2 months pregnant on Subutex

[BabyOnTheWay220]

I was reading your comments that you've written back to others regarding Pregnancy & being on Subutex...Is it safe for me to detox now during the 1st trimester? or should I wait until the 2nd? or should I just stay on small doses?? I'm currently prescribed an 8 mg Pill...but break it into 8 -10 tiny pieces...I can't get an exact dose that I'm on..but what do you suggest I do?? I really have the will power to quit...I'm just worried it will affect the baby that is still developing.  What should I do...And does the baby really feel the withcrawl symptoms??? It probably does...but obviously won't remember...the thing that worries me is will there be any long-term effects down the road?? Sorry so many questions...but its my first baby..and I want to make sure I don't mess up anything, Thank You so Much!

[J T Junig, MD PhD]

We know that the worst thing is to go on/off/on/off etc.  I worry about your statement 'will power to quit';  most people who treat addiction would find that to be a sign of certain relapse.  The reason? If I have will power, WHY would I quit?  I don't use because I know that I cannot control my use.  My relapse in 2001 started with the thought, 'Im real sick and in pain today... I think I learned from my experience in the Bahamas how to stop using'.  Once I 'knew' I could stop, it was off to the races!  Gratefully, I now know that regarding opiates, I have NO will power-- and so I don't EVER use them.  Simple as that.

That is the basis, by the way, for the first step of every twelve step group--
we decided we are powerless over ....whatever.

This will stir things up, but withdrawal in newborns is overblown.  They go through a canal that squeezes their tiny heads down so far that the skull changes shape!  Don't you think that would hurt?  Until 15 years ago they did open heart surgery on newborns without anesthetic, just with paralysis-- splitting their chests open!  THAT would hurt!  They cut off the foreskin in many hospitals without anesthetic-- ouch!  Much of w/d consists of feelings and thoughts that babies don't have.  They don't feel guilty, for example, like the withdrawing mother feels.  So I encourage you to avoid being overly concerned about this issue, even though people will pile onto you and do their best to make you feel like a bad person.  We do the best we can.

The standard for decades has been for pregnant opiate addicts to stay on methadone throughout the pregnancy.  I prefer Subutex, and have had a number of women go through pregnancy staying on that medication and doing fine.  

I strongly disagree, though, with how you are taking your Subutex;  in my opinion it should ALWAYS be taken once per day, in the morning.  Buprenorphine is a 'microgram' medication;  it is active at 5-10 micrograms, and one tab of Suboxone is 8000 micrograms!  You DON'T need multiple doses;  you could easily dose every third day and be fine!  The goal of using buprenorphine is to break, or 'extinguish', the conditioned behavior-- to get rid of the relationship between you and the substance.  You are taking it in a way that makes it more like vicodin, and less like subutex!  Go on my blog and search for the article about 'optimizing absorption of buprenorphine'.  If you take it right, once dose per day will abolish any desire to use.

I also have articles on my blog about pregnancy and subutex;  search for the posts on pregnancy and you will find them.  

[nicole179]

you are not alone there are other women on the site in the same boat, i sent you a private message.

[BabyOnTheWay220]

another question:

You are a PhD...Do you think my doctor can prescribe me a sleeping med to help me sleep at night?? If I do decide to get off?? ...but your telling me its not safe to get off...right??

[BabyOnTheWay220]

Thanks for all the information...really  stress relieving...now I just have to deal w/ my boyfriend putting me down about ir...he yells at me almost every other day, telling me to quit it already... he doesn't take the Subutex...so he doesn't understand.  Thanks!

**Another 7 1/2 months to go!

oh..another question

I smoke cigarettes...Since i found out I was Pregnant about 2 weeks ago...I've cut back to about 3 a day...I almost feel like I don't want to smoke..but do you know when the most fragile stages of development are where cigarettes can hurt the foetus?