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Treating Cocaine Addiction In Pregnant Women

Debra Wallace, MA.Ed, LPCC-S, LICDC-CS

Medically reviewed by

Debra Wallace, MA.Ed, LPCC-S, LICDC-CS

March 5, 2019

Exposing babies to harmful substances while they are still in their mother’s womb can leave the baby with serious and lasting health problems. It is important for women who are pregnant and addicted to cocaine or other drugs to seek professional treatment immediately.

How Is Cocaine Addiction Treatment In Pregnant Women Different?

There are a few things that make getting treatment for cocaine addiction more difficult for pregnant women. These can include increased negative social stigma around drug addiction, fear of losing custody of their children, lack of insurance coverage, lack of transportation and child care and difficulty finding the right treatment program.

There are around 750,000 cocaine-exposed pregnancies every year in the U.S., but the number of pregnant women who receive treatment for addiction remains low. Between the years 2000 and 2010, the number of pregnant women (age 15 to 44) admitted to substance abuse treatment facilities stayed between 4.4 and 4.8 percent, according to data from the Treatment Episode Data Set (TEDS).

It can also be difficult for women to tell that they are pregnant because some of the withdrawal symptoms of cocaine use can mimic early signs of pregnancy. Currently, there is no medication approved by the FDA for the treatment of cocaine addiction, however, researchers continue to look at medications that target the same areas of the brain affected by cocaine use.

As there is no approved medication-assisted treatment, cocaine treatment typically consists of gradually tapering off the dosage amount until it is no longer present in the body. This can be tricky to do when pregnant because the drug influences both the mother and the baby.

Timing of the doses must be precise, otherwise, the baby can experience multiple periods of withdrawal in the womb. This precise timing can be difficult to manage because of the fast-acting effects of cocaine.

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Treatment Options For Pregnant Mothers

There are many medical concerns that can result from abusing cocaine while pregnant. The identification of cocaine addiction, comprehensive treatment and integrated services all play a role in ensuring the safety of a mother and her child while she goes through the recovery process.

People who suffer from addiction to stimulants like cocaine respond in a similar manner to various treatment options. Treating cocaine addiction with a supervised detox and individualized management plan, in conjunction with therapy, has been shown to work best for people who struggle with cocaine addiction, including pregnant women. There are also specialized treatment facilities that focus on treating specific needs of pregnant women who struggle with cocaine addiction.

Cocaine Addiction And Pregnancy

Cocaine is an illegal stimulant that causes the brain to be flooded with excessive amounts of foreign chemicals at once. Cocaine acts on the pleasure centers of the brain, and though it is not known exactly what receptors cocaine influences, it is known to influence the level of dopamine (happy hormone) within the brain.

The rush of dopamine, paired with the quick action time of cocaine (within minutes of use) are two contributing factors as to why this drug is so addictive. Studies have also shown that cocaine use in pregnant women can also be associated with higher risk of alcohol abuse, increased likelihood of smoking cigarettes and higher risk of marijuana use.

Abusing cocaine is dangerous, and doing so while pregnant can cause permanent damage to the unborn baby and possibly result in death. It is hard to say exactly how cocaine use during pregnancy will affect an unborn child, because multiple factors can influence the outcome for the baby and mother.

These factors may include:

  • the amount and type of all drugs used (including nicotine and alcohol)
  • extent of prenatal care
  • exposure to violence
  • socioeconomic conditions
  • maternal nutrition and other health conditions
  • exposure to sexually transmitted diseases

There is still a lot of mystery about the effects of prenatal cocaine exposure. Cocaine abuse by pregnant woman can be an indication of multiple medical and social risk factors such as the ability to access prenatal care, gain supportive and effective case management services and obtain substance abuse treatment.

Some of the effects of cocaine on the fetus may be dose amount and time dependent, and significant cocaine use during pregnancy has been associated with negative consequences for both the baby and the mother.

How Cocaine Addiction Affects The Fetus

Limited studies have reported that cocaine-exposed infants had smaller head circumference, lower birth weight and length, irritability, poor interactive abilities and an increased incidence of stillbirth, prematurity and sudden infant death syndrome.

Infants with high exposure to cocaine differed in birth weight, length and head circumference from infants with low or no exposure. Heavily cocaine-exposed infants were found to have more jitteriness and attention problems than infants with light or no exposure to cocaine and lower auditory comprehension than unexposed infants.

Infants exposed to cocaine during pregnancy are also more likely to have infections, including hepatitis and HIV/AIDS exposure. In the 1980s, babies born to mothers who abused crack cocaine, sometimes referred to as “crack babies,” were predicted to have reduced intelligence and social skills. These predictions were a gross exaggeration based on the evidence they had at that time.

More recently, advanced technologies have been used to investigate the true effects of cocaine exposure in the womb. These studies have shown that cocaine exposure may lead to subtle, but significant, changes in some children. Some of the changes include behavioral problems and deficits in information processing and attention span. However, more research is still needed to determine the long-term effects of prenatal cocaine exposure.

How Cocaine Addiction Affects The Mother

Cocaine use during pregnancy can also have negative impacts on the mother.

Some symptoms associated with cocaine use may include:

  • maternal migraines and seizures
  • premature water breakage
  • separation of the placenta from the lining of the uterus, prior to delivery

General pregnancy is associated with some normal changes to the heart. Cocaine abuse can exacerbate these changes, and this can sometimes lead to very serious problems such as high blood pressure, spontaneous miscarriage, preterm labor and more difficult delivery.

Cocaine Withdrawal In Pregnant Women

Withdrawing from cocaine can be a difficult process, and with the addition of pregnancy, it becomes even more complicated. Stimulants like cocaine often produce withdrawal symptoms that affect an individual’s emotions.

While abused, cocaine alters the brain structures responsible for pleasure and, depending on the length of the addiction, the alterations can become permanent. When cocaine is detoxed from the body, it is common to experience severe depression, intense cocaine cravings, and sometimes suicidal thoughts. These withdrawal symptoms can be even more potent in pregnant women, who are already going through hormonal imbalances and pregnancy mood swings.

Finding a treatment program that can work with the increased intensity of the detox and withdrawal from cocaine for pregnant women could make all the difference in the overall outcome of the pregnancy and health of the mother and unborn child.

National Center for Biotechnological Information - Treatment of cocaine addiction during pregnancy

National Institute on Drug Abuse - What are the effects of maternal cocaine use?

Substance Abuse and Mental Health Services Administration - Trends in Substances of Abuse among Pregnant Women and Women of Childbearing Age in Treatment

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