Drug addiction in pregnancy and the neonate

Drug addiction during pregnancy has been managed in two ways: the detoxification program and the methadone-maintenance treatment program. In the detoxification program, there have been few complications for the mother and child except for low birth weight, meconium-stained amniotic fluid, and an increase in breech presentation. The methadone-maintenance treatment program at this time is the most satisfactory approach to the treatment of heroin addiction. The complications of pregnancy in this program are similar to those of the average obstetric population. Low birth weight at term is still frequent for those on methadone maintenance. The problem of multiple drug abuse, including heroin, cocaine, alcohol, tranquilizers, and amphetamines, requires more attention. The characteristics of the withdrawal syndrome and its treatment in infants are described. Excessive weight loss and irritability are commin in these infants. Of the many drugs available for the treatment of the newborn withdrawal syndrome, diazepam is currently favored. The long-term effects of intrauterine drug exposure, the withdrawal syndrome, and treatment are generally unknown. Schedules for management of adult narcotic, alcohol, and barbiturate abuse and newborn narcotic withdrawal are suggested.