Although methadone maintenance has some distinct advantages compared to continued heroin use for pregnant heroin addicts, e.g., better prenatal care, bigger infants, it has the disadvantages of needing daily administration of a clinic to avoid withdrawal symptoms and diversion of take-home doses. Further, infants exposed to methadone in utero have a high incidence of moderate to severe abstinence symptoms and display various neurobehavioral deficiencies. Levo-alpha-acetylmethadol (LAAM), a long-acting opiate which is given three times a week, may be a better maintenance treatment. We hypothesize that LAAM will produce a less severe neonatal abstinence syndrome than methadone and facilitate patient compliance. At present there is no information regarding LAAM's disposition in pregnancy or its possible effects on the neonate. This project will determine the half life of elimination and excretion patterns of LAAM and its active metabolites during various periods of the pregnancy, at delivery, and after delivery in the neonate. Throughout the pregnancy, drug use questionnaires and urine toxicology screening will be done. At birth, abnormalities will be determined by physical and neurological exam. A Brazelton Behavioral Assessment will be performed to assess responsiveness. Signs and symptoms of an abstinence syndrome will be evaluated daily in the hospital and after discharge for 8 weeks. Rates of LAAM elimination will be correlated to incidence and severity of abstinence. Follow-up evaluations of the infants will be done repeatedly at 6, 9, 12, 15, 21 and 24 months. To determine neurobehavioral development, a neurological exam and the Bayley Scales of Mental Motor Development will be administered at six month intervals. Additionally, structured assessments of maternal functioning and maternal depressive symptoms will be performed. HOME assessment scale will also be administered. Multivariate analysis will be employed to determine relationships between LAAM and other drugs abused, perinatal and maternal psychosocial variables and neurodevelopmental outcome. Group comparisons of LAAM versus methadone will also be made. This study will determine the efficacy, disposition, and effects of pregnant women on LAAM versus methadone during pregnancy as well as the physical and neurodevelopment of the offspring. Using this information, further studies can be designed and intervention programs may be developed.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Specialized Center (P50)
Project #
3P50DA009236-05S1
Application #
6104083
Study Section
Project Start
1998-09-30
Project End
1999-09-30
Budget Start
1998-10-01
Budget End
1999-09-30
Support Year
5
Fiscal Year
1999
Total Cost
Indirect Cost
Name
New York State Psychiatric Institute
Department
Type
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
Metz, Verena E; Sullivan, Maria A; Jones, Jermaine D et al. (2017) Racial Differences in HIV and HCV Risk Behaviors, Transmission, and Prevention Knowledge among Non-Treatment-Seeking Individuals with Opioid Use Disorder. J Psychoactive Drugs 49:59-68
Metz, Verena E; Jones, Jermaine D; Manubay, Jeanne et al. (2017) Effects of Ibudilast on the Subjective, Reinforcing, and Analgesic Effects of Oxycodone in Recently Detoxified Adults with Opioid Dependence. Neuropsychopharmacology 42:1825-1832
Babalonis, Shanna; Haney, Margaret; Malcolm, Robert J et al. (2017) Oral cannabidiol does not produce a signal for abuse liability in frequent marijuana smokers. Drug Alcohol Depend 172:9-13
Herrmann, Evan S; Cooper, Ziva D; Bedi, Gillinder et al. (2016) Effects of zolpidem alone and in combination with nabilone on cannabis withdrawal and a laboratory model of relapse in cannabis users. Psychopharmacology (Berl) 233:2469-78
Levin, Frances R; Mariani, John J; Pavlicova, Martina et al. (2016) Dronabinol and lofexidine for cannabis use disorder: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend 159:53-60
Bedi, Gillinder; Shiffrin, Laura; Vadhan, Nehal P et al. (2016) Effects of levodopa-carbidopa-entacapone and smoked cocaine on facial affect recognition in cocaine smokers. J Psychopharmacol 30:370-7
Cooper, Ziva D; Haney, Margaret (2016) Sex-dependent effects of cannabis-induced analgesia. Drug Alcohol Depend 167:112-20
Jones, Jermaine D; Sullivan, Maria A; Manubay, Jeanne M et al. (2016) The effects of pioglitazone, a PPAR? receptor agonist, on the abuse liability of oxycodone among nondependent opioid users. Physiol Behav 159:33-9
Cooper, Ziva D; Johnson, Kirk W; Pavlicova, Martina et al. (2016) The effects of ibudilast, a glial activation inhibitor, on opioid withdrawal symptoms in opioid-dependent volunteers. Addict Biol 21:895-903
Mariani, John J; Malcolm, Robert J; Mamczur, Agnieszka K et al. (2016) Pilot trial of gabapentin for the treatment of benzodiazepine abuse or dependence in methadone maintenance patients. Am J Drug Alcohol Abuse 42:333-40

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