Pregnancy and methadone? Newborns and methadone?
Pregnancy and methadone? Newborns and methadone?
Posted: 12/30 07:46 AM
I need a bit more exposure than just the few people who post in this section of this forum so I also posted this in the suboxone pregnancy section, so please excuse the double post because I think it to be real important to get the most info as I can.
I met this young lady 24 years old in our methadone clinic two years ago. We both were new and had to drive an hour one way to go to the clinic everyday in the dead of winter where snow was such a problem so we began riding together and my husband could always take us when the snow was bad. I am 48 years old so I kind of have tucked her under my wing and mothered her since then and now I love her as if she were one of my own. So needless to say when she came to me and told me she was pregnant, I was overjoyed with excitement because she has polycystic fibroids disease and was told she probably would never have children and although she seemed to be ok with this I mourned for her because there is no better joy than motherhood and grandmother hood.
She takes 180 mgs of methadone and well we have seen many pregnant girls well into their pregnancy continue on methadone and then have their babies and continue on after that. I have never asked any questions about how they did on the methadone while pregnant. What happened when the baby was born? Is the baby is addicted? Etc….Is a Test administered when a baby is born showing methadone in baby’s system? Do they report it to DSS? Can they take her baby? Her counselor told her to come off methadone would be more stressful on her and the baby. It may take longer than 9 months to effectively taper/detox her from 180 mgs per day. In fact he told her they probably are going to have to increase her.
Without any angry/rude comments please can anyone give any feedback on this subject? I want to gather as much info as I can. Should she consider changing to suboxone? Now her counselor has told her it is safe. That if the baby shows withdrawals they can be treated effectively. Of course he did not tell her if DSS was going to be an issue etc…
Posted: 12/30 10:44 AM
when I was in active addiction, a very close friend of mine was on methadone for pain management, 130mg a day Im pretty sure. I know it was at least 100.
She was able to go on, just as 'normal' all the docs knew about it and everything, they encouraged her to get her dose 'down' before the end of pregnancy and she did try but I think she was only able to go to 80mg. Im not 100% sure on the dosages, becuase it was such a 'blurry time'
But I still talk to her now once in awhile, and I do rember that after the baby was born they watched her very closely, she had some mild w/d's but not a whole bunch. Im not sure WHAT drugs they gave the baby. the baby stayed in the hospital 5 days longer than the mother. but went home after about 10 days total. she had a c-section.
Anyway, there havent been any 'long term' affects, her daughter was a lil slow to talk and saw a speech therapist around age 4, and thats really been it. the kids 8 now and just fine.
so this was almost 10 years ago when having a 'drug baby' (so they told her) was even LESS popular than it is now.
I would have your friend do as much research as she can to have something to tell the drs and nurses, other than just letting them 'run the show' becuase they definitely will try to.
and i would have her ask as many questions as possible about what will happen after the babys born,,,, like how they KNOW if the baby is w/d.
I think an overload of information, or articles, whatever you can get your hands on will help here.
I wish her and the baby the best of luck......
my friend was able to stay at the hospital, in the 'waiting area' she slept there every night. She was so scared something bad would happen if she left......but remember this was like 2002
I hope this helps
Posted: 12/30 11:37 AM
I haven't had a child on sub or methadone (at all as a matter of fact), but I've learned much about opiates and pregnancy in the last 3 years just from being around this forum. Methadone has been used much longer than sub and has been studied in pregnant women as well. Suboxone/bupe hasn't had but initial studies only, but they have been positive.
The following is what I gathered from my own research:
Methadone and Neonatal Abstinence Syndrome (NAS):
Between 60% and 80% of infants born to mothers using methadone will experience NAS symptoms. Symptoms generally begin within the first 2 to 3 days, but can be delayed by as much as 4 weeks. Symptoms generally endure for between 10 and 21 days, but can last as long as 42 days.
Using buprenorphine during pregnancy can result in neonatal abstinence syndrome (NAS):
In clinical studies, about half of babies born to women using buprenorphine suffered from NAS that was severe enough to merit treatment. Women in these studies may have been using other drugs that exacerbated the NAS, and so buprenorphine only may result in NAS less frequently.
Buprenorphine NAS symptoms most typically peaked within 3 or 4 days and dissipated within a week.
"While methadone is the accepted standard of care drug for pregnant opiate addicted women, doctors may, in some cases, decide that buprenorphine is a better choice. Initial case studies of buprenorphine (the active ingredient in Suboxone and Subutex) on pregnant women indicate that it is a well tolerated and effective medication for use by pregnant women."
As you can see, methadone has higher rates of NAS symptoms in newborns than sub does and can be delayed much longer.
This is just informational only and I'm not giving you my opinion one way or the other.
Some of this information is from this website: http://www.choosehelp.com/topics/suboxone-and-methadone/methadone-or-suboxone-during-pregnancy
I hope this helps.
Posted: 12/30 06:43 PM
If a woman about to give birth tests positive for drugs, CPS is called.
As they should be.
Posted: 12/30 09:41 PM
Im not saying they should or will take the child away, they usually don't. Just that they should and would do a short investigation.
Author: Diary of a Quitter
Posted: 12/31 06:10 AM
Not every state requires CPS or DSHS involvement for mothers on MMT or other opiate replacement treatment. It really just depends on local laws or policy.
She and the baby will probably be tested to see if she has used any other drugs during her pregnancy. The hospital can test the baby's meconium which will indicate any drugs the mom has used going pretty far back into the pregnancy.
As long as she has only used medication that was prescribed to her, things should be fine. If her baby develops NAS, the hospital will treat the baby's symptoms with morphine (usually), which they will taper down over a number of days. If CPS gets involved, she will have to follow their plan and basically do what they tell her. They will be concerned about things like: is the home environment safe and appropriate for a baby? Are there other adults in the home and are they using drugs? etc. They might be up in her business for a bit, but they won't take a baby away JUST because the mom is on MMT.
Your friend needs to talk to the people at the methadone clinic. I'm sure they have dealt with many mothers who have been pregnant and delivered while on MMT. They will be able to tell her what to expect, they will know what doctors and hospitals have experience with moms on MMT.
I'd also encourage your friend to educate herself as much as possible about MMT and pregnancy and newborns, and for her partner (or whoever will be her support person/people through her pregnancy) to educate themselves as well. The more she knows, the better she will be able to advocate for herself and her baby. Good luck.
Posted: 12/31 07:41 AM
It's so nice to have a community to turn to. I often wonder if I would have had the resources I have today back then would things be different? Nonetheless, it is very comforting today to the suffering addict etc...btw I was on a website SAMSHA and...I came up on this article you might want to post a sticky in the pregnancy forum Hatmaker
Buprenorphine Favoured Over Methadone for Opiate Addiction in Pregnancy
Because not too long ago methadone was noted as the best nethod of treatment when pregnant. And....SAMSHA is a very reliable website as they pretty much govern over the Opoid Treatment Facilities.... From suboxforum.com