| Heroin abuse during pregnancy
and its many associated
environmental factors (e.g.,
lack of prenatal care) have been
associated with adverse consequences
including low birth
weight, an important risk factor
for later developmental delay.
Methadone maintenance combined
with prenatal care and a
comprehensive drug treatment
program can improve many of
the detrimental maternal and
neonatal outcomes associated
with untreated heroin abuse,
although infants exposed to
methadone during pregnancy
typically require treatment for
withdrawal symptoms. In the
United States, several studies
have found buprenorphine to
be equally effective and as safe
as methadone in the adult outpatient
treatment of opioid
dependence. Given this efficacy among adults, current studies are
attempting to establish the safety
and effectiveness of buprenorphine
in opioid-dependent
pregnant women. For women
who do not want or are not able
to receive pharmacotherapy for
their heroin addiction, detoxification
from opiates during
pregnancy can be accomplished
with relative safety, although the
likelihood of relapse to heroin
use should be considered.
Why are heroin users at special
risk for contracting HIV/AIDS
and hepatitis B and C?
Heroin users are at risk for
contracting HIV, hepatitis C
(HCV), and other infectious
diseases, through sharing and
reuse of syringes and injection
paraphernalia that have been
used by infected individuals,
or through unprotected sexual
contact with an infected person.
Injection drug users (IDUs)
represent the highest risk group
for acquiring HCV infection;
an estimated 70 to 80 percent of
the 35,000 new HCV infections
occurring in the United States
each year are among IDUs.
NIDA-funded research has
found that drug abusers can
change the behaviors that put
them at risk for contracting HIV
through drug abuse treatment,
prevention, and community-based
outreach programs. They
can eliminate drug use, drug-related
risk behaviors such as
needle sharing, unsafe sexual
practices, and, in turn, the risk
of exposure to HIV/AIDS and
other infectious diseases. Drug
abuse prevention and treatment
are highly effective in preventing
the spread of HIV.
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