| Naltrexone in the treatment of opioid-dependent pregnant women: the case for a considered and measured approach to research. | |
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MedLine Citation:
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PMID: 22471668 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The present paper considers naltrexone to treat opioid dependence during pregnancy. The public health problem of opioid dependence and its treatment during pregnancy is reviewed first. Next, the naltrexone and opioid dependence treatment literature is summarized, with overviews of the pre-clinical and clinical research on prenatal naltrexone exposure. Finally, considerations and recommendations for future medication research for the treatment of opioid dependence in pregnant women are provided. The efficacy of long-acting injectable naltrexone relative to placebo, its blockade of opioid agonist euphoric effects, its lack of abuse and tolerance development and its modest adverse effect profile make it a potential medication for opioid-dependent pregnant women. However, it is not without seriously concerning potential drawbacks, including the difficulty surrounding medication induction that may lead to vulnerability with regard to relapse, physical dependence re-establishment, increased risk behaviors, treatment dropout and resulting opioid overdose. Before embarking on future research with this medication, the benefits and risks for the mother-embryo/fetus/child dyad should be weighed carefully. Should future research be conducted, a multi-level commitment to proactive ethical research is needed to reach the ultimate goal of improving the lives of women and children affected by opioid dependence. |
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Authors:
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Hendrée E Jones; Margaret S Chisolm; Lauren M Jansson; Mishka Terplan |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-4 |
Journal Detail:
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Title: Addiction (Abingdon, England) Volume: - ISSN: 1360-0443 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9304118 Medline TA: Addiction Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction. |
Affiliation:
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RTI International, Research Triangle Park, NC, USA, Departments of Psychiatry and Behavioral Sciences, Obstetrics and Gynecology Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA and Departments of Obstetrics, Gynecology and Reproductive Sciences Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. |
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