Pediatric Drugs

, Volume 13, Issue 5, pp 277–279 | Cite as

The Worldwide Opioid Epidemic

Implications for Treatment and Research in Pregnancy and the Newborn


  1. 1.
    Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med 2010; 363 (18 Nov): 1981–5PubMedCrossRefGoogle Scholar
  2. 2.
    College of Physicians and Surgeons of Ontario. Report of the Opioid Working Group. Avoiding abuse, achieving a balance: tackling the opioid public health crisis. Toronto (ON): College of Physicians and Surgeons of Ontario, 2010 SepGoogle Scholar
  3. 3.
    He Q, Wang X, Xia Y, et al. New community-based methadone maintenance treatment programs in Guandong, China, and their impact on patient quality of life. Subst Use Misuse 2011; 46(6): 749–57PubMedCrossRefGoogle Scholar
  4. 4.
    Hallinan R, Osborn N, Cohen M, et al. Increasing the benefits and reducing the harms of prescription opioid abuse. Drug Alcohol Rev 2011 May; 30(3): 315–23PubMedCrossRefGoogle Scholar
  5. 5.
    Cornish R, Macleod J, Strang J, et al. Risk of death during and after opiate substitution treatment in primary care: prospective observational study in UK General Practice Research Database. BMJ 2010; 341: C5475PubMedCrossRefGoogle Scholar
  6. 6.
    Maremmani I, Gerra G. Buprenorphine-based regimens and methadone for the medical management of opioid dependence: selecting the appropriate drug for treatment. Am J Addiction 2010; 19 (Nov–Dec): 557–68CrossRefGoogle Scholar
  7. 7.
    Krupitsky E, Woody GE, Zvartau E, et al. Addiction treatment in Russia [letter]. Lancet 2010; 376 (Oct): 1145PubMedCrossRefGoogle Scholar
  8. 8.
    Basu D, Gaur N, Das PP, et al. Herbal medicines: perfect garb for opioid abuse? A case series from India. Am J Addiction 2010; 20: 174–5Google Scholar
  9. 9.
    Strain EC, Harrison JA, Bigelow GE. Induction of opioid-dependent individuals onto buprenorphine and buprenorphine/naloxone soluble films. Clin Pharm Ther 2011; 89 (Mar): 443–9CrossRefGoogle Scholar
  10. 10.
    Draper R. Opium wars. Natl Geogr 2011; 219: 58–83Google Scholar
  11. 11.
    Jones HE, O’Grady KE, Johnson RE, et al. Infant neurobehaviour following prenatal exposure to methadone or buprenorphine: results from the neonatal intensive care unit network neurobehavioral scale. Sub Use Misuse 2010; 45 (July): 2244–57CrossRefGoogle Scholar
  12. 12.
    Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010; 363: 2320–31PubMedCrossRefGoogle Scholar
  13. 13.
    Seligman NS, Almario CV, Hayes EJ, et al. Relationship between maternal methadone dose at delivery and neonatal abstinence syndrome. J Pediatr 2010; 157: 428–33PubMedCrossRefGoogle Scholar
  14. 14.
    Liu AJW, Jones MP, Murray H, et al. Perinatal risk factors for the neonatal abstinence syndrome in infants born to women on methadone maintenance therapy. Aust N Z J Obstet Gynaecol 2010; 50: 253–8PubMedCrossRefGoogle Scholar
  15. 15.
    Jansson LM, DiPietro JA, Elko A, et al. Infant autonomic functioning and neonatal abstinence syndrome. Drug Alcohol Depend 2010; 109: 198–204PubMedCrossRefGoogle Scholar
  16. 16.
    Dashe J, Sheffield JS, Olscher DA, et al. Relationship between maternal methadone dosage and neonatal withdrawal. Obstet Gynecol 2002; 100: 1244–9PubMedCrossRefGoogle Scholar
  17. 17.
    Lim S, Prasad MR, Samuels P, et al. High-dose methadone in pregnant women and its effect on duration of neonatal abstinence syndrome. Am J Obstet Gynecol 2009; 200: 70.e1–5CrossRefGoogle Scholar
  18. 18.
    Berghella V, Lim PJ, Hill MK, et al. Maternal methadone dose and neonatal withdrawal. Am J Obstet Gynecol 2003; 189: 312–7PubMedCrossRefGoogle Scholar
  19. 19.
    Kuschel CA, Austerberry L, Cornwell M, et al. Can methadone concentrations predict the severity of withdrawal in infants at risk of neonatal abstinence syndrome? Arch Dis Child Fetal Neonatal Ed 2004; 89: F390–3PubMedCrossRefGoogle Scholar
  20. 20.
    Sarkar S, Donn SM. Management of neonatal abstinence syndrome in neonatal intensive care units: a national survey. J Perinatol 2006; 26: 15–7PubMedCrossRefGoogle Scholar
  21. 21.
    O’Grady MJ, Hopewell J, White MJ. Management of neonatal abstinence syndrome: a national survey and review of practice. Arch Dis Child Fetal Neonatal Ed 2009; 94: F249–52PubMedCrossRefGoogle Scholar
  22. 22.
    Hoder EL, Leckman JF, Poulsen J, et al. Clonidine treatment of neonatal narcotic abstinence syndrome. Psychiatry Res 1984; 13: 243–51PubMedCrossRefGoogle Scholar
  23. 23.
    Hunt RW, Tzioumi D, Collins E, et al. Adverse neurodevelopment outcome of infants exposed to opiate in-utero. Early Hum Dev 2008; 84: 29–35PubMedCrossRefGoogle Scholar
  24. 24.
    Nanovskaya TN, Nekhayeva IA, Hankins GDV, et al. Transfer of methadone across the dually perfused preterm human placental lobule. Am J Obstet Gynecol 2008; 198: 126.e1–4CrossRefGoogle Scholar
  25. 25.
    Nekhayeva IA, Nanovskaya TN, Deshmukh SV, et al. Bidirectional transfer of methadone across human placenta. Biochem Pharmacol 2005; 69: 187–97PubMedCrossRefGoogle Scholar
  26. 26.
    Malek A, Obrist C, Wenzinger S, et al. The impact of cocaine and heroin on the placental transfer of methadone. Reprod Biol Endocrinol 2009; 7: 61PubMedCrossRefGoogle Scholar
  27. 27.
    Gordon AL, Lopatko OV, Somogyi AA, et al. (R)- and (S)-methadone and buprenorphine concentration ratios in maternal and umbilical cord plasma following chronic maintenance dosing in pregnancy. Br J Clin Pharmacol 2010; 70: 895–902PubMedCrossRefGoogle Scholar
  28. 28.
    Kraft WK, Dysart K, Greenspan JS, et al. Revised dose schema of sublingual buprenorphine in the treatment of the neonatal opioid abstinence syndrome. Addiction 2010; 106: 574–80PubMedCrossRefGoogle Scholar
  29. 29.
    Agthe AG, Kim GR, Mathias KB, et al. Clonidine as an adjunct therapy to opioids for neonatal abstinence syndrome: a randomized, controlled trial. Pediatrics 2009; 123: e849–56PubMedCrossRefGoogle Scholar
  30. 30.
    Soyka M, Kranzler HR, van den Brink W, et al. The World Federation of Societies of Biological Psychiatry (WF SBP) guidelines for the biological treatment of substance use and related disorders: part 2. Opioid dependence. World J Biol Psychiatry 2011; 12: 160–87PubMedCrossRefGoogle Scholar
  31. 31.
    Kakinohana M, Oshiro M, Saikawa S, et al. Intravenous infusion of dexmedetomidine can prevent the degeneration of spinal ventral neurons induced by intrathecal morphine after a noninjurious interval of spinal cord ischemia in rats. Anaesth Analg 2007; 105: 1086–93CrossRefGoogle Scholar
  32. 32.
    Sanders RD, Sun P, Patel S, et al. Dexmedetomidine provides cortical neuroprotection: impact on anaesthetic-induced neuroapoptosis in the rat developing brain. Acta Anaesthesiol Scand 2010; 54: 710–6PubMedCrossRefGoogle Scholar
  33. 33.
    Mitchell TB, Dyer KR, Newcombe D, et al. Subjective and physiological responses among racemic-methadone maintenance patients in relation to relative (S)- vs. (R)-methadone exposure. Br J Clin Pharmacol 2004; 58: 609–17PubMedCrossRefGoogle Scholar
  34. 34.
    Elkader AK, Brands B, Dunn E, et al. Major depressive disorder and patient satisfaction in relation to methadone pharmacokinetics and pharmacodynamics in stabilized methadone maintenance patients. J Clin Psychopharmacol 2009; 29: 77–81PubMedCrossRefGoogle Scholar
  35. 35.
    Eap CB, Crettol S, Rougier JS, et al. Stereoselective block of hERG channel by (S)-methadone and QT interval prolongation in CYP2B6 slow metabolizers. Clin Pharmacol Ther 2007; 81: 719–28PubMedCrossRefGoogle Scholar
  36. 36.
    McCance-Katz EF. (R)-methadone versus racemic methadone: what is best for patient care? Addiction 2011; 106: 687–8PubMedCrossRefGoogle Scholar
  37. 37.
    Totah RA, Sheffels P, Roberts T, et al. Role of CYP2B6 in stereoselective human methadone metabolism. Anesthesiology 2008; 108: 363–74PubMedCrossRefGoogle Scholar
  38. 38.
    Bunten H, Liang WJ, Pounder DJ, et al. OPRM1 and CYP2B6 gene variants as risk factors in methadone-related deaths. Clin Pharmacol Ther 2010; 88: 383–9PubMedCrossRefGoogle Scholar
  39. 39.
    Yuferow V, Levran O, Proudnikov D, et al. Search for genetic markers and functional variants involved in the development of opiate and cocaine addiction and treatment. Ann N Y Acad Sci 2010; 1187: 184–207CrossRefGoogle Scholar
  40. 40.
    Wang JS, Ruan Y, Taylor RM, et al. Brain penetration of methadone (R)- and (S)- enantiomers is greatly increased by P-glycoprotein deficiency in the blood-brain barrier of Abcb 1a gene knockout mice. Psychopharmacology 2004; 173: 132–8PubMedCrossRefGoogle Scholar
  41. 41.
    Piercefield E, Archer P, Kemp P, et al. Increase in unintentional overdose deaths -Oklahoma, 1994–2006. Am J Prev Med 2010; 39(4): 357–63PubMedCrossRefGoogle Scholar
  42. 42.
    Rettig R. Federal regulation of methadone: table of contents and executive summary. Washington, DC: National Academy Press, 1995Google Scholar
  43. 43.
    Strain EC, Harrison JA, Bigelow GE. Induction of opioid-dependent individuals onto buprenorphine and buprenorphine/naloxone soluble-films. Clin Pharmacol Ther 2011; 89: 443–9PubMedCrossRefGoogle Scholar
  44. 44.
    Ling W, Casadonte P, Bigelow G, et al. Buprenorphine implants for treatment of opioid dependence. JAMA 2010; 304: 1576–83PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  1. 1.London Health Sciences CentreLondonCanada
  2. 2.Pharmacy ServicesLondon Health Sciences CentreLondonCanada

Personalised recommendations