Methadone withdrawal and pregnant

Question

I have been on methadone for about 4 years and it worked very well for me.  It seemed to be the only thing that worked.  now I am pregnant again, this is my third.  My other two babies were born on it, the first I was taking 150 mgs, the second 40 mgs, and I was in the process of tapering to get off and got down to 25 and found out I was pregnant.  NO JUDGEMENT PLEASE.  I used no other drugs during pregnancy and my previous two children were born healthy with absolutely ZERO withdrawals.  Luck?  I don't know.  But with my clinic and my OB we made the decision to taper off.  The plan is to do 5 mgs every two weeks, right now I am at 15 mg.  

My questions is how bad will the withdrawals be when I go from 5 to 0?  I don't expect it to be painless.  But I wonder if I will be throwing up and constant diahrrea.  My OB said some withdrawal is fine, as long as I am not risking dehydration or worse, as that could cause me to miscarry.  I have take home medication every 2 weeks, and usually when I have to go in, I am a little uncomfortable bc the clinic does not open until 7 and I dose at 5-6.  But I went from 20 to 15 mgs three days ago and I felt uncomfortable, could not sleep last night and it got worse.  I woke up at 4am, waited to go to the clinic and by 6:30 am I was super uncomfortable.  I was chilly and my skin felt clammy.  Now, I have been through some wicked withdrawals in my life.  Just before the clinic I was on A LOT of heroin for a few years and went to jail, and detoxed for three days in jail and it was pure hell.  I did not eat for three days and still threw up constantly.  Will it be like that going from 5 to 0??  

Again, I am doing this under the supervision of my OB, they are doing extra appointments to check the baby and response to dosage decrease and they are prescribing me Zofran for nausea and something else for diahhrea.  I asked for clonidine and Ativan but they said because I am pregnant that those drugs need to be given under more closer observation.  I tried going to a rehab facility and called the best one in my area and they wont take me.  I also called an addictionologist to see if he could prescribe suboxone or subutex but they wont even give a consultation because I am pregnant.  Which pisses me off bc I have the approval of two doctors.  I thought subutex would be an obvious solution since its fairly easy to detox from.  That's what they gave me once when I was in rehab and it was painless except for lack of sleep.  And I am pregnant I already don't sleep so I can deal with that.

So sum up my question: How long and how intense is methadone withdrawal from 5 to 0?  How about 10 to 0?  And is there anything natural I can take that would ease and or speed up the process?

Thanks in advance.

atthebeach · Answer

Hun are you attending support groups? Counseling? 
You can live a clean and sober live free from the chains and bondage
Of addiction. Don't believe the lies of your addiction.
The recovery road is a marathon not a sprint. It takes daily work.
Do you attend church, exercise?
There are many things you can do to get support.

Were you able to taper down anymore at all?
Sloooooow and steady wins the race. 
Smaller drops, longer period in between.

kkmama1423 · Answer

You all were right it was too fast. And now i am really frustrated bc if i stay on it then as soon as baby comes I'll have to come off really fast. And the mental part is so much worse for me than the physical. The chills, and anxiety is ok i can deal with it. But the part where I start thinking that i actually NEED it and will always need it and won't be normal without it is the worst. How am I going to detox later after baby with 3 kids??!!

kkmama1423 · Answer

We want to get off sooner than later because after December I wont have the money for methadone anymore.  My father was paying for it and he is retiring and just does not have the money any more.  He had given me til the end of the year before I knew I was pregnant.  I was already tapering when I found out I was pregnant, and I just asked my clinic if I could keep doing it, they said ok, just get an OB to monitor you and the baby.  I went to my OB and told him what I wanted to do, and he said yes.  He said he has seen lots of women detox and as long as you don't do it too fast and throw yourself into violent withdrawals its fine.  I really think the reason they discourage women on methadone from detoxing is bc they think you will go back to heroin or whatever and that can be worse for the baby.  I am grateful for methadone and the stability it gave me but I don't want to take methadone the rest of my life.  And if I don't get off it now, then I will have to come off in March, when I will have to contend with a newborn plus my two kids.  I don't want to do that.  Also, they do frequent ultrasounds to monitor the baby.  Everytime I dose down, about 4 days later they do an ultrasound to check the baby.  So far its only been twice.

kkmama1423 · Answer

When would I need to start doing 1 mg at a time? I know when I went from 25 to 20 I did not feel any different at all. Not even loss of sleep. So I am at 15 now for 7 days. I feel okay as long as I stay busy. Should I stay where I am a little longer? And what about splitting doses? My clinic will only decrease in 5 mg intervals no matter how low you are, believe me I asked. If I do it on my own, I have take homes, could I do 2 mg a week for two weeks, til I get to 10, then 1 mg a week?

Jinx_777 · Answer

i don't think a psychiatrist will prescribe anything since you are pregnant.  

honestly, if you could just drop 1 mg at a time, it could be relatively painless.  of course, nothing will make it totally pain free, but i have read MANY success stories when people only drop 1 mg at a time.

kkmama1423 · Answer

Thanks for your comments everyone!!  So from 20 to 15 was not so bad.  The only thing is that it feels a little rough from about 9pm til I dose in the early morning.  Should I split it??  Or is that pointless because the dose is pretty low?  
what about 2.5mg a week?  I was able to eat and take care of my kids this week just fine.  But I know 15 to 10 even if I stay on it for a month will be ROUGH.. 
Oh and my OB will not give me clonidine.  Should I see a psychiatrist about it?

gnarly_1 · Answer

Hi after detoxing off 150  I would not recamed dropping 5 a week it is to much you need to slow down  it is all about serum levels your body cannot recuperate in a week from the drops your doing time to slow it down keep posting for support but I would have a serious talk with your doctor..................Gnarly

vicki595 · Answer

I agree with Tony and Deb. Going from 20 to 15mg was a 25% drop and that's too much, in my opinion. I would be concerned about fetal seizures and fetal demise under that kind of stress and I think the taper is too fast. This is such a delicate time in your pregnancy.

So, I would be concerned with what's happening now as opposed to when the drop is from 5 to 0.  Dosage demands increase during pregnancy so all the more reason to taper slowly and by small amounts.   What is the rush? There's plenty of time to do this slowly so you don't have much discomfort. It's up to you, of course.

weaver71 · Answer

I agree with atthebeach, Maybe talking to your doctor about making smaller drops and further apart would be a good idea for this taper. As you pointed out, that is up to you and your doctor. And by the way, we are only sharing opinions, simply because we care. No judgement nor criticism here, just concern and paying it forward for all the help we have received. Good luck.

weaver71 · Answer

You shoukdnt throw up much, if at all, with a slow taper. Nausea and inability to eat is more common with a taper. That is why the protein shakes are vital. The aminos are needed to form cell structure and help your brain start making it's own chemicals that have been supplied artificially for years.

atthebeach · Answer

Going down from 20 to 15 is too much of a drop when under 20mgs it is advisable to drop in increments of 1 to 2 mgs.
Yes there will still be withdrawal once you stop. Your body still needs to be detoxed and that takes time from your last dose.

weaver71 · Answer

10-0, I wouldn't even think of it while pregnant. 5-0 is commonly about 14 days of intense anxiety, depression, confusion, diarrhea, RLS, insomnia, all the usual opiated detox symptoms, only longer. Most say that the first 14-21 days are the worst, then the energy crash and post acute symptoms last till about 90 days. 

What helped me most was protein shakes, cal/mag/zinc, EmergenC, and a good multi vitamin. Being pregnant, I would add a hefty dose of fish oil I or some form of Omega fatty acids, that will help the brain development of the baby. 

Below 20mgs is when the symptoms increase. What you describe are standard. Personally, I wouldn't detox methadone while pregnant, but I have no judgment if that is your choice. I would slow the taper down though. The final decent is rough for long time users of methadone, no matter how one does it. I am actually surprised you have 2 doctors who have agreed to detoxing while pregnant, that is not standard protocol. Tapering off, just after the birth has been clinically studied to be the safest and easiest on mother and child. Anyway, I wish you the best of luck and hope you keep us posted. This is the first time I have seen an OB advise methadone detox, I would love to know how it works out. 

Congrats on the new family member, what a joy.

kkmama1423 · Answer

I am 16 weeks pregnant, and this is my decision that I made with my clinic and my OB,  so far its going fine, baby is fine and perfect.  

While I respect your position on not going down or off of methadone while pregnant, please don't try to convince me otherwise.  The decision to take a women off methadone while pregnant is individually based.  For example, someone in active addiction who gets pregnant is not likely to be detoxed because it is risky to pick up the habit again.  And in a situation like that they would be less likely to ok a detox.  Also, it has to be closely monitored and slow, and if a woman goes too fast and goes into severe withdrawal then that is risky for baby.  I am doing neither.  I have been doing a slow taper under the supervision of my doctor.  

I don't want a debate as to whether I should stay on it or not.  I am asking about the withdrawals when I go from 5 to 0,  Can you function or are you constantly throwing up?

atthebeach · Answer

Hello and welcome. How far along are you?
A drop from 20 to 15mgs not pregnant is rough. 
Are you sure your doctor's are on board with this?
Most times the methadone has to be increased during pregnancy.

rousewife123 · Answer

I have three boys and my last one I had almost 3 years ago.  I did not know I was pregnant for the first 4 months with my last one and I was a severe roxy and oxcy user.  So my husband actually found a clinic where we live that allows and recommends pregnant women to come to so that the baby is not born from pill addiction and so that the children and families dont get involved and take our child if I would have stayed on the pills they would have came and took him from right after the delivery. Instead the methadone is recommended and the DCF people will not take your child if you are in a program and are doing the right thing, as long as you are only taking the methadone and nothing else.  I first went to a place that did detoxing when I first found out I was pregnant ad they new I was and allowed me to stay for 2 days with no medication before they realized that I could not detox because of the pregnancy.(DA) doctors if you ask me.  So that's when my husband found the other place that was out patient care.  It was the best move I ever made since my struggle with addiction to narcotics.  They told me if you try to detox while you are pregnant it can cause you to miscarriage and other problems can arise from detoxing.  I would not detox at all during a pregnancy even if it was supervised by a doctor or an OB.  The stories I have been told and heard is the only reason I would wait til after the baby is born.  IF you are comfortable doing it though to each is own.  Good luck and well wishes to you and your family!!!