If you are pregnant and worried about opioid use, withdrawal, or whether treatment could affect your baby, you are not alone. Opioid use disorder is a medical condition, and getting treatment during pregnancy is one of the most protective steps you can take for yourself and your baby.
Opioid Use Disorder Can Impact the Health of You and Your Baby
Pregnancy can be a special time, full of joy and anticipation. But for women struggling with an addiction to fentanyl or other opioids, it can be difficult and stressful. Every woman wants to be a good mother and do everything she can for her baby, but having to deal with an addiction makes it significantly more challenging.
Some women try desperately to stop all drugs by tapering or going “cold turkey,” but then they feel miserable, unable to eat or sleep well, and struggle with intense cravings. None of these are good for the baby! When women finally cave in and use drugs again, they feel guilty and shameful. They may be trying to hide their use from their friends and family, which only increases their stress and isolation.
In addition, women who have an active opioid addiction during pregnancy are more likely to deliver early, have smaller than average babies, and have complications with pregnancy. They are also far less likely to follow up regularly with their OB, making caring for a newborn much more difficult without the extra support and medical assistance.
The most important thing to know is this: you do not have to choose between getting help and protecting your baby. Getting stabilized on evidence-based medication can reduce withdrawal symptoms, cravings, relapse risk, and exposure to unpredictable opioids such as fentanyl.
Is Medication-Assisted Treatment Safe for Pregnant Women?
The short answer is yes. Methadone and buprenorphine are recommended medications for pregnant patients with opioid use disorder. This type of care is often called medication-assisted treatment, or MAT. You may also hear it called medications for opioid use disorder, or MOUD.
If you are pregnant and suffering from an opioid use disorder, there is hope. Medication-assisted treatment (MAT) can help treat your addiction and keep your unborn child safe. No medication is completely risk-free. But for most pregnant patients with opioid use disorder, remaining stable on methadone or buprenorphine is safer than cycling through opioid use, withdrawal, and relapse.
Leading medical organizations recommend medication treatment during pregnancy because untreated opioid use disorder and repeated withdrawal can create serious risks for both the pregnant patient and the baby. Quickly stopping opioids during pregnancy is not recommended unless you are under close medical supervision, because it may increase the risk of relapse and pregnancy complications.
Continuing treatment produces the best outcomes for both the baby and the mother. The American College of Obstetricians and Gynecologists (ACOG) and the American Society of Addiction Medicine (ASAM) have agreed that this is the best course of action based on the best science and data available.
How Does Medication-Assisted Treatment Affect the Baby?
Pregnant patients can be reassured that available evidence does not show methadone or buprenorphine to be significant causes of birth defects. They both are associated with better outcomes for both the baby and the mother.
Babies are not “addicted” in the way adults can be. Some babies can be born physically dependent on opioids and may have withdrawal symptoms after birth. This is called neonatal opioid withdrawal syndrome, or NOWS.
This can sound scary, but NOWS is treatable. Many babies improve with simple, supportive care such as breastfeeding when appropriate, swaddling, skin-to-skin contact, low light, a quiet environment, rooming-in with the mother, and frequent small feedings. Some babies need medication, such as very small doses of morphine or methadone, which is gradually reduced as symptoms improve. Trying to lower your MAT dose during pregnancy does not reliably prevent NOWS. The safest dose is usually the dose that keeps you stable: without withdrawal, cravings, sedation, or ongoing opioid use.
The Benefits of MAT During Pregnancy
Medication-assisted treatment can help women through this time and restore the special nature of pregnancy. By getting and keeping up with MAT during pregnancy, women can feel normal and have healthier babies. They no longer have to struggle with horrible withdrawal symptoms, intense cravings, and feelings of shame and inadequacy.
Treatment can also help you:
- Stay out of withdrawal
- Reduce cravings
- Avoid fentanyl and other unpredictable street opioids
- Eat and sleep more regularly
- Attend prenatal appointments more consistently
- Coordinate care between your OB provider, addiction treatment provider, and delivery team
- Prepare for birth, breastfeeding, postpartum recovery, and newborn care
Babies born to women on MAT are much healthier. Medication treatment does not guarantee a complication-free pregnancy, but it can improve the chances of a healthier pregnancy by helping the mother stay stable and connected to care.
Women on MAT can breastfeed when they are not using illicit drugs and do not have another medical reason to avoid breastfeeding. Breastfeeding may also help reduce the severity of newborn withdrawal symptoms for some babies. Always talk with your OB provider and your baby’s pediatric care team about your specific situation.
How Does MAT Work During Pregnancy?
Your OB provider can refer you to a practice or clinic that provides MAT with either buprenorphine (Suboxone or Subutex) or methadone. Both methadone and buprenorphine are recommended treatment options during pregnancy. Your medical provider can help you decide which medication is safest and most appropriate based on your opioid use, current withdrawal symptoms, pregnancy, health history, and treatment needs.
Once you get stabilized on MAT, your withdrawal symptoms and cravings will go away, and you will feel normal without having to use any other drugs. Your OB and MAT providers can work together to help you through your pregnancy and delivery so that you have a healthy baby.
If you are already taking naltrexone when you become pregnant, do not stop it on your own. Current safety information about naltrexone in pregnancy is more limited than it is for methadone and buprenorphine, so the decision to continue or change treatment should be made with your healthcare provider.
What Happens When I Start Treatment at CMS?
At Community Medical Services, all our providers are trained and experienced in co-managing pregnant patients on MAT. We routinely work with obstetricians to provide the best care for the mother and the baby. We prioritize pregnant patients, so all you have to do is call or come into one of our clinics. We are dedicated to starting MAT as soon as possible, from the day you walk in.
We treat everyone with respect and dignity. You do not have to feel ashamed or guilty about coming into our clinics – you are doing the right thing for you and your baby when you do. Your medical provider will help you choose the proper medication and get you onto a stable dose as soon as possible. You will also talk to a counselor who can help you tackle underlying emotional causes linked to addiction and help you get ready to have a new baby in your life.
Your care team can also help coordinate with your OB provider, answer questions about delivery and breastfeeding, and support you through the postpartum period, a time when many people need extra help staying stable in recovery. If you are worried about being judged, losing trust, or asking for help too late, please know this: seeking care is a protective step. Our goal is to help you and your baby get the safest care possible.
Frequently Asked Questions About Medication-Assisted Treatment During Pregnancy
Should I just quit opioids cold turkey?
Even though women may be highly motivated to do the best for their baby, simply stopping all drug use is extremely difficult. The grip of an opioid addiction is so firm that willpower is not nearly enough. Nearly every woman needs MAT to help treat their addiction so they can have a healthy pregnancy.
Quitting cold turkey while pregnant can be risky. Sudden withdrawal can cause intense cravings, dehydration, poor sleep, poor nutrition, relapse, and serious pregnancy complications. If you want to stop using opioids, the safest next step is to start medical treatment, not to go through withdrawal alone.
If I’m already on MAT, should I taper my dose?
Studies have shown that the risk of NOWS is unrelated to the medication dose. They also show that attempting to taper off all medication does not decrease the frequency or severity of NOWS. The best outcomes are achieved by using the dose of medication that allows women to feel normal, without withdrawal symptoms or severe cravings, but also not too high so that they aren’t excessively tired or drowsy. In some cases, the dose must be increased temporarily, usually during the third trimester, due to the faster metabolism rate associated with late pregnancy.
If you are already taking methadone or buprenorphine and become pregnant, do not stop or taper your medication without medical guidance. Pregnancy can change how your body processes medication, so your care team may adjust your dose to keep you and your baby stable.
Can I breastfeed while taking methadone or buprenorphine?
In many cases, yes. Breastfeeding is encouraged for mothers on buprenorphine or methadone who are not using illicit drugs and do not have another medical reason to avoid breastfeeding.
When should I get help right away?
Call CMS, your OB provider, or seek urgent medical care if you are pregnant and Using fentanyl, heroin, kratom products, or prescription opioids in a way you cannot control
- Having withdrawal symptoms
- Worried you may relapse
- Taking opioids from the street or from someone else
- Feeling too sick to eat, drink, or sleep
- Having severe abdominal pain, heavy bleeding, or other pregnancy warning signs
- Worried about overdose
If you think you or someone else may be overdosing, call 911 immediately and use naloxone if available.
Get Medication Assisted Treatment at CMS
Community Medical Services is dedicated to helping individuals struggling with substance addictions reclaim their lives. We treat patients using a holistic method that focuses on both the physical symptoms of their addiction and the deeper psychological issues leading to it.
Our 70 clinics across the United States offer medication-assisted treatment programs featuring methadone, buprenorphine, and naltrexone to accommodate our patients’ needs better. We also offer counseling, peer support groups, and the resources you need to stay the course during your addiction treatment.
If you are pregnant, you don’t have to wait until things get worse. CMS prioritizes pregnant patients and can help you start treatment as soon as possible. Find your nearest Community Medical Services clinic and book an appointment today. A brighter, addiction-free future is just a call or click away.
