If you’ve just discovered you’re pregnant, you may be wondering about the choice between methadone and Suboxone and pregnancy—what should you do? What’s better for your unborn baby? Are you already a client at a medication-assisted treatment (MAT) clinic or are you going to be new at rehab?
If You’re Already in Treatment…
For those women who are already participating in treatment at a methadone or MAT program, your first job is to tell the doctor and the program staff about your news. Don’t worry about how they’ll react; they will share your joy and help you make the choices that are right for you.
If you see the doctor on a weekly basis, be certain to announce your news at your next visit. If your next appointment is several weeks away, call the receptionist and tell them you need to move up your appointment now. If the appointments are all filled up, tell them you are pregnant and you have questions about methadone, Suboxone and pregnancy. They’ll schedule you to come in right away. Pregnant women get first priority treatment!
You also need to see an obstetrician right away, so that you can start on prenatal vitamins and receive regular prenatal checkups. Your obstetrician can communicate with your MAT doctor about your Suboxone and pregnancy as long as you sign a release.
If you are taking methadone, you are undoubtedly wondering whether you should stick with that or switch to Suboxone. The National institute on Drug Abuse has some input to help you with your decision. In a study called MOTHER (Maternal Opioid Treatment: Human Experimental Research), researchers have determined that buprenorphine is a better alternative for a woman who is expecting a baby. The study cites buprenorphine as a “safe and effective alternative to methadone.”
Methadone or Suboxone and pregnancy usually resulted in the same amount and type of complications during the pregnancy itself, according to the study. Both resulted in the same indicators of the baby’s health at the time of birth. However, babies whose mothers received buprenorphine generally had an easier time with their withdrawal symptoms.
Subutex or Suboxone and Pregnancy
Suboxone and pregnancy has become the recommended therapy for opiate addiction in just the past couple years. Even more important, however, is the fact that your doctor may want to switch you to Subutex, a tablet that contains only buprenorphine and no naloxone. The naloxone is the ingredient in the Suboxone that removes the urge to abuse the Suboxone. By switching to Subutex, which is simply a brand name for generic buprenorphine, you will still receive the medication you need to calm your cravings and withdrawal symptoms.
The buprenorphine really can’t make you high anyway, because it’s a partial agonist, so you should feel no urge to take it when pregnant. The recommendation for Suboxone during pregnancy generally means you will simply switch from the Suboxone strip to the Subutex tab. Just like the strip, it simply dissolves under your tongue. There is also some evidence that because it is just a partial agonist, it’s a little easier on the unborn baby, both during gestation and after childbirth.
Whether you stay on Suboxone or switch to Subutex, the buprenorphine will show up in your breastmilk once your baby is born. Talk with your doctor so you can decide whether or not to breastfeed your baby.
If You’re Not in Treatment…
If you have been abusing opioids and you’ve just found out you’re pregnant, the single most important thing you must do is call your local MAT program right away. You will get first priority in scheduling, because it’s so important to treat with methadone or Suboxone during pregnancy. Nobody will judge you, and if you’ve got crazy stories to tell, nobody will be surprised. Many methadone and Suboxone treatment programs even offer special group sessions just for pregnant women, and you will find yourself right at home.
You also should minimize any worries you have about Children’s Services becoming involved with your pregnancy. The American Society of Addiction Medicine and the National Council on Alcoholism and Drug Dependence both support an expectant mother’s decision to get help for addiction treatment. You are more likely to get in trouble with Children’s Services if you don’t get help.
Should You Wean Off Your Suboxone?
One of the biggest questions people have about methadone or Suboxone and pregnancy is whether they should simply wean off the medication during the pregnancy. The answer is no. The withdrawal symptoms could be harmful to the safety of your unborn baby and could even bring on a miscarriage. The same applies to a woman taking any kind of medication: It’s not good to disrupt the status quo. A woman who receives medication for diabetes or epilepsy does not stop her medication, and neither should you.
Taking regular doses will prevent extreme fluctuations of opiate levels in your bloodstream, which is important for the health of your unborn baby. It’s important to follow your doctor’s advice on this and stick with the protocol for Suboxone and pregnancy. When the baby is born, a pediatrician will be standing by to provide immediate care for your new son or daughter. So pick up the phone and call your local MAT program, and oh—by the way—congratulations on your pregnancy!