Addiction (1999) 94(2), 231±239 RESEARCH REPORT Comparison of methadone and slow-release morphine maintenance in pregnant addicts GABRIELE FISCHER, 1 REINHOLD JAGSCH, 1 HARALD EDER, 1 WOLFGANG GOMBAS, 1 PETRA ETZERSDORFER 1 , KATRIN SCHMIDL-MOHL, 2 CHRISTIAN SCHATTEN, 3 MANFRED WENINGER 4 & HARALD N. ASCHAUER 1 1 Department of General Psychiatry, 2 Department of Social Psychiatry and Evaluation Research, 3 Department of Gynaecology & 4 Department of Neonatology, University Hospital of Vienna, Vienna, Austria Abstract Aims. To investigate whether the neonatal abstinence syndrome (NAS) is different in children born to women maintained on slow-release morphine, compared with those maintained on methadone, and to compare additional drug consumption in these groups of women. Design, Setting and Participants. An open, randomized trial was conducted in an established clinic. Forty-eight pregnant women who presented to the clinic as opiate or polysubstance abusers were enrolled and maintained on either methadone (24 women) or slow-release morphine (24 women) up to and following delivery. The programme included psychosocial therapy and support for their opiate-addicted partners. Measurements. Standard urinalysis methods were used to measure consumption of cocaine and benzodiazepines during pregnancy. Injection sites were monitored to indicate additional opiate use. NAS was measured according to Finnegan score and the amount of phenobarbiturates prescribed to alleviate the symptoms. Findings. No difference was found in the number of days that NAS was experienced by neonates born to methadone or morphine maintained mothers (mean 5 16 and 21 days, respectively). All children were born healthy and no serious complications arose. Fewer benzodiazepines ( p , 0.05) and fewer additional opiates ( p , 0.05) were consumed by the morphine- maintained women compared with those who took methadone, but no difference was seen in cocaine consumption. Nicotine consumption was reduced signi®cantly in both groups during pregnancy ( p , 0.02). Conclusions. Both methadone and morphine are suitable maintenance agents for pregnant opiate addicts. Maintenance agents that result in a less prolonged NAS should be studied in further trials. Introduction Drug use has created escalating problems in Europe since the middle of the 19th century. Today, the average age at which addicts ®rst register for treatment in a specialized institution is between 20 and 30 years, and one-third of this population are women of child-bearing age. De- spite this, little research has focused on female addicts and pregnancy to date (European Moni- toring Centre for Drugs and Drug Addiction, Correspondence to: Gabriele Fischer MD, Drug Addiction Outpatient Clinic, Department of General Psychiatry, University Hospital of Vienna, Wa Èhringer Gu Èrtel 18±20, 1090 Vienna, Austria. Tel: 1 43 1 40 400/3543; Fax: 1 43 1 40 400/3500; e-mail: gabriele.®scher@akh-wien.ac.at Submitted 2nd March 1998; initial review completed 5th June 1998; ®nal version accepted 8th September 1998. 0965±2140/99/020231±09 $9.50 Ó Society for the Study of Addiction to Alcohol and Other Drugs Carfax Publishing Limited