EFFICACY OF LAAM MAINTENANCE FOR OPIOID DEPENDENT PREGNANT WOMEN

探讨左旋乙酰美沙醇对阿片类药物依赖孕妇的疗效。传统上，美沙酮一直被用来治疗怀孕和非怀孕患者的阿片成瘾。LAAM是最近批准的一种阿片激动剂，其化学结构类似于美沙酮，具有隔天给药的优点。然而，关于LAAM在妊娠患者中使用的研究几乎不存在，因此这种新制剂在妊娠患者中的安全性、有效性和最佳剂量尚不清楚。这项研究的目标是了解阿片类药物的效率、身体反应的方式以及最佳剂量，以防止母亲和新生儿出现戒断症状，但不会在母亲中产生阿片类药物中毒或对胎儿产生不良影响。受试者将是通过纳入标准的怀孕阿片依赖女性。将进行身体和心理检查，并进行尿液和血液检测。将对各种疾病进行测试，并将结果通知患者。将在研究诊所停留2-3周，在那里将对患者进行监测。然后将给予美沙酮，直到患者达到足够的维持剂量。然后，在美沙酮稳定后，患者将被安置并维持足够剂量的LAAM。在诊所，患者将完成问卷调查。当访问完成后，患者将在门诊基础上返回并接受他们的LAAM剂量。这将持续到婴儿出生，并持续6个月。研究完成后，病人将被转移到美沙酮，并被转介到美沙酮诊所。

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.