Opiate dependence and pregnancy: 20-year follow-up study

Marie Whitty,John O'Connor

doi:10.1192/pb.bp.106.011585

Abstract

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

Highlights

The drug-using population have higher rates of hepatitis and HIV infection (Broers et al, 1998) and untreated opiate use is associated with major social problems, including a greater degree of illegal income generation and increased need of emergency care facilities (Fischer et al, 1999)
The mortality rate was almost three times that of the general drug-using population (Rehum et al, 2005) and was many times higher than what would be expected in a non-drug-using population
There are no comparative studies to date examining outcome in the general problem of female drug users with HIV

Summary

Methods

We conducted a 20-year follow-up study of 55 women who were pregnant and using opiates on first assessment in the DTCB in 1985. This urban-based out-patient facility provides specialised assessment and treatment of persons with substance misuse. Our original study (O’Connor et al, 1988) reported on the characteristics and progress of a subsample of 45 of the 55 women assessed in 1985, whereas in the present study we examined the outcome of all 55 women attending for methadone maintenance at that time. The DTCB was the only substance misuse clinic in Ireland and we could include all pregnant women using opiates receiving methadone maintenance treatment.

Results

Discussion

Conclusion