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There are some situations that have lots of shades of grey that allow room for error, experimententaion, rationalization, and delay....
Pregnancy is not one of those.
Baby first. Possibly detoxing would harm the baby-but continuing to use will also harm the baby.
Have you ever seen an infant withdraw from drugs?
I rest my case.
ps-I say go to the hospital because they won't detox you in a way that would harm the fetus.
Pixie
Luckily, my daughter was born healthy, although she was one month premature and only weighed 4 lbs. I think it's a miracle, since I was using heroin EVERY day in my 7th & 8th months. I HAD TO, doctor, because I was so sick from withdrawals, I just couldn't stand it! I hope you understand.
Over the past 20 years I have been an addict, I have had many girlfriends and known other women who were pregnant and hid it from their clinics as long as they could because they were absolutely TERRIFIED about going to "Hospital X!" After buying a subscription to Methadone Today, I learned that addictionologists, including the ones who write the TIP and TAP books, recommend completely the opposite of what "Hospital X" is doing to women. Can't someone make them stop!? Or why can't the other methadone clinics in the Detroit area give pregnant patients a choice whether to stay at their clinic or to go to "X"? - A Very Worried Patient (With Not Much Time Left Before I Start Showing)
Dear Worried:
The mistreatment which you suffered eight years ago that resulted in your child's low birth weight and premature birth is now subject to a claim of malpractice due to the clinical research and practice guidelines that attest to the following:
Methadone should be increased, commonly as much as 30 percent, during pregnancy. Failure to medicate adequately increases fetal distress, prematurity and spontaneous abortion. Methadone maintenance, when adequate to suppress the need for illicit drug abuse, results in healthier, higher birth weight newborns compared with mothers who continue to use heroin. Infants born to methadone-maintained mothers do not over time differ significantly from those born to non-dependent mothers in ways that can be attributed to methadone.
Management of neonatal opioid withdrawal is a safe procedure and not to be feared, especially compared to the risks of underdosing pregnant patients who relapse as a result. Many of the infants of methadone maintained mothers may not require much in the way of management of neonatal abstinence, but it is almost impossible to predict for an individual case (at CAP clinics, there was at least one infant whose mother delivered at a maintenance dose of 180 mg/d whose abstinence syndrome was easily managed).
"Blind" dosage should never be practiced when not requested by the patient. It is demeaning, unsafe, anxiety provoking, and encourages diversion among nursing staff. It is a sign of a punitive and non-medically oriented program where administration has little understanding of the disease of addiction and even less empathy for the patients whom they serve. Run, do not walk, from such a facility.
I have no idea why pregnant patients should be banned from MMT programs and will not comment on this bizarre practice, which you describe, of herding them all into a single clinic. It is not done anywhere else in the world in my experience.
There are guidelines about monitoring prenatal care that all clinics must observe in the federal regulations. This implies that pregnant women should be served. Depriving women of the option of attending the clinic of their choice should be addressed with the State of Michigan or with the agencies who license or fund these no-service clinics.
Providing care to pregnant women should be a primary requirement for licensing or funding in my opinion. It is one of the truly critical health care interventions that MMT clinics can do better than any other facility. The federal rule regarding admission criteria for pregnant addicts is minimal compared with those for others and reflects the government's expectation that licensed clinics should serve this population ahead of everyone else and certainly not have the option of excluding it.
I've been clean for over 12 years now, thanks be to God.
My wife and I had a son six years ago. I’m 47 now. He is the joy of my life. I know the heartache your going through, and I wish I had information from better sources.
But I heard that very little methadone passes through the wall when your dose is below 25 mgs. Common sense tells me the lower the dose you can stand, the better your baby will be.
Methadone is a horrible trap. Way worse than heroin. You need to be free. Free to be the mother you know you can be. Loving, caring, you know... mom!
And it not a matter of deciding to be a good mom. God can make you a hero in your child’s eyes. Not someone they are afraid to lose at any second. Someone they can count on to love and nurture them.
Get your dose down and get a hold of God. He will do more than just set you free. He will give you a new life.
We do want to hear from you so start a new post. Click the green Post A Question button and post away. :-)
My own mother was put on methadone pills for chronic pain before she passed away. And now, my son's girlfriend, who is due to have their son May 22, 2009 has been put on it because of abusing oxycontin AND heroin. She's not even showing yet and you can't tell she's pregnant at all.
Her mother had to sneak behind her father's back to get her on it and her father forced her off of it last week with no time to detox whatsoever.
He has no idea or does not care what effects this can and will have on the baby. She told my ex-husband this past Monday that she hadn't felt the baby move in two days and, since I live 500 miles away and can't go to her, I sent a text message asking if everything were alright.
Her father intercepted the text and basically told me that now is the time for me and my family to leave her alone and get on with our lives. I told him he'd lost his mind if he thought for one minute I'd turn my back on my grandson, IF he survives after what he's done to his daughter, who, btw, is 21 and totally dependent on him financially.
My son also got into a methadone clinic, but has since checked himself into the hospital and they are detoxing him with Seboxin (sp) and he has now moved on to rehab.
Her father hates my son, but this isn't about her father OR my son OR her, for that matter.
It's about the unborn baby and the withdraw he's going through due to her father's inaction to help his daughter kick her habit. She was just at someone's house days ago begging for pills because she was "sick". It could also cost us all the life of that precious and innocent baby.
I have to say that I totally agree with some comments made above. Methadone is a very nasty synthetic form of opium and is much, much harder to kick than heroin. It destroys your bones, causes you to lose your teeth, and many other side effects aside from the fact that it's extremely addictive. Even more so than heroin.
That's not to say I'm telling anyone to get off of it and go back to illegal drugs, but there ARE other alternatives out there now that are less stressful and less harmful to you AND your unborn child and it would be in your best interest to discuss this with your OBGYN as soon as humanly possible.
Methadone is no miracle drug. It's just a plain old drug. Period. And way too many rely on it to keep them off the streets and it, too, is abused. While that may be good for some, I don't agree that it should be the case with anyone who is pregnant.
No baby deserves to come into this world having to fight an addiction to anything. The world is cruel and hard enough without the added stress of addiction.....on both baby and mother.
First let me start off by mentioning that in New York City, and most of the US, the standard practice is NOT to taper pregnant women off methadone. Tapering off too quickly has been shown to lead to miscarriage, low birth weight, and premature birth in many cases. Usually when a woman is pregnant a doctor will not only advise her to stay on the maintenance dose throughout the pregnancy, but to also possibly increase her dose as she gains more body weight later on. The reasoning is that doctors cannot treat a fetus in withdrawal but can effectively treat a baby once it has been born.
That said I was taking a split dose of 96mg a day when I found out I was pregnant (48mg at the clinic in the morning and 48mg given to me as a take-home bottle for the evening.) I have always been on a split dose, which is necessary for some people who metabolize methadone very quickly -- this sometimes occurs in younger, more active patients.
When I found out I was pregnant my first reaction was to get myself off the methadone as I did not want the baby to be born addicted. However I found out that the medical community was very much against this, saying they did not want me to possibly have a miscarriage. After much discussion and getting many many opinions from many different medical professionals in a variety of different fields (addictions medicine, ob/gyn, pediatrics, etc.) I decided to very slowly initiate a taper during the second month of the pregnancy.
At first I began by taking away 6mg (3mg from each bottle) every 7 days. After getting down to about 70mg I slowed the taper to go down 4mg (2mg out of each bottle) every 7 days. After I went down to about 50mg I slowed the taper down even further to go down 4mg (2mg from each bottle) every 9 days.
I had to sign a number of papers for the doctor including a statement saying that the taper is against medical advice. I also told the doctor that I would report to him immediately if I was feeling any signs of withdrawal, at which point I would consider discontinuing going down on the taper for that week. Furthermore, I found an ob/gyn who is monitoring the pregnancy who specializes in high risk pregnancies, particularly for women with substance abuse issues and women in methadone treatment. She is making me get a sonogram every 3 weeks to monitor the growth of the fetus because she says a methadone taper during pregnancy can result in slow fetal growth. If she tells me that the baby is not properly growing, I will either slow or stop my taper.
So far everything has luckily been going fairly well, but I believe it is important to pay very very close attention as to what's going on while pregnant. If you want to get off methadone while you are pregnant, make sure you have a good set of doctors backing you up. Make sure you speak to both an addictions specialist (shouldn't be difficult if you are part of a methadone program), as well as choosing an ob/gyn that has plenty of experience with pregnant women on methadone. Make sure the taper is done very slowly. Remember that if you are, for example, taking 100mg and reduce that by 10mg, you are taking out a tenth of your dose, but if you are taking 20mg and take out 10mg, you're taking away half the dose! You'll obviously want to go slower and slower as your dose gets lower. You will, however be constrained by the length of the pregnancy, so if you only have a couple of months left in your pregnancy, I would not recommend initiating a taper unless you are already on a fairly low dosage of methadone, as it could lead to fetal distress and potentially much more serious issues such as miscarriage. However, if it is still pretty early on in your pregnancy, I definitely would not discourage trying a very slow, highly supervised methadone taper.
Best of luck to you. Feel free to ask me any questions you may have.