Methadone Maintenance During Pregnancy | Benefits & Risks

Many health care providers use methadone to treat opiate or opioid addiction, also known as opioid use disorder. When taken as prescribed and supervised by a doctor, methadone use can reduce opioid withdrawal symptoms and cravings. 

However, because methadone is an opioid itself, some people hesitate to begin this form of treatment, which is called methadone maintenance treatment. 

In particular, pregnant women may worry that using methadone will harm their baby. That’s because any prescription or illicit drugs they take can travel to the fetus through the placenta. 

Most obstetricians, gynecologists, and other health care professionals consider methadone maintenance a much safer alternative to not treating your opioid addiction while pregnant. 

The Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) also share this view. 

Still, to make the best decision for you and your baby, it’s important to learn about the benefits and risks of methadone maintenance during pregnancy.

Benefits Of Methadone Maintenance During Pregnancy

When you leave your opioid addiction untreated during pregnancy, your baby faces an increased risk of:

• fetal convulsions
• fetal death
• premature birth
• low birth weight
• birth defects
• sudden infant death syndrome (SIDS)

In addition, when you suffer from untreated opioid addiction while pregnant, you may experience poor physical and mental health and engage in risky behavior that harms both you and the fetus. 

For example, you may find yourself in violent situations when trying to buy drugs off the street. You may also contract a bloodborne illness such as hepatitis C or HIV if you share needles with others or have unprotected sex with an infected person. 

Methadone maintenance treatment can reduce the risk of all of the above problems. It can also prevent or decrease the severity of neonatal abstinence syndrome. 

What Is Neonatal Abstinence Syndrome?

Neonatal abstinence syndrome (NAS) occurs when a fetus regularly encounters an opioid medication while in the womb and develops a physical dependence on the drug. 

Within a few days to a week after birth, the neonate (newborn baby) may start experiencing postpartum withdrawal symptoms due to the lack of opioids outside the womb. 

Common symptoms of NAS include:

• fever
• sweating
• diarrhea
• vomiting
• high-pitched or excessive crying
• hyperactivity
• irritability
• difficulty feeding
• difficulty gaining weight
• fast breathing 
• seizures

A baby who displays any of these symptoms will need medical care right away. For most babies, inpatient NAS treatment takes anywhere from 1 week to 6 months, depending on factors such as the length and dosing of the mother’s drug use. 

Risks Of Methadone Maintenance During Pregnancy

Although methadone maintenance treatment lowers the risk of NAS, it’s still a possibility. However, according to the National Institute on Drug Abuse, the condition will be less severe and your baby will recover more quickly than if you left your opioid addiction untreated.

Using methadone while pregnant can also contribute to premature birth and low birth weight. 

In addition, if you breastfeed while continuing methadone maintenance treatment, the drug may pass into your breast milk. Your baby may then experience side effects of methadone such as:

• extreme drowsiness
• limpness
• trouble feeding
• trouble breathing

Call your baby’s doctor right away if you notice these symptoms or any other unusual behavior. Also, talk to your baby’s doctor before you stop breastfeeding. 

In most cases, the doctor will recommend weaning gradually so your baby doesn’t experience withdrawal symptoms from the lack of methadone. 

Methadone Vs. Buprenorphine

If you’re still concerned about using methadone while pregnant, talk to your obstetrics doctor about buprenorphine, which is another medication that can treat opioid addiction. Compared to methadone, it’s less likely to cause premature birth, low birth weight, and NAS. 

If you or someone you love is struggling with opioid dependence or other substance use issues, please contact an ARK Behavioral Health specialist to learn about our addiction and substance abuse treatment programs.