Abstract
The objective of this study was to determine if acute detoxification of pregnant heroin-dependent women could be accomplished using clonidine and to describe a protocol for this detoxification. The study design was an observational cohort study of women participating in an inpatient, five-day protocol at a substance abuse treatment facility. Dicyclomine, phenobarbital, and acetominophen were used for symptom control in addition to clonidine. Thirty-three women with an average gestational age of 15.2 weeks sought detoxification. The average daily dose of clonidine was 0.34 milligrams. Fifty-two percent of women did not miss any clonidine doses due to hypotension. Those women who missed at least one clonidine dose had a lower mean entry systolic blood pressure (102.5 v. 112.6; p =.05). Overall, 69.7% of women successfully completed detoxification. There were no significant medical or obstetrical complications which required clinical interventions. Conclusions: This is the first study documenting the use of clonidine as a means of managing opioid withdrawal in pregnant heroin users and may offer an alternative to methadone maintenance for pregnant women who cannot or are not willing to begin methadone maintenance. Clonidine detoxification must be viewed as the first step in a larger context of comprehensive treatment for drug-dependent women.
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