Is It Safe to Take Opiates While Pregnant?

The rise of opiate and opioid addiction in the United States is a major cause for concern. However, knowing how the drug epidemic started gives some insight into why so many people suffer from a dependence on drugs such as codeine, heroin, hydrocodone, morphine, oxycodone, and other opioids.

The U.S. Department of Health and Human Services states that pharmaceutical companies told medical experts in the 1990s that opioid pain-relief medicines did not have a risk of addiction. This misinformation led to health care providers prescribing pain-relievers at higher rates, which led to people building a tolerance for opioids, and in many cases, turning to illegal drugs like heroin.

According to data from the Department of Health and Human Services, 116 Americans died each day in 2016 due to opioid-related drug overdoses, and 11.5 million people in the country misused prescription opioids in the same year. Around 17,000 deaths that year were due to overdoses from commonly prescribed opioids. The same data noted that more than two million people struggled with opioid addiction and almost 950,000 misused heroin in 2016.

The rising death toll is a statistic that many people focus on, but there is a much broader scope to consider when thinking about which people are impacted by opiate misuse. Pregnant women who take opiates run the risk of not only becoming addicted themselves but also negatively affecting their fetus.

Many people ask, “Can I take opiates while pregnant?” The answer is not whether it’s possible, but whether people should and how to find treatment if a pregnant woman begins taking opiates either with or without a prescription.

Is It Safe to Take Opiates While Pregnant?
Taking opiates or opioids (even with a prescription) while pregnant is associated with birth defects for a baby. These issues can be extremely detrimental to the physical growth of a baby and or the development of one or multiple body parts. The March of Dimes website states that risk of heart defects is increased for newborns who were exposed to substances while in the womb. Another potential defect is spina bifida, which means “open spine.” Babies born with spina bifida do not have a properly formed spinal cord and this defect can deter the development of a child’s brain, spine, spinal cord, and meninges.

Other potential risks to combining opiates and pregnancy include improper growth for the fetus while in the womb. When a fetus is exposed to harmful substances during pregnancy, they might not gain a healthy weight or size before birth.

Another factor for women to consider regarding taking opiates while pregnant is the potential for a baby to develop Neonatal Abstinence Syndrome (NAS), which is a baby’s dependence on a substance due to its exposure in the womb. The Food and Drug Administration (FDA) requires a boxed warning, also called a black box warning, for NAS on prolonged narcotic use in pregnancy. After birth, a child with NAS may experience similar withdrawal symptoms that people with an addiction to an opiate or opioid struggle face.

Some of these cardinal symptoms of NAS include:

  • Irritability
  • Sleep disturbance
  • Abnormal movement
  • Feeding problems
  • Stomach problems
  • Central nervous system issues

A diagnosis of NAS can result in issues for a child, including small size for age, breathing problems immediately after birth and the risk of seizure. However, NAS is treatable and does not lead to long-term complications.

Many people ask about the risk of taking opiates while pregnant but also inquire about whether there are any differences between these drugs and opioids. The two drug classifications are in many ways interchangeable. The only major difference between opioids and opiates is that the former is a man-made drug while opiates are naturally derived substances. However, the two drugs interact with the brain in the same manner and can cause the same effects for people, including the same withdrawal symptoms and potential for addiction and injury.

The National Institute on Drug Abuse revealed staggering statistics about the prevalence of babies being born addicted to opiates and opioids, which is the definition of NAS. According to the organization, every 25 minutes there is a newborn who comes out of the womb suffering from withdrawal symptoms. The experience of these effects can increase the amount of time a child needs to stay in a hospital after birth, which ultimately can increase medical costs. Additionally, the National Institute on Drug Abuse states that maternal opioid and opiate misuse and babies born with NAS has been on the rise in the U.S. since 2000.

If a woman has a prescription to an opioid or opiate, such as OxyContin or codeine, or is misusing an illegal street drug such as heroin, abruptly discontinuing taking the drug can be extremely harmful to both the mother and her fetus.

As a person consistently takes a drug, they are likely to form a tolerance for the substance and require larger doses to achieve the same desired effects, whether it’s pain relief or a euphoric high sensation. Increasing dosage can result in the person developing a physical and psychological dependence on the substance to achieve basic bodily reactions, such as calmness or happiness. Suffering from a heavy dependence on a substance and then no longer taking it at all can lead to extremely uncomfortable withdrawal symptoms, which can make it much more difficult to properly detox from the drug and continue recovery in a safe manner.

There also are serious physical risks that can occur due to going “cold turkey,” which involves abruptly discontinuing taking a drug. For the mother, a cold-turkey approach can increase her risk of experiencing a relapse. Additionally, discontinuing all use of a drug can negatively affect a fetus since it also is reliant on the substance. Premature birth could occur, for instance. Another potential risk is a stillbirth, which is the death of a baby after at least 20 weeks of pregnancy.

If you or someone you know is pregnant and taking opiates or opioids, either as prescribed or without a doctor’s orders, discussing this with a doctor is the safest way to find an alternate. In many situations, women feel the need to take prescription opiates to relieve pain. However, doing so can have long-term consequences for the fetus.

Treatments for addiction include methadone, Subutex and Suboxone. Methadone is the standard treatment for doctors to help pregnant women who are addicted to opioids. Taking methadone can still result in NAS after birth and withdrawal symptoms for the baby. Subutex, which is also called buprenorphine, is an alternative to methadone. Suboxone is a combination of buprenorphine and naloxone. There is currently not as much data on Suboxone use as there is on Subutex use, and therefore Subutex is generally preferred by medical professionals.

If someone experiences extreme pain and is pregnant, they should discuss the risks and benefits of pain medications with their doctor. Many women do not know about some of the natural remedies for pain while pregnant. Some non-medication alternatives to pain-relief include:

  • Behavioral therapy
  • Physical therapy
  • A warm or cold compress
  • Prenatal yoga
  • Massages
  • Acupuncture
  • Exercise

Many women who are addicted to drugs or rely on prescription medications for pain relief have dreams of giving birth and becoming a mother. However, continuing to take some drugs can be extremely harmful to a fetus. While substance use disorders are extremely challenging and difficult for many people, help is available to manage withdrawal symptoms and remove the substances from the body with the fetus’ health in mind. Once detoxification is complete and the person is in recovery from their addiction, there is a higher chance of a healthier pregnancy and birth for both the mother and her child.

The Recovery Village can help people who wish to get pregnant but are addicted to opiates or opioids. Call today and speak to a representative about the safest and most effective treatment options so that dreams of motherhood and pregnancy can soon become a reality.

The Department of Health and Human Services. “The Opioid Epidemic By the Numbers.” Updated January 2018. Accessed February 2019.
Is It Safe to Take Opiates While Pregnant?
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