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” use [12]. Methadone substantially minimizes theV6T-1Z3 Full list of author information is available at the end of the articleBackground The prevalence of maternal drug use during pregnancy in Canada [1] and the US [2] has been estimated to be as high as 6-10%. The consequences for the newborn are severe, and include increased risk for perinatal mortality and morbidity, as well as ongoing physical, neurobeha-vioral, and psychosocial problems [3-7]. Between 60-90% of infants exposed to illicit drugs in utero will exhibit clinical symptoms of withdrawal, particularly if opiates are among the drugs used [8-10]. Methadone treatment is currently the recommended approach to opiate addiction during pregnancy [11]. The purpose of this treatment is to alleviate the symptoms of drug withdrawal in order to prevent use of street drugs. It is widely believed that intrauterine death or fetal com-promise is due to the “bingeing ” or drastic fluctuations in serum levels of opiates or cocaine associated wit