BMJ  2008;336:1303-1305 (7 June), doi:10.1136/bmj.39514.554375.AE

Practice

Pregnancy Plus

Pregnancy and injecting drug use

James Bell, consultant in addictions1,2, Lucy Harvey-Dodds, fellow in addiction medicine2

1 National Addiction Centre, Institute of Psychiatry, London SE5 8RS, 2 The Langton Centre, Sydney, NSW 2011, Australia

Correspondence to: J Bell james.bell@sesiahs.health.nsw.gov.au

Injecting drug use has adverse effects on pregnancy and perinatal outcomes. Methadone treatment improves birth rate but carries a risk of neonatal abstinence syndrome; withdrawal of methadone during pregnancy is not recommended

The first 150 words of the full text of this article appear below.

The case described in the Scenario box highlights some of the problems of managing a pregnant injecting drug user. Such patients often present late and have chaotic lifestyles, including poor care for themselves and compromised capacity to care for infants and children.


A 23 year old woman presented, stating she was pregnant and requesting methadone treatment. She reported having used heroin since the age of 13. She had been on buprenorphine for six months but had dropped out two months earlier. She was started on methadone and confirmed to be 20 weeks pregnant. In addition to heroin, she reported smoking cigarettes and cannabis.

She lived with her partner of five months, who was also on methadone. Medically, she had asthma and was hepatitis C positive. She rarely accessed health care. This was her second pregnancy. Her first child had been born one year earlier. During that pregnancy she was homeless . . . [Full text of this article]



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