1. Running Head: METHAMPHETAMINE AND METHADONE DURING PREGNANCY 1
Methamphetamine and Methadone: The Real Victims
Tiffany Becerra
California Baptist University
Author Note
This paper is presented to Doctor Carter in partial fulfillment for the requirements of
Research and Writing, NUR375A on November 20, 2015

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Introduction
Addiction is a reality in many people’s lives. Opioid dependence does not disappear
when a woman becomes pregnant, despite the negative effects opioids may have on the infant.
Methadone has been used for many years, as early as the 1960s, to treat pregnant women who
are opioid dependent (Wilbourne, Wallerstedt, Dorato, & Curet, 2010). Various studies around
the globe have shown that women who have an addiction before pregnancy are more likely to
receive treatment for such an addiction during pregnancy, compared to those who are not
pregnant (Wilbourne et al., 2010). This paper discusses the treatment of methamphetamine
addiction and methadone use during pregnancy and the negative effects that such drugs can have
on the fetus and infant (Pritham, Troese, & Stetson, 2011). In addition, this paper addresses the
relationships between methamphetamine and the effects that such opioids have on newborn
reflexes within the first six months of life. This paper examines whether there is a difference
between methamphetamine use during pregnancy, versus methadone use, and the effects on
newborn reflexes within the first six months of life.
Literature Review
Studies conducted by Pritham, Troese, & Stetson (2011) list the specific symptoms that
infants, age zero to six months, exhibit immediately after birth from mothers who were treated
for opioid addiction exclusively with methadone. In order to answer the research question of: Is
there a difference between methamphetamine use during pregnancy versus methadone use and
the effects on newborn reflexes within the first six months of life, one must first find out what
the effects are from methadone use. Secondly, this research must include why methadone is
used to treat pregnant mothers who suffer from addiction. This is an important factor relating to
the original research question in order to find out why such medication is being used despite the

3. METHAMPHETAMINE AND METHADONE DURING PREGNANCY 3
negative side effects they may have.
Research conducted by Wilbourne et al. (2010) includes significant information
regarding fetal harm that is caused by methadone use during pregnancy and specific withdrawals
that neonates have. This is a valuable part of understanding what neonates experience through
the first few days of life. Infants not only have to endure the harmful side effects caused by their
mother’s methamphetamine use, but also suffer from the withdrawals of the very medication that
they are being exposed to help treat their mother’s addiction.
Research piloted by Na Manorom et al. (2010) contains pertinent information about the
strict side effects of methamphetamine on the infant directly after birth. Research such as this is
imperative to aid in answering the proposed research question previously mentioned. An
examination of said research is necessary in order to understand what is going on not only
medically, but also mentally in the mother’s mind. One must wonder if the mother truly
understands the risks that she will be exposing her unborn child to despite her drug use.
Methodology
To address the question if there a difference between methamphetamine use during
pregnancy versus methadone use and the effects on newborn reflexes within the first six months
of life, a quantitative approach must be used. Because subjects are being grouped for the
particular studies being analyzed, one must consider how these groups of women are selected.
This is an important factor that may have an effect on the variables of studies that were
conducted. In order to gain an appropriate group of subjects for a reliable, quantitative study,
women must meet two criteria. First, these women must be currently using methamphetamine or
on a methadone treatment, and secondly, these women must be pregnant.
Moving forward with the quantitative approach, mothers using methamphetamine or on a

4. METHAMPHETAMINE AND METHADONE DURING PREGNANCY 4
methadone treatment will be asked a series of questions during an interview about the length of
their methamphetamine use or methadone treatment during pregnancy. Grounded theory is the
basis of gathering information about the fetus while the mother is still pregnant and after she
gives birth. It is with the grounded theory approach that one can examine the process of a
phenomenon and culminate it in the generation of a theory (Schmidt & Brown, 2015). Current
literature will be reviewed to gain a complete understanding of the normal developmental stages
an infant, age zero to six months, should have. It is now with this information that the study will
move forward and evaluate the developmental level and milestones of an infant who is born to a
mother who was either using methamphetamine or on a methadone treatment during pregnancy.
Such infants shall either meet these milestones or have delayed, absent, or possibly normal levels
of development.
Throughout the pregnancies of the women being studied, essential information will be
gathered, such as how their fetuses are growing and if they are growing at the normal appropriate
rate such as that of women who have not used methamphetamine or were on a methadone
treatment during their pregnancies. The women being sampled will represent a dependent
variable. Next, material will be gathered comparing the normal reflexes that infants should have,
age zero to six months, to those infants who were exposed to methamphetamine or methadone in
utero. Observations will be made within the clinic setting during the infant’s first wellness check
up and continuing up to the six-month check up. During this time, a sampling of three hundred
women and their infants will be observed. The women will be given a small survey containing
two questions regarding their past methamphetamine use since pregnancy as well as if they were
on a methadone treatment during the course of their pregnancy. Furthermore, the infant’s
developmental reflexes will be assessed and compared to that of healthy infants. The

5. METHAMPHETAMINE AND METHADONE DURING PREGNANCY 5
information being gathered will be without bias because the results will not contain any personal
information pertaining to the women being sampled. Therefore, the samples will not withhold
any truthful information in regards to drug use during pregnancy out of fear of being exposed to
the public. It is with this knowledge that the study will have enough information to come to a
plausible conclusion about the difference between reflex delays such infants studied have
because of their exposure to methamphetamine and methadone in utero.
Anticipated Findings
Using a series of questions for mothers who brought their infants in for wellness check
ups, a quantitative approach to conduct this study was implemented. Simultaneously, the infants
were also being assessed for discernable delays in reflexes appropriate for their age. A
homogenous sample was used for this research. Specifically, the study examined three hundred
women and their infants, all of who were either currently using methamphetamine or were on a
methadone treatment during the time of their pregnancy. Of those who were studied, both
mothers and infants, 98% of the research results were within one standard deviation (+/- 1) of the
bell curve (Schmidt & Brown, 2015). More specifically, results concluded that 98% of women
who were either ingesting methamphetamine or on a methadone treatment during the course of
their pregnancy had infants with marked developmental delays and reflexes within the first six
months of the infants’ lives. Reflexes that should have been present at certain wellness check-
ups, appropriate for the infant’s age, were either completely absent or severely delayed.
During the sequence of collecting data during the wellness infant check-ups, nominal
data was used to assemble information about the mothers of said infants in conjunction with
accumulating specific yes/no questions about the mother’s drug use during pregnancy. To gain
even more constant and precise information, three specific questions will be asked to these

6. METHAMPHETAMINE AND METHADONE DURING PREGNANCY 6
mothers. The standard variable deviation was 98% of those who were studied. As
aforementioned, the results can be concluded as valid. The research that was conducted is one-
dimensional and straightforwardly reproducible, therefore the results are reliable. The
correlation between methamphetamine and methadone use during the course of pregnancy, along
with the deferment or absence of infant reflexes, proves that there is a definite correlation
between these factors.
Application to Practice
The medical occupation is quite diverse, with ever-changing implications to practice. In
the profession of nursing, information and research is gathered first and then applied to nursing
with evidence-based practice (Schmidt & Brown, 2015). It is with such information that
professionals are able to continually treat and aid in preventing illness and disease. Results from
the study conducted, in regards to methamphetamine and methadone use and the reflex delays on
infants up to six months, contribute to the information physicians already know about the effects
of illicit drug use and the harmful effects of pharmacological agents. With this knowledge,
nursing interventions can focus on preventative drug use during pregnancy, thus decreasing the
need for medications such as methadone.
Implementation in the Clinical Setting
If nurses recognize patterns and behaviors of individuals at risk, they can implement care
directed towards education and awareness of mothers who have addictions. Nurses can educate
women who are at risk for drug use during pregnancy by providing information about safe sex
practices and their desire to have a healthy child along with proper resources to drug treatment
programs. These nursing interventions can be carried out in the clinical setting, both outpatient
and inpatient. The nurse should use every opportunity possible to inform their patients about

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safe sex practices and effects of methamphetamine use on infants and identify key factors that
play a role in these mothers who are at risk. To be more precise, showing videos of infants with
reflex delays that have been researched, compared to video clips of otherwise healthy infants,
would allow nurses to highlight specific consequences of the choices these mothers make.
Mothers may now acknowledge that methamphetamine and methadone use while pregnant
should not be taken lightly. The motivation for these mothers to avoid methamphetamine use,
and subsequently methadone use, during pregnancy should be the desire to give birth to a healthy
infant. Furthermore, all available and appropriate birth control methods should be presented to
these mothers to assist in the practice of safe sex. It is the nurses’ responsibility to identify
mothers who are at risk. These mothers would include those who have a previous history of drug
abuse, particularly methamphetamine, those with a low socioeconomic status, and those with
little or no family or spousal support. In addition to risk factors previously discussed, lower
levels of education should also be included. It is with this prevention that infants can have a
better chance at a healthy childhood without complications that could have otherwise been
prevented.
Conclusion
Current literature on the effects of methamphetamine and methadone use clearly
identifies the negative affects of these drugs during pregnancy. However, they do not address
the question of whether these mothers truly recognize and understand the risk factors associated
with such drug use. The methodology used for this study is key to valid and reliable findings in
that direct information will be gathered from the sample population without the variable of
possible negative affects the women would face in truthfully answering the proposed questions.
Not only is the sample population of sufficient size for further generalizations to be made, but it

8. METHAMPHETAMINE AND METHADONE DURING PREGNANCY 8
is also of sufficient duration so that observations made will have enough time to surface in
regards to developmental delays. Implications to practice are significant, not only monetarily,
but also in regards to preventative care. If these education techniques were implemented and
infants were no longer affected, it would decrease medical costs greatly. Although monies from
treating pregnant, drug addicted mothers and their children after birth would then be diverted to
treatment and education programs before such problems would occur, the cost would be
significantly reduced. Early identification and application of education practices used to stop the
cycle of drug abuse while pregnant could change the outcome of these pregnancies considerably.
Thus, a lower percentage of infants would have delayed or absent reflexes, which could
potentially lead to these infants leading healthier lives in latter years.

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References
Na Manorom, N., Watanarungsan, P., Chomchai, S., & Yossuck, P. (2010). Methamphetamine
abuse during pregnancy and its health impact on neonates born at Siriraj Hospital,
Bangkok, Thailand. The Southeast Asian Journal Of Tropical Medicine And Public
Health, 35(1), 228-231. Retrieved from
http://www.tm.mahidol.ac.th/seameo/journal_35_1_2004.html
Pritham, U. A., Troese, M., & Stetson, A. (2011). Methadone and Buprenorphine. Nursing for
Women's Health, 11(6), 560-567. doi:10.1111/j.1751-486X.2007.00243.x
Schmidt, N. A., & In Brown, J. M. (2015). Evidence-based practice for nurses: Appraisal and
application of research (3rd ed.).
Wilbourne, P., Wallerstedt, C., Dorato, V., & Curet, L. B. (2010). Clinical management of
methadone dependence during pregnancy. Journal of Perinatal and Neonatal Nursing,
14(4), 26-45. Retrieved from http://web.a.ebscohost.com.libproxy.calbaptist.edu/ehost

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Appendix A
Note to surveyors: The results of this survey will remain anonymous; please do not fear that your
answers will result in any repercussions in the future. Again, thank you for your honesty.
1. Did you use methamphetamine at any time during your pregnancy? Yes No
2. Were you on a methadone treatment at any time during your pregnancy? Yes No