morphine and Marijuana-Abuse

Drug use during pregnancy is a critical global challenge, capable of severe impacts on neonatal development. However, the consumption of cannabis and synthetic cannabinoids is on the rise in pregnant women. Obstetric complications with increased risks of miscarriage, fetal growth restriction, and brain development impairment have been associated with perinatal cannabis exposure, but data on synthetic cannabinoid use during pregnancy are limited.. We reviewed studies that investigated the risks associated with cannabis and synthetic cannabinoid use and those that reported the concentrations of cannabinoids and synthetic cannabinoids in maternal (breast milk) and neonatal (placenta, umbilical cord, meconium, and hair) matrices during human pregnancy. A MEDLINE and EMBASE literature search to identify all relevant articles published in English from January 1998 to April 2019 was performed.. Cannabis use during pregnancy is associated with increased risks of adverse obstetrical outcomes, although neurobehavioral effects are still unclear. Analyses of cannabinoids in meconium are well documented, but further research on other unconventional matrices is needed. Adverse effects due to perinatal synthetic cannabinoid exposure are still unknown, and analytical data are scarce.. Awareness of the hazards of drug use during pregnancy should be improved to encourage health care providers to urge pregnant women to abstain from cannabis and, if cannabis-dependent, seek treatment. Moreover, substances used throughout pregnancy should be monitored as a deterrent to cannabis use, and potential cannabis-dependent women should be identified, so as to limit cannabis-fetal exposure during gestation, and provided appropriate treatment.

Topics: Cannabinoids; Cannabis; Drug Monitoring; Female; Hair; Humans; Marijuana Abuse; Meconium; Milk, Human; Placenta; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Prevalence; Risk Factors; Umbilical Cord

Topics: Cannabis; Humans; Marijuana Abuse; Organic Chemicals; Primary Health Care

Cannabis misuse during pregnancy is associated with severe impacts on the mother and baby health, such as newborn low birth weight, growth restriction, pre-term birth, neurobehavioral and developmental deficits. In most of the cases, drug abuse is omitted or denied by the mothers. Thus, toxicological analyzes using maternal-fetal matrices takes place as a suitable tool to assess drug use. Herein, meconium was the chosen matrix to evaluate cannabis exposure through identification and quantification of 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic (THCCOOH). Accelerated solvent extraction (ASE) was applied for sample preparation technique to simultaneously extract and hydrolyze conjugated THCCOOH from meconium, followed by a solid-phase extraction (SPE) procedure. The method was developed and validated for gas chromatography-mass spectrometry (GC-MS), reaching hydrolysis efficiency of 98%. Limits of detection (LOD) and quantification (LOQ) were, respectively, 5 and 10 ng/g. The range of linearity was LOQ to 500 ng/g. Inter and intra-batch coefficients of variation were <8.4% for all concentration levels. Accuracy was in 101.7-108.9% range. Recovery was on average 60.3%. Carryover effect was not observed. The procedure was applied in six meconium samples from babies whose mothers were drug users and showed satisfactory performance to confirm fetal cannabis exposure.

Topics: Dronabinol; Female; Gas Chromatography-Mass Spectrometry; Glucuronides; Humans; Hydrolysis; Infant, Newborn; Linear Models; Marijuana Abuse; Meconium; Pregnancy; Pregnancy Complications; Reproducibility of Results; Sensitivity and Specificity

Topics: Adolescent; Adult; Cocaine-Related Disorders; Enzyme-Linked Immunosorbent Assay; Female; Gas Chromatography-Mass Spectrometry; Hospitals, University; Humans; Marijuana Abuse; Meconium; Pregnancy; Pregnancy Complications; Prevalence; Socioeconomic Factors; Substance Abuse Detection; Trinidad and Tobago; Young Adult

Cannabis is the most frequently used illicit drug among pregnant women, but data describing the effects of prenatal cannabis exposure and concurrent nicotine and cannabis exposures on neonatal growth are inconsistent. Testing of meconium, the first neonatal feces, offers objective evidence of prenatal cannabis exposure, but the relative ability of meconium testing and maternal self-report to identify affected neonates remains unclear.. Eighty-six pregnant women provided detailed self-reports of daily cannabis and tobacco consumption throughout pregnancy. Cannabinoids and tobacco biomarkers were identified in oral fluid samples collected each trimester and quantified in meconium at birth.. Cannabis-using women were significantly more likely to also consume tobacco, and smoked similar numbers of cigarettes as non-cannabis-using tobacco smokers. As pregnancy progressed, fewer women smoked cannabis and those who continued to use cannabis reported smoking a smaller number of cannabis joints, but positive maternal oral fluid tests cast doubt on the veracity of some maternal self-reports. More neonates were identified as cannabis exposed by maternal self-report than meconium analysis, because many women quit cannabis use after the first or second trimester; meconium was more likely to be positive if cannabis use continued into the third trimester. Cannabis exposure was associated with decreased birth weight, reduced length, and smaller head circumference, even after data were controlled for tobacco coexposure.. Prenatal cannabis exposure was associated with fetal growth reduction. Meconium testing primarily identifies prenatal cannabis exposure occurring in the third trimester of gestation.

Topics: Biomarkers; Cannabinoids; Female; Growth Disorders; Humans; Infant, Newborn; Marijuana Abuse; Maternal-Fetal Exchange; Meconium; Pregnancy; Smoking

To investigate the prevalence of in utero exposure to cannabis in a cohort of 974 mother-infants dyads from Barcelona (Spain).. A validated gas chromatographic-mass spectrometric assay was used for meconium analysis.. Prenatal exposure to cannabis was detected in 5.3% newborns; however, only 1.7% of the participating mothers disclosed gestational drug use. Ethnicity was not associated with cannabis use, nor were the maternal features or newborns somatometry. A significantly higher percentage of cannabis using mothers had a managerial professional job versus nonusers.. Meconium analysis is especially important to identify neonates who have been exposed to cannabis in utero, which appear normal at birth and therefore may not be recognized. Timely detection of these newborns at risk provides the basis for appropriate treatment and adequate medical and social follow-up.

Topics: Adult; Analysis of Variance; Biomarkers; Cannabinoids; Cannabis; Cohort Studies; Female; Gas Chromatography-Mass Spectrometry; Humans; Infant, Newborn; Male; Marijuana Abuse; Maternal Exposure; Meconium; Pregnancy; Pregnancy Complications; Prevalence; Risk Factors; Socioeconomic Factors; Spain; Substance Abuse Detection; Surveys and Questionnaires

In a pilot study to determine the local prevalence of maternal drug misuse, meconium from 400 infants was analysed for metabolites of eight controlled drugs. Cannabinoids were found in 13.25%, cocaine in 2.75%, and amphetamine in 1.75%. The prevalence of opiate and benzodiazepine misuse was masked by the presence of prescribed drugs so was undeterminable.

Topics: Cannabinoids; Female; Gas Chromatography-Mass Spectrometry; Humans; Infant, Newborn; Marijuana Abuse; Maternal-Fetal Exchange; Meconium; Pilot Projects; Pregnancy; Pregnancy Complications; Prevalence; Scotland; Substance-Related Disorders

To compare the sensitivity and specificity of maternal interview, maternal hair analysis, and meconium analysis in detecting perinatal exposure to cocaine, opiate, and cannabinoid.. The use of cocaine, opiate, and cannabinoid during pregnancy was determined prospectively in 58 women by 3 methods: structured maternal interview, maternal hair analysis, and meconium analyses. The results of the 3 methods were compared with one another.. The maternal interview showed the lowest sensitivity in detecting cocaine and opiate exposures (65% and 67%, respectively), but it had the highest sensitivity in detecting cannabinoid exposure (58%). Both hair and meconium analyses had high sensitivity for detecting cocaine or opiate exposures. Hair analysis had a sensitivity of 100% for cocaine and 80% for opiate detection. However, it had a false-positive rate of 13% for cocaine and 20% for opiate, probably as a result of passive exposure. Meconium analysis had a sensitivity of 87% for cocaine and 77% for opiate detection, but unlike hair analysis, it had no false-positive test results for cocaine. Both hair and meconium analyses had low sensitivity in detecting cannabinoid exposure (21%-22.7%), most probably because of the sporadic use of cannabinoid.. Meconium and hair analyses had the highest sensitivities for detecting perinatal use of cocaine and opiate, but not for cannabinoid. The principal drawback of hair analysis is its potential for false-positive test results associated with passive exposure to drugs. Maternal interview is a time-consuming test of low sensitivity. The high sensitivity of meconium analysis and the ease of collection make this test ideal for perinatal drug screening.

Topics: Adult; Cocaine-Related Disorders; Female; Hair; Humans; Infant, Newborn; Interviews as Topic; Marijuana Abuse; Meconium; Opioid-Related Disorders; Pregnancy; Pregnancy Complications; Prospective Studies; Sensitivity and Specificity; Substance Abuse Detection; Substance-Related Disorders

The relationship of maternal illicit drug use to congenital syphilis was studied in a population of newborn infants (N = 1012) who were screened for intrauterine exposure to illicit drugs by meconium analysis and whose mothers were screened for syphilis by the rapid plasmin reagin fluorescent treponemal antibody, absorbed (RPR/FTA-ABS) test. The result of the meconium drug screening was positive in 449 (44.3%) infants: 401 (39.6%) screening results were positive for cocaine, 71 (7%) positive for opiate, and 31 (3.1%) positive for cannabinoid. The maternal RPR/FTA-ABS result was positive in 72 (7.1%) women, and congenital syphilis was diagnosed in 46 (4.5%) infants on the basis of Centers for Disease Control and Prevention definitions. The incidence of positive RPR/FTA-ABS result (10.5% vs 4.4%) and congenital syphilis (7% vs 2.5%) was significantly higher (p < 0.01) among infants with positive results compared with those with negative drug screening results. Similarly, the incidence of positive RPR/FTA-ABS (11% vs 4.6%) and congenital syphilis (8% vs 2.3%) was significantly (p < 0.01) higher among infants with cocaine-positive results compared with those with cocaine-negative results. We conclude that maternal illicit drug use, specifically cocaine, is significantly related to the resurgence of congenital syphilis among newborn infants.

Topics: Adult; Cocaine; Female; Fluorescent Treponemal Antibody-Absorption Test; Humans; Incidence; Infant, Newborn; Male; Marijuana Abuse; Meconium; Opioid-Related Disorders; Risk Factors; Syphilis, Congenital

A large-scale, prospective drug screening of newborns by meconium analysis was done to determine more accurately the prevalence and epidemiologic characteristics of drug use in a high-risk urban, obstetric population. Every other neonate delivered in a perinatal center from November 1988 to September 1989 was prospectively enrolled and their meconium was analyzed by radioimmunoassay for the metabolites of three commonly abused drugs--cocaine, morphine (opiates), and cannabinoid. In 3010 subjects studied, 44% were positive for cocaine, morphine, or cannabinoid; 31% were positive for cocaine, 21% for morphine, and 12% for cannabinoid. In contrast, only 335 (11%) mothers admitted to illicit drug use: 52% of their newborns had a positive urine drug screen and 88% had a positive meconium drug screen. Prevalence of drug use among the pregnant women varied per month. A profile of the pregnant addict in the population studied was noted (P less than .001): service patient, single, multigravid (greater than 3), and little or no prenatal care. The major problems associated with drug use during pregnancy were principally noted in the group that was exposed to cocaine and opiates and in the group where the mothers admitted to the use of illicit drugs. On the other hand, a large number of neonates who have been exposed to drugs in utero, particularly those whose mothers denied the use of drugs, appear normal at birth and may not be recognized. Improved detection of these newborns at risk can be achieved with a high index of suspicion and meconium drug analysis.

Topics: Cannabis; Cocaine; Female; Humans; Infant, Newborn; Marijuana Abuse; Mass Screening; Meconium; Morphine; Morphine Dependence; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Prevalence; Prospective Studies; Sensitivity and Specificity; Substance-Related Disorders; United States