent.
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