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Pregnant women are also afraid that taking methadone will increase
the chances that the baby will be taken by CPS at birth. This is most
unfortunate because a therapeutic dose of methadone and participation
in a treatment program vastly increases the chance that a woman will
be drug-free at delivery and able to take care of herself and a baby.

Polysubstance Abuse During Pregnancy

Polysubstance use is a common problem among pregnant women
being admitted to methadone maintenance. Use of non-opioid drugs
poses risks to a pregnant woman and her baby and may compromise
the efficacy of methadone treatment. Many patients will not volunteer
that they are using drugs other than opioids. It is important to ask
directly, comprehensively and neutrally about all the various drugs and
to provide the level of treatment necessary to support cessation and
sustained abstinence from all drugs.

Treatment Goals During Pregnancy

Many of the treatment goals during pregnancy are the same as those
for any patient on methadone maintenance as discussed elsewhere in
this document. These include: to fully suppress symptoms of
withdrawal between doses of methadone, to eliminate drug hunger
(unwanted thoughts about using or urges to use), to normalize
physiologic functions disrupted by drug use, to block the effects of
illicit opioid use, to support sustained abstinence and participation in a
recovery program and to decrease risky behaviors.

Additional goals during pregnancy include: to increase participation
in prenatal care, to improve maternal nutrition, to reduce obstetrical
complications, to minimize fetal drug exposure, to establish a
sustainable abstinence, to ensure a safe and stable living environment
and to improve parenting skills.

Early and ongoing evaluation of each woman’s situation is vital. This
evaluation can then be used to determine the intensity of treatment
necessary to adequately address the combination of life problems that
could stand in the way of recovery. It may not be possible for a