NEONATAL METHADONE WITHDRAWAL SYNDROME: CORRELATION WITH PLASMA METHADONE CONCENTRATION AND MATERNAL METHADONE DOSAGE

Abstract

The relationships between maternal dose of methadone and neonatal withdrawal, and between neonatal plasma levels of methadone ([M]) and symptomatology have been investigated. Methadone was analyzed by gas chromatography; recovery was 88-94 % in the 0.1-1.0 ug/ml range. Ten mothers and their neonates were studied: 3 mothers were taking methadone 10 mg/day and 5, 40-60 mg/day; 2 mothers were detoxified during the 3rd trimester of pregnancy. All 8 infants of mothers on methadone exhibited withdrawal; 3 had no detectable [M] in the 1st 24 hours of life; 2 of these began withdrawal in the 1st few hours of life and the 3rd after 24 hours. In the other 5 symptomatic infants [M] at birth = 0.07-.14 ug/ml; in 4,[M] = 0-.06 uq/ml after 24 hours, at which time withdrawal began, and the 5th had [M] = 0.12 ug/ml at 24 hours with no detectable [W] at 48 hours. Withdrawal commenced in this infant shortly thereafter. Neither infant of the detoxified mothers developed withdrawal nor had they any detectable [M] at birth. Thus there appears to be no relationship between maternal dosages of methadone (10-60 mg/day) and the time of onset of neonatal withdrawal. Infants born to mothers who are drug-free in the 3rd trimester do not withdraw. Newborns with [M] = .07-.14 uq/ml do not withdraw: withdrawal begins when [M] falls to 0-.06 ug/ml.

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