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Treating Opiate Addiction During Pregnancy

Dr. Alan Weiner MD

Medically reviewed by

Dr. Alan Weiner, MD

March 19, 2019

Facing addiction during pregnancy can be a challenging experience. It is important to seek out a professional treatment program in order to keep both the mother and baby safe during the addiction treatment process.

Pregnancy can be an empowering experience. Facing an opiate addiction while pregnant changes the dynamic, bringing an entirely new level of urgency to the need to stop the addiction. Unfortunately, an opiate addiction rarely ends cold turkey and the risk to mother and the pregnancy are significant. Finding the right treatment facility to meet your needs is essential; one that will meet your emotional and physical needs as your body both undergoes the stress of withdrawal as well as changes resulting from the developing baby.

If you are addicted to opiates or other drugs while pregnant, you are not alone. More than 4 percent of pregnant women report having used an illicit substance during their pregnancy and that number is growing. The American College of Obstetricians and Gynecologists reports that some heart anomalies and other physical deformities may appear as the result of use of opiates during the first trimester, but other factors may also come into play. Large unknowns loom about how opiates affect the developing fetus both prior to and following the birth, though cognitive delays and social delays are often reported.

Common known risks from opiate use to both fetus and baby following birth can include:

  • Spontaneous Abortion
  • Lower Birth Weights
  • Sudden Infant Death Syndrome
  • Nutritional Deficiencies

While it is essential to stop using opiates while pregnant, abrupt cessation of opiates can also be problematic, resulting in spontaneous abortion and other pregnancy-related complications. Medical management of withdrawal symptoms along with an evidence-based, comprehensive approach to addressing the addiction and underlying issues fueling the addiction is imperative to the health of both mother and child.

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How To Treat Opiate Addiction During Pregnancy

Treating opiate addiction during pregnancy really means addressing both the needs of mother and developing fetus. When an opiate-addicted mother goes through withdrawals, the fetus, also addicted, also goes through opiate withdrawals. This can put enormous stress on both mother and baby. Treating the addiction means careful monitoring, especially during the initial withdrawal phase.

Commonly, to reduce stress to both mother and baby, treatment of opiate addiction in pregnant women include pharmacological interventions including methadone maintenance. Methadone, while also highly addictive, blocks the effects of other opiates, allowing someone to function closer to normal without the severe withdrawals. Methadone can also prevent fetal distress during pregnancy.

More recent studies have indicated the use of the medication buprenorphine is superior to methadone in reducing withdrawal discomforts for both mother and baby, though both medications are effective in preventing dangerous complications associated with the detox period.

Buprenorphine, when compared with methadone, has a lower risk of addiction and may be tapered more easily when an individual is ready.

Improving Care for Pregnant Women Undergoing Treatment for Opiate Addiction

Pregnant women are a special population of individuals facing addiction. In addition to regular treatment services, they may encounter additional barriers to treatment that must be addressed to ensure success for these individuals.

Services for pregnant women should include a woman-centered model, or approach that addresses issues specific to women and offer child care services for existing children. For the baby following birth as well as the mother should have access to safe, affordable housing and transportation, nutritional counseling, emotional support for overcoming the addiction and for the pre- and post-natal period, as well as assistance for any other unmet needs.

One of the primary barriers to care is the social stigma surrounding addiction and pregnancy. Women may be less inclined to seek help from a medical professional during this time for fear of punishment or criminalization of the addiction disease. Women must be encouraged by their support network and medical professionals to seek help for the sake of their health and that of their baby.

Men and women abuse drugs for different reasons. Women, more commonly, have suffered from some kind of physical, sexual, or emotional trauma and tend to turn to drugs to numb the effects. Support for these underlying issues is essential to a successful long-term outcome in treating the opiate addiction.

Treating Opiate Addiction In Pregnant Women Means:

  • Reducing barriers to treatment, including reducing stigma and criminalization of addiction disease.
  • Woman-centered support, including emotional support for the addiction, underlying addiction-related issues, and pre- and post-natal period.
  • Understanding of physical changes that impact metabolism of pharmacological management of opiate addiction.
  • Child-care during treatment.
  • Access to safe housing and transportation.
  • Nutritional counseling.
  • Access to pharmacological interventions to reduce withdrawal stress to mother, developing fetus.

Is It Safe To Detox While Pregnant?

Opiates are powerful and detoxification can be dangerous, but not more so than continuing the use of these drugs. A properly managed withdrawal period can significantly reduce any negative outcomes for both mother and baby. It is far safer to undergo detox than to continue abusing opiates.

Medically, the pregnant body is ever changing, and the way drugs like methadone or buprenorphine are metabolized will also change between the first and third trimester, as well as post-delivery. In seeking treatment for the addiction, it is important both the attending physician as well as treatment staff is aware of the potential for acute toxicity to develop.

Get Help Today and Begin Again

At, we understand the disease of addiction and are here to connect you with the resources, professional support, and comprehensive, evidence-based care to take you from a place of addiction, to a place of recovery. Contact us today and speak with someone in confidence and discover the options available to meet your individual needs and preferences. You and your baby deserve better. Call today and begin again.

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