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Opiate Detox while Pregnant....Pros & Cons of Substitution Program
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savvybame posted:
I am a 30 yr old, approx 20 wks pregnant 1st time mom-to-be. I found out I was pregnant at 6 weeks & confirmed it via ultrasound at a free pregnancy clinic at 8 wks. Due to an ongoing battle with oxycontin addiction I went in to have an abortion 2 wks later, only to be told I was actually 15 wks along & couldn't have the procedure. I have always looked forward to having children and am great with kids, but am a firm believer in a toxic free environment for my baby & felt shame, guilt & fright that I hadn't given that to my baby from the start. I was shocked to find out (when I called several treatment centers & detox facilities in the Puget Sound area) that NO ONE will detox a pregnant lady ~ they all promote methodone or subutex replacement maintenance. I DO NOT want to continue taking drugs & have a baby going thru withdrawals - that would kill me. On the other hand I can't find ONE medical facility or person to assist me in detoxing due to the risk of miscarriage. I have done a vast amount of research and found no studies or data indicating the effects detox can have on a fetus...I am wanting to wean off completely (have slowly decreased my use) but wish I could do it under supervision to make sure my baby is OK...that doesn't seem to be an option because no one wants the liability on their shoulders. I cant believe that the medical society promotes drug use for an entire pregnancy with such a lack of research done on the alternative; detoxing the mother as early as possible (but after the first trimester when miscarriage risk decreases) Oxycontin are a category B drug by the American Pregnancy Association & are not known to be harmful or cause birth defects, but the list of side effects of withdrawals is enormous. I don't want my baby to go thru that...I would do so for him/her in a heartbeat if I could rest assured that I wasn't harming him/her in the process. PLEASE HELP!??!!

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Have you detoxed off opiates/oxycontin/painkillers on your own while pregnant without harm to your baby? If so, how & at what stage of pregnancy?
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  • Yes, with the assistance of a medical facility
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AnAugustsunset responded:
Hi, I am 25 years old, 11 weeks pregnant and have struggled with addiction for many years. Although I do not have experience detoxing while pregnant, I have read about the risks of late miscarriage. I am on Subutex but I don't really want to be because of the risk of withdrawals for the baby but from what I have read it is much safer to take it while pregnant than to detox while pregnant. I would suggest talking to a Dr. that prescribes Subutex or Methadone, I think they would know the best ways to deal with your addiction during pregnancy.
 
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An_244570 responded:
Hello, I know it has been a cpl years since you wrote and I think it's a real bummer know one responded much. I'm in a similar boat that you were in. Addicted to opiates, 4 months pregnant. I have obsessively researching and trying to get help to even just get on subutex, but that alone is difficult. Either they are booked months out or they don't see pregos, etc. dead end after dead end! I really would prefer subutex detox, but maintenance if I have too. Obviously methadones the easier and most recommended, but despite the fact that they've been using it longer, the wds are so much stronger! Subs have less intense wds for newborns. Which obviously sounds much better. The other piece to that is I know and have read of people doing from a week to 6 week detox with subs with out much if art discomfort or wd symptoms what soever. (aside the first dose/induction stage) Anyway if I could do this with out wds, then my baby should b ok too. I think as u said they r scared of liability w risks. Often docs don't realize that subs r SOO much better taken short term for detox then long term new addiction/maintenance plans for whatever reason. If only I could miraculously find a more knowledgeable and wise sub detox Doc who was also open to work w detox trial for me during that "golden less risky 2nd tri window" that I'm in. I'm thinking like you of doing it on my own if I have to. But I soo wish I could see a doc to get me started w the induction. Problem is I'm also fearful w induction. so as many know u have to be at least in a decent level of mild to mod wd to assure you don't go into precipitated wd. I'm a baby w the icky crawl out of ur skin feeling and I know it's not good for baby to deal w wd. So I imagine they do things slightly dif w pregos. I've tried to do it on my own already but become fearful if it's been long enough. I hear some people take 8 hrs after an h dose and do just fine others wait along time and go into precipitated. I do have the cows chart and from research it sounds like as long as u start off very low and are for sure in a decent level of wds it's fine. But it's still scares me. I finally found a methadone clinic I can go to but I'm apprehensive of how they will want to do it as well. They told me that it's usually 24hrs they want u to wait. That maybe less since I'm prego but I can't ask the doc until I see him in wds seems weird.... I might just have to do it on my own. Maybe I'll start w there doc and finish on my own. It's cheaper getting the pills on the streets then going in. It's all such a big pain in the rear. I wish there was more help for women like us, it's pretty ridiculous. They want u to get off opiates rt away, but they make it near impossible to do so...

Please if u get this, I'd love to know if u did it on your own after all and what your outcome was either way. if any one else has experience getting completely off opiates in a safe way please let me know your experience as well. I am seeing an ob/gyn and a midwife as well as everything else possible. I didn't want or plan to be in this situation. It's a nightmare and a blessing together. I too was going to abort innitially but found that most women are able to go full term with healthy babies despite our misfortune of timing and poor choices prior to becoming pregnant. I still am amazed I ever found myself an addict, let alone pregnant while in this life mishap, btw, I'm 31, in a health care profession myself. Not the typical or expected "junkie" I can't wait for this all to be behind me and to focus on this beautiful life born out of my ashes of triumph out of this evil addiction that also unexpectedly grabbed me near 2 years ago...
 
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An_244731 replied to An_244570's response:
My Aunt and Uncle adopted a little boy that was born addicted to opiates almost 3 years ago. While the first several weeks were very complicated and they had to wean him off of methadone he is an extremely smart and strong little boy now. His mother was an addict but did check herself into a program as soon as she found out she was pregnant and they replaced her oxy pill addiction with the methadone. The baby's symptoms were much like an adult going thru w/d's. Shaking, sneezing, diarrhea and all over body pain. While it was a rough process to see a newborn going thru he did survive and is such an amazing blessing to our family.

I hope that you are able to find the best treatment possible for you and your growing baby. Addiction is a hard battle but having a little life inside you to fight for will be the most motivating thing you will ever experience. My boyfriend has struggled with opiate addiction in the past and now that we are expecting he has told me that even though he's not the one carrying the child he wants to be the best role model and stay as healthy as possible for our child.

Good luck to you. Please keep us posted and you are in my prayers!
 
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lesliegrayrn replied to An_244731's response:
Hey! I'm 29 now but when I was 25 I had been addicted to opiates for roughly 8 months when I found out that I was pregnant. As an RN and someone who already wanted to quit abusing oxycontin, I assumed that quitting cold turkey was the best way. So at first I tried to wean myself off with suboxone in minimal doses and only when the w/d symptoms were unbearable...

Well, needless to say, outside of a rehab facility that was impossible for me (as i assume it would also be for most addicts). So I just had to quit. Cold turkey. Around 11 weeks, on day 6 of my cold turkey w/d's, I began cramping VERY badly and within an hour or two began to bleed. I accepted that I was just going to miscarry. So I called someone to take me to the ED. When I got there, as I said before, I just figured that a miscarriage was inevitable but when they did the ultrasound, there was my baby, turning flips and playing 'happily' with a perfect heartrate. However, because of the involuntary contractions of smooth and skeletal muscle in the body during w/d's, my amniotic sac had detached almost completely from my uterine wall and I had a large active bleed in my uterus. I was put on complete bedrest for the next 3 months until the 'scab' was reabsorbed by my body.

Obviously the guilt that I have dealt with was (at times) overwhelming... But now my son is 4 years old and perfectly healthy. I had no other complications during pregnancy or after his birth. Now that I have done my research and I know how high the miscarriage rate is if a woman quits opiate use during pregnancy, I would never do that again. I even have several friends who have since then found themselves in a similar situation so I always tell them my experience and encourage them to do their research.

Research has shown that you can use subutex during pregnancy with the least side effects and the mildest withdrawal symptoms for baby. Methodone is very hard for baby to w/d from and suboxone has very little research regarding the effects on a fetus... Suboxone also can interfere with the meds given during labor where as subutex doesn't.

Hope that helps!
 
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momtobe78 responded:
am in same situation except already on subs and want to detox off them due to the preg going to let doc know on thurs thats I am 3 months just found out though. i dont want my baby to have to withdrawl at birth


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