An attempt to determine the effectiveness of LAAM (levo-alpha acetyl methadol) for opiod dependent pregnant women. Traditionally, methadone has been used to treat opioid addiction in both pregnant and non-pregnant patients. LAAM is a recently approved opioid agonist chemically similar to methadone, which offers the advantage of every-other-day dosing. However, studies regarding the use of LAAM in pregnant patients are virtually nonexistant, so the safety, efficiency, and optimal dosing of this new agent in pregnant patients is not known. The goal of this study is to realize the efficiency, the way the body reacts, and the best dosing that will prevent withdrawal symptoms in both the mother and the newborn, but does not produce opioid intoxication in the mother or adverse effects in the fetus. Subjects will be pregnant opioid-dependent women who pass inclusion criteria. Physical and psychological exams will be given, urine and blood will be tested. Tests for various diseases will be done and patients will be informed of their results. There will be a 2-3 week stay at the research clinic where the patients will be monitored. Then methadone will be given until the patient reaches the adequate maintenance dose. Then, after stability on methadone, patients will be placed and maintained on an adequate dose of LAAM. While at the clinic, patients will complete questionnaires. When visit is complete, patients will return on an out-patient basis and receive their LAAM dosage. This will continue until the birth of the babies and for six months after that. At the completion of the study, patients will be transferred to methadone and referred to a methadone clinic.
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