All opioids – even legal opioids you get from your doctor – can harm you and your baby during pregnancy. Opioids include prescription pain relievers, such as codeine, hydrocodone (Lorcet, Vicodin), oxycodone (OxyContin, Percocet), and heroin, an illegal drug. These drugs release chemicals in your brain that make you feel good. After using them for a while, your body may become dependent on them. Then you may not be able to stop taking them. This is called opioid use disorder. Your unborn baby may also become dependent.
Opioid use is often stigmatized. It can be difficult to talk about it, even with your doctor. But if you are pregnant, getting treatment for opioid addiction as soon as possible will give you a better chance of having a healthy pregnancy and a healthy baby.
Risks to you and your unborn baby
When you take opioids, they cross the placenta and reach your growing baby. These medicines can slow down your baby’s growth and cause problems such as:
Using opioids during pregnancy can also cause you problems. You could develop preeclampsia. It’s high blood pressure combined with signs of organ damage, usually in the liver or kidneys. This can cause serious illness, even death, for you and your baby.
Your baby may continue to struggle after birth. Neonatal abstinence syndrome (NAS) occurs when babies become dependent on opioids in the womb. Once born, these babies show withdrawal symptoms such as:
Opioids also indirectly affect your baby. When you take these medicines, you may not eat well or get the antenatal care you need to help your baby grow.
Some people who take opioids do dangerous things like having unprotected sex, which increases their risk of sexually transmitted diseases (STDs). Opioids also increase your risk for infections like HIV and hepatitis, which you can pass on to your baby.
Talk to your doctor
If you take opioids for pain management, consider whether you can switch to a safer pain reliever during pregnancy. Your doctor will balance the need to treat your pain against the risks of taking these medications. If you take opioids, use the smallest dose possible for the shortest amount of time to manage your pain.
If you have an opioid use disorder, see an obstetrician / gynecologist and primary care physician who are experienced in the treatment of addiction. Or have an addiction specialist work with your other doctors to create a treatment plan for you.
Talking to your doctor about substance use can be scary. You might fear that you will be arrested or that your baby will be taken away. Some states consider drug addiction during pregnancy a crime, but it may be easier for pregnant women who get help. Share your concerns with a doctor you trust.
What treatments for opioid dependence are safe during pregnancy?
Even if you are ready to stop taking opioids, it is not safe to stop them suddenly during pregnancy. Stopping smoking cold turkey can be very dangerous for your baby.
Opioid replacement therapy is a safer way to reduce your dependence on opioids. You are taking a different type of opioid to prevent withdrawal symptoms in you and your baby. Because these drugs stay in your body for a long time, they safely reduce your need for opioids.
Opioid replacement therapy will lower your baby’s risk of developing neonatal abstinence syndrome and keep you and your baby healthier during your pregnancy. This is a better option than a doctor-supervised withdrawal or detox program. After a detox program, you are more likely to have a relapse. This means that you start to use again.
Your doctor may also prescribe naloxone (Narcan). This medication reverses the effects of opioids on your body. If you overdose Narcan could save your life and your baby’s life.
Therapy is another part of the treatment for opioid addiction. An addiction counselor or therapist will help you find healthier ways to cope with challenges than using drugs. Therapy also teaches you to avoid situations that make you more likely to resume opioids.
Special care during pregnancy
Due to the effects opioid use can have on your body, your OB / GYN might recommend additional tests and special care during your pregnancy, including:
If you or a loved one needs help with an opioid use disorder, talk to your doctor or call the National Substance Abuse and Mental Health Services Administration (SAMHSA) helpline at 800-662-HELP.
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