title: The treatment of alcohol and opioid dependence in pregnant women.
abstract: OBJECTIVE
  This article addresses the question of 'best treatment options', which clinicians face when treating pregnant women with alcohol and opioid dependence.
  
  
  RESULTS
  Studies show that alcohol consumption is associated with fetal abnormalities and long-term cognitive problems depending on the amount consumed, drinking pattern, and time of gestation. Screening and evaluation of specific interventions are important to reduce alcohol consumption during pregnancy and associated problems in infants. Opioid detoxification is only recommended beyond the first trimester and only in those pregnant women who refuse opioid maintenance therapy. Methadone is the most established treatment of pregnant opioid-dependent women, though recent results indicate some advantages of buprenorphine, slow-release oral methadone and diamorphine compared with methadone.
  
  
  CONCLUSIONS
  Benzodiazepines seem to be the most recommendable option for managing alcohol withdrawal, and psychosocial interventions succeed in reducing alcohol consumption or in maintaining abstinence in alcohol-dependent pregnant women. Regarding opioid dependence, current results suggest that factors like the health status of the mother, the need for additional medications (e.g. treatment for HIV), comorbid drug dependence, and concurrent drug use need to be considered in order to find the 'best opioid substitute'.
authors.affiliation: Department of Psychiatry, Social Psychiatry and Psychotherapy, Center for Addiction Research (CARe), Hannover Medical School, Hannover, Germany. heberlein.annemarie@mh-hannover.de
authors.forename: Annemarie
authors.initials: A
authors.lastname: Heberlein
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Leggio
authors.forename: Dirk
authors.initials: D
authors.lastname: Stichtenoth
authors.forename: Thomas
authors.initials: T
authors.lastname: Hillemacher
mesh_terms: D000437:Alcoholism / Q000628:therapy*; D005260:Female; D006801:Humans; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*