Evidence map›Paper›PMID 24474873›Full record

ArticleSubstance abuse and rehabilitation2012

Comparing methadone and buprenorphine maintenance with methadone-assisted withdrawal for the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes.

Ingunn O Lund, Heather Fitzsimons, Michelle Tuten, Margaret S Chisolm, Kevin E O'Grady, Hendrée E Jones

Open access · goldAbstract read

In one paragraph

Article in Substance abuse and rehabilitation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it

0cells of the map it votes in

10citing papers in PubMed, 3 pooled it

1.3field-weighted citation impact, top 15% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.

Opioid Detoxification During Pregnancy: A Systematic Review.Obstetrics and gynecology · 2018
Pooled it
Management of opioid use disorders: a national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018
Guideline
Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes: Executive Summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Maternal-Fetal Medicine, Centers for Disease Control and Prevention, and the March of Dimes Foundation.Obstetrics and gynecology · 2017
Guideline
Treatment of Opioid Use Disorder in Pregnant Women via Telemedicine: A Nonrandomized Controlled Trial.JAMA network open · 2020
Article
Opioids affect the fetal brain: reframing the detoxification debate.American journal of obstetrics and gynecology · 2019
Article
Risk Factors Associated with the Occurrence of Neonatal Opioid Withdrawal Syndrome: A Review.CNS drugs · 2019
Review
Early postpartum resting-state functional connectivity for mothers receiving buprenorphine treatment for opioid use disorder: A pilot study.Journal of neuroendocrinology · 2019
Article
Effects of opioids on the parental brain in health and disease.Frontiers in neuroendocrinology · 2019
Review
Treatment of Prescription Opioid Use Disorder in Pregnant Women.The American journal of psychiatry · 2017
Article
Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance.Journal of addiction medicine
Review

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Ingunn O LundSERAF-Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.

Heather FitzsimonsDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.

Michelle TutenDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.

Margaret S ChisolmDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.

Kevin E O'GradyDepartment of Psychology, University of Maryland, College Park, MD.

Hendrée E JonesDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD ; Substance Abuse Treatment evaluations and interventions Research Program, RTI International, Research Triangle Park, NC, USA.

Johns Hopkins Medicine · USJohns Hopkins University · USUniversity of Maryland, College Park · US

Funding

Maternal Opioid Treatment: Human Experimental ResearchR01DA015764 · NIDA · JOHNS HOPKINS UNIVERSITY · PI JONES, HENDREE E · 2004 to 2008

$5.8M

Reinforcement Based Treatment for Pregnant Drug AbusersR01DA014979 · NIDA · JOHNS HOPKINS UNIVERSITY · PI CHISOLM, MARGARET SMITH · 2002 to 2013

$4.4M

NIDA NIH HHS R01 DA014979NIDA NIH HHS R01 DA015764

6 · The paper itself

Abstract

Pregnancy can motivate opioid-dependent women to seek substance abuse treatment. Research has demonstrated that although prenatal exposure to buprenorphine results in less severe neonatal abstinence syndrome (NAS) relative to prenatal methadone exposure, the maternal and other neonatal outcomes are similar for the two medications. Maternal and neonatal outcomes for opioid-dependent pregnant women receiving these medications have not been systematically ompared with methadone-assisted withdrawal. The present study provides an initial assessment of the relative efficacy of both methadone and buprenorphine maintenance versus methadone-assisted withdrawal in terms of neonatal and maternal delivery outcomes. Data were derived from (1) the MOTHER (Maternal Opioid Treatment: Human Experimental Research) study at the Johns Hopkins University Bayview Medical Center (JHBMC), or (2) retrospective records review of women who underwent methadone-assisted withdrawal at the JHBMC during the time period in which participants were enrolled in the MOTHER study. Compared with the methadone maintenance group, the methadone-assisted withdrawal group had a significantly lower mean NAS peak score (Means = 13.7 vs 7.0; P = 0.002), required a significantly lower mean amount of morphine to treat NAS (Means = 82.8 vs 0.2; P < 0.001), had significantly fewer days medicated for NAS (Means = 31.5 vs 3.9; P < 0.001), and remained in the hospital for a significantly fewer number of days, on average (Means = 24.2 vs 7.0; P < 0.019). Compared with the buprenorphine maintenance group, the methadone-assisted withdrawal group required a significantly lower mean amount of morphine to treat NAS (Means = 8.2 vs 0.2; P < 0.001) and significantly fewer days medicated for NAS (Means = 12.0 vs 3.9; P = 0.008). Findings suggest that it is possible for some opioid-dependent pregnant women to succeed with methadone-assisted withdrawal. Future research needs to more fully evaluate the potential benefits and risks of methadone-assisted withdrawal for the maternal-fetal dyad.

Indexed as

buprenorphinedetoxificationmethadoneneonatespregnancywomen

Identifiers

PMID24474873

DOI10.2147/SAR.S26288

PMCPMC3889178

OpenAlexW2091750888

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.