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Julia M Aharonov, DO  
Female, 51
Southfield, MI

Specialties: Addiction, Drug abuse and dependence

Interests: My family

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Pregnancy and Addiction

Feb 14, 2012 - 13 comments
Tags:

Pregnancy

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Addiction

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Meconium drug testing

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Drug Testing

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Having a healthy pregnancy



One day, while doing one of my medical school rotations at St. Barnabas Medical Center in Livingston, NJ, where, incidentally, I gave birth to my three children, the hospital was abuzz with the news that the amazing Whitney Houston was having her baby on the top floor in the VIP suite.
I must confess that I, being a lowly medical student in 1993, did not get to lay my eyes on the famous singer, but I did feel a common bond with her. We were the same age, and I had a baby in this same hospital less than two years before her.
What I feel now is deep sadness for her and, especially, for her 18-year-old daughter, whom she had while I was just a few floors below her. Whitney’s death is just so senseless, so painfully early. She was a mother who left her child an orphan, and being a mother was so important to her, as it is for most every woman.
We dream of being a mother while still little girls; we play with dolls, we cradle them in our arms, we dress them and we pretend to feed them. We grow up dreaming of one day carrying little ones under our hearts, and nursing them at our breasts.
But what happens if we make mistakes along the way? What if a woman gets addicted to drugs or alcohol while she is young and foolish? Can she still have a healthy pregnancy and a healthy baby? I get asked these questions very often from concerned women who either want to get pregnant or are already pregnant and want to know the consequences of their mistakes.
We all know that our actions must bear consequences, but our children should not be the ones bearing the brunt of them. So we must be careful how to treat our bodies prior to getting pregnant and, certainly, even more so once we are expecting. Most women start taking prenatal vitamins months before getting pregnant, so how much more important would it be to start taking care of your body by getting off whatever drugs you are on way before you conceive? Did you know that drugs are not only harmful to you, but are readily transferred though the placenta and will harm an unborn fetus, even before your know you may be pregnant? For instance:
Benzodiazepines like Valium, Xanax and Ativan have been shown to lead to lip and palate malformation such as split lip.
Alcohol consumption leads to Fetal Alcohol Syndrome.
Pain pills, heroin, methadone and Suboxone, if not tapered during pregnancy, will leave the baby addicted at birth.
Cocaine use can lead to insufficient blood supply to the baby and death of the fetus in the womb.
If you quit before you are pregnant, none of these will be a concern. You will not have to worry about telling anything to the obstetrician or midwife, and you will not have to worry about what they may suspect. There are things you should know about pregnancy and drug testing. There are no uniform laws throughout the states and most physicians do not know the ins and outs of those laws.
There are laws that obligate a health provider to notify authorities whenever there is a suspicion of neglect or potential of abuse.
You may be able to refuse a drug test for yourself, but if any of the staff has any suspicion, they still have a right to test your newborn.
Your baby’s meconium (first stool) can show your drug use as early as the 20th week of pregnancy, and it will show practically every illicit drug you have put into your body.
If you have not been truthful and cooperative with your healthcare team, many states grant them lots of leeway in what they can do with this newly obtained information. No state wants to separate children from their parents, but if you are not showing them that you are on the side of your own good and your baby’s best interest, they do have the power to do things that you may not want!
So, what is the best course of action?
First, get clean before you get pregnant, or as soon as you think that you are. I know this is hard, but trust me, this is not the first hard thing you will be doing for your child, nor the last.
If you are unable to, or find out too late into pregnancy that you are expecting, get prenatal care as soon as possible. Talk to your obstetrician or midwife, and start off with being honest and totally cooperative. Come up with a plan of action that will get you clean and sober as quickly as possible, so that when the baby is born, both of you are healthy and ready for meaningful bonding.
We want to see our children grow up unencumbered with our problems. To give them the best chance of a healthy life, we must be at our best, ourselves. Some of us, like Whitney Houston, seemingly have it all – beauty, talent and wealth – yet we are unable to give our children what we owe them, which is a healthy, happy, clean and sober version of ourselves. If we can commit to give them that, we have a chance to be there for them when they get married, and to babysit their children and their children’s children, as well. Is it not what we owe them? Not to leave them orphaned at 18 with only a song that says that we will always love them.


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by kelly791, Feb 22, 2012
Julia,

This post was very good. I have been reading a lot lately on pregnancy and addiciton. Please consider adding this link into your blog post as an added resource.

This can help expectant mothers learn more.  good facts and easy to follow
http://www.recoveryconnection.org/pregnancy-and-addiction-infographic/

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by expectingmyfirst, Mar 16, 2012
Thank you for this post. I am a couple days away from my tenth week. I am a recovering heroin addict, I have been clean for a little over seven months. Still, thoughts of my Pryor drug use affecting my baby is bothersome. So I appreciate any info I find on addiction and pregnancy.  Thanks :-)

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by sreee, Apr 19, 2012
the information which you have been given about the women pregnancy the content which u have update and shared with us is really good with meaningful matter and ur words which have given lots of information to me thanks for publishing good job

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by pandabear51807, Apr 22, 2012
I am currently fourteen weeks preg and I am 19. I have been an addict for 5 years now.. I know young.. but I started on pain pills them recently within the past year I started heroine.. both me and my boyfriend are addicts and he has been doing stuff every now and thn.. I was on methadone and then wound up not having it ..it was the worst withdrawal I've ever had- mow my dr actually is subscribing me subutex which at times doesn't feel like its doing anything for me..it also doeant help wen my boyfriend is snorting coke and other things around..its just hard sometimes being pregnant and I know I want a healthy baby and I dont want to do anything but my mind doesn't care half of thw time..its lust really hard sometimes and my boyfriend doesn't quite get it... sorry just had to get thqt out .. thanks guys


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by Tirzha, May 09, 2012
I was on heroin and coke and when i was about 4months preg i went on subutex to help me quit.  i had my babygirl in dec 2011 and she is healthy and growing strong. i feel so blessed that she's ok but I cant shake the feeling that my past might affect her in the future and regret everytime i got high before and during pregnancy.  she is so beautiful and innocent and special and if anything happens to her i dont think i could live with me.  Please Pandabear51807 if you are reading this please stay away from substances while you're pregnant even if it means taking time out from people that are using please.  I've been there and this my advice to you.

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by gungalmama, May 09, 2012
I do have to say there are mothers with chronic pain that can not stop taking their pain medications.
I have a few friends (from a support group for mom's with chronic pain)that have been through pregnancies while on pain medication,s under dr supervision, that were treated HORRIBLY by nurses and dr's while in the hospital and after.

It's funny that of all the kids I know not one of the kids from this very large support group has any health problems but I know many other kids(who's mom's were not on meds) that have complications (long term ones that the drs told my CP friends WOULD happen) and the number of autistic kids is going up, up, and away....an epidemic from what I have seen.

My point is there are mom's out there with a valid reason for taking medications while pregnant that are dependent on them but not addicted to them and they should NOT be treated as addicts.

Heck even if a pregnant mom IS an addict they should NOT treat them so terribly(like my friends had been treated) one even sued the hospital (and WON:) for the way the dr's and nurses treated her. She had been in a car wreck broken her neck and back ....and it never stopped hurting. She hurts on the pain scale at 6-7 each day sometimes worse sometimes better but always there. Yet through all that she got pregnant!(they'd given up trying). Her son is now a 6.5yo and is in 4th grade!!

Please(dr's and nuses treat all pregnant mom's with love and compassion.....or you might get sued:)

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by Riplexilayne, Jun 17, 2012
Please read my post I need help

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by Sirene79, Aug 06, 2012
Gunglamama, I just have to say I TOTALLY agree with you and happen to be a cpp myself. Luckily I was not diagnosed with my illness until after my only child was born. If I wanted a child, I wouldn't be able to stop taking my pain medication. I am not addicted but dependent and without them, I would be completely bed ridden. I do fear of being mistreated by docs if I ever wanted to get pregnant and conceive. I think I'd do it at home with a compassionate mid-wife. You bring up a good point and I appreciate your post. Thank you.

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by Sarahnoah, Jan 28, 2013
I am currently 14 weeks pregnant  and did not find out I was till 9 weeks I am also a addict but was able to ween myself from 7-8. 4mg tabs of dilidid to a 4mg tablet a day. My question is this, my dr right away said she wanted me  to go on methadone for the rest of my pregnancy and I am a health care worker so I know all about methadone maintenance treatment  as my husband has been on methadone and clean from IV use for many years but he was injecting up to 200 mg a  day if not more so yes I see why he was put on this medication. But myself i do not inject never ever have and now i am only doing a 4 -8 mg tablet a day . I feel going on methadone for that is a step backwards as I don't feel 4mg a day is even worth being on methadone as i think it will be putting more synthetic opiates into my body then I do with the dilidid. I just want someone to help me and tell me what I should so or give me advice . I can maintain the 4-8 mg a day but I really don't want to be on methadone. What should  I do.:(

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by Julia M Aharonov, DOBlank, Jan 28, 2013
It is better to gently taper of the opiates all together. However, if you feel that you are unable to do that, you should talk to an OB who is more familiar with pregnancy and addiction.  I feel very strongly that methadone is not the best choice for drug treatment during pregnancy. I am sure you want what is best for your baby and so do I. Methadone is an opiate, very long acting one and very addictive. You are still opiate dependent and if you continue to be on methadone through your pregnancy, your child will also be born opiate dependent. Your baby will be in withdrawals after birth and will have be spend time in the Neonatal ICU to go through those withdrawal. If you choose to nurse your baby while you are still on methadone, there have been documented cases of babies dieing due to respiratory suppression (they stop breathing).
You need to get your OB/GYN involved in this and if s/he is not familiar with this process, find one who is. You should not be on methadone during pregnancy. The standard of care for pregnant addicted women is Suboxone or Subutex taper, even though maintenance Suboxone or Subutex is still considered safer than methadone because of much less risk of the respiratory suppression.
Please get a second opinion   before you get yourself and your baby into a whole lot of trouble.  Your baby deserves to be in your loving arms, being nursed at your breast right after it is born, not being for days or weeks in the NICU, not able to go home with you.
Good luck and stay safe.

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by ErikaLove, Jul 18, 2013
You cannot take suboxone during pregnancy! I suggest u go to a methadone clinic or see if a hospital has a detox program to help u and get winged off it may take up to 3 weeks.

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by Julia M Aharonov, DOBlank, Jul 19, 2013
Erika is not correct. Even though WHO (world health org) sites methadone as a treatment of choice during pregnancy, the prevailing opinion in the western (read "advanced") medical literature prefers Subutex  or Suboxome to methadone. WHO is guided mostly by economic consideration, but methadone is of course far safer then shooting up heroin. Thank you for you comment.  

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by Lm4scared, Jun 19, 2014
I've been clean from heroin for about 2 years abd was prescribed suboxone..I was down to 4 mg a day when I found out I was pregnant..I've slowly been tapering down through out my pregnancy and now at 19 weeks just took my last dose 2 days ago..however I never told my dr I was taking it.and had no idea about the meconium testing and wasn't worried about the actual drug testing as my plan was to be completely off of suboxone well before I gave birth..now hearing about the testing I'm totally freaking out about the idea of cops getting involved..so my question for Dr.a is how far back into my pregnancy will the meconium testing go..scared

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