Hopefully you’re already ahead of the game if you’re pregnant. All pregnant women with an opioid dependency, no matter how fearful they are, need to get help at a medication-assisted treatment program as early as possible in their pregnancy. While you’re pregnant your treatment will most likely be with a medication such as Suboxone or known generically as Buprenorphine with Naloxone. You also undoubtedly have questions about opioid withdrawal and your newborn.
Some people may ask why you should go into Suboxone treatment if you’re pregnant? Can that be any better for your baby than heroin or the pain pills you’ve been using? The answer is a resounding yes, Suboxone withdrawal for your newborn is much easier than heroin or pain pills on this new little creature you’re bringing into the world. It’s your responsibility to protect your child’s welfare even before he or she is born.
We know that women hate to come forward when they are pregnant and using drugs. They are ashamed and they don’t want to be judged by outsiders. Most of them are young, under the age of 24. They also worry if their mates learn about their opiate use, they’ll be angry. Then there is concern that Children’s Services will come into their home and take their newborn baby, and possibly other children. They fear arrest on top of everything else. But if you begin medication-assisted treatment during your pregnancy, you’ll have professionals in your corner helping you get through this.
From the National Center on Substance Abuse and Child Welfare, we learn that 10 to 11 percent of all pregnancies involve a mother with a substance use disorder. That amounts to some 440,000 affected infants. Specific statistics on opioid withdrawal and newborns are a little sketchier. The American College of Obstetricians and Gynecologists (ACOG) quotes a source estimating that one percent of pregnant women are using opiates. However, urine analysis performed on pregnant women at a metropolitan teaching hospital revealed 2.6 percent—more than double the admitted amount.
What Can Happen to Your Baby?
The babies of addicted mothers are sometimes born with birth defects. Studies show a possibility of heart defects in babies born to codeine-addicted mothers. However, the same study performed with mothers addicted to heroin or pain pills showed no heart defects. With any type of opiate use, neural tube defects can occur such as spina bifida, as well as rare defects of the newborn’s abdominal wall.
Opiate addiction during pregnancy brings additional potential fetal complications. The ACOG reports that mothers who use heroin chronically have increased rates of low birth-weight babies; premature separation of the placenta from the uterus, which is called abruptio placentae; premature labor; meconium circulating throughout the uterus; and fetal death.
Neonatal Abstinence Syndrome
The range of symptoms associated with opioid withdrawal in newborns is called Neonatal Abstinence Syndrome (NAS). NAS occurs in 55 to 94 percent of babies born to opioid-addicted mothers. What a huge statistical range! The level of addiction depends on what drug the mother has been using, how much per day, and for how long.
Symptoms include splotchy skin, irritability and excessive crying, diarrhea, hyperactive reflexes, excessive sucking or poor feeding, sleep problems, sweating, trembling, vomiting, stuffy nose, increased muscle tone, fever, and even seizures. Studies done on children who were born addicted but have reached school age demonstrate more difficulty in the classroom, both behaviorally and scholastically. They are also affected by the drug-using culture when it continues in the household. Symptoms are less drastic in babies whose mothers took Suboxone or methadone under medical supervision during the pregnancy.
Easier Opioid Withdrawal in Newborns
Initially, the American College of Obstetricians and Gynecologists threw its support behind the use of methadone for pregnant women. However, research over the past decade demonstrates that Suboxone may offer your newborn a safer, gentler alternative.
In a study of 309 infants, neonatal abstinence syndrome became apparent in 62 percent of them, with 48 percent requiring treatment. For babies whose mothers were using Suboxone, the neonatal abstinence syndrome appeared within 3 to 4 days after the baby’s birth and symptoms persisted for 2 to 2.5 weeks. They did better if the mothers had begun Suboxone treatment during the pregnancy. Babies requiring treatment whose mothers used Suboxone required fewer days of hospitalization.
The good news is that Suboxone withdrawal seems to affect fewer babies and they have an easier time of it. The bad news is that the numbers of pregnant women are increasing each year and have increased by a thousand percent since 1995. The National Institute on Drug Abuse estimates that opioid withdrawal in newborns occurs once every hour of the day, with numbers reaching beyond 14,000 per year in this country.
The doctor at your buprenorphine or methadone clinic will make note of your due date and will then be anxious to learn if your newborn suffers from opioid withdrawal. It’s comforting to know that you, the mother, can take steps to make things easier on your baby. Remember that when you get in treatment as early in your pregnancy as possible, your obstetrician will be on the alert and will have pediatric specialists standing by in the delivery room.
Additional Research Offers Hope
Many mothers of newborns fear admitting their drug use because they don’t want to lose their children. They will even hide the symptoms of opioid withdrawal in their newborns, such as disposing of diapers containing opioid-contaminated stools. However, new research on these babies is being undertaken using their umbilical cords. Of drug-using mothers whose babies’ umbilical cords were tested, approximately 25 percent of them were positive for THC and just one or two points less for opioids. There was a significant drop to less than 10 percent for babies whose cords tested positive for all other drugs.
If you’re worrying what doctors will say to you about opioid withdrawal in your baby, this testing cannot tell when you last used drugs or even if you used during your first trimester. It’s important to get into Suboxone treatment during your pregnancy, to protect your newborn as he or she comes into the world in order to provide the best opioid withdrawal newborn treatment. It’s also important to put you in touch with the kinds of services you need in order to stabilize your household. You shouldn’t be afraid to go into medication-assisted treatment if you’re pregnant. On the contrary, you should be afraid not to. Call your local methadone program and ask for more information—the best time to call is now.
