Psychosocial characteristics and poly-drug use of pregnant women enrolled in methadone maintenance treatment

• We examined the health and psychosocial characteristics of women maintained on methadone in pregnancy.
• Patterns of licit and illicit polydrug use were also recorded.
• Results suggest complex psychosocial adversity and continuing use of other substances during pregnancy.
• Infants born to these mothers are at high risk.

Pregnant women with substance dependency are a high-risk psychiatric and obstetric population, with their infants also at elevated neonatal risk. This paper draws on prospective, longitudinal data from a regional cohort of 81 methadone-maintained (MM) and 107 comparison women and their infants to describe the obstetric, socio-familial and mental health needs of women in methadone maintenance treatment during pregnancy. Of particular interest was the extent and pattern of maternal licit and illicit drug use over the course of pregnancy. Results showed that MM women had complex reproductive histories, chronic health problems, and were subject to high rates of socioeconomic adversity and comorbid mental health problems. During pregnancy, more than half continued to use licit and illicit drugs, although there was a general trend for drug use to reduce over time. No differences were observed between women maintained on low (12.5–61.0 mg/day) and high (61.1–195.0 mg/day) doses of methadone, with the exception of opiate abuse which was higher in the low dose group (p = .07). Findings highlight that pregnant women enrolled in MMT and their infants represent a vulnerable group with complex, social, obstetric and psychiatric needs. They also reinforce the need for services that can provide on-going wrap-around, multidisciplinary and multiagency care for these high risk dyads, both during pregnancy and in the transition to parenthood.