Opioid use during pregnancy is not uncommon.
Rates of opioid use disorder increased over 300 percent among women delivering babies between 1999 and 2014. This information is based on data obtained from 30 states.
During pregnancy, opioid use disorder can be fatal for mom and baby, and it can cause a variety of other problems. Because of this, doctors and addiction specialists may recommend Suboxone to help women refrain from using opioids of abuse for the duration of their pregnancies.
Before taking Suboxone during pregnancy, it is important to understand the details. This will ensure that pregnant women are making the best choice for them and their baby.
What is the Purpose of Suboxone?
Suboxone is prescribed to people with opioid use disorder. This prescription medication reduces the cravings that people get, so they have a lower risk for relapse. This medication is only one tool.
When someone takes this medication, they usually participate in a comprehensive treatment plan for opioid use disorder. This will likely include taking Suboxone along with counseling and other behavioral therapies. The key is to use Suboxone to reduce cravings for opioids while doing mental and emotional work in behavioral therapies.
Is Suboxone Safe During Pregnancy?
Women who are taking Suboxone when they get pregnant are generally advised not to stop taking it. Since this medication is a partial opioid agonist, stopping use could result in acute opioid withdrawal, which can present dangers to an unborn baby, such as fetal distress, preterm labor, and miscarriage.
Because of the potential dangers of withdrawal, it is best to continue to take the medication in most cases. It might also be prescribed as a type of replacement drug for pregnant women struggling with an opioid use disorder when they become pregnant.
Prescribed and Recreational Use During Pregnancy
Whether a woman is taking recreational or prescribed opioids during pregnancy, it is imperative to alert the doctor. Due to the dangers posed by acute opioid withdrawal, there are steps doctors need to take to protect mom and baby.
Switching from an illicit opioid to a prescription option, such as Suboxone, may be the safest choice for both mother and baby. In this instance, mom should take the medication exactly as prescribed. Abusing opioids during pregnancy will cause serious medical issues for the fetus.
Never snort or inject any opioid drug. Both have dangers, but injecting opioids increases the risk of the following:
- Cellulitis
- Sepsis
- Abscesses
- Osteomyelitis
- Endocarditis
- Hepatitis C and B
- HIV
Are There Safer Alternatives During Pregnancy?
Regarding pregnancy, Suboxone is a Category C drug. This means that there is a potential for congenital disabilities and pregnancy complications. Newborns may experience some level of withdrawal after birth.
For most pregnant women, Suboxone is considered the safer choice compared to opioid abuse. Suboxone is often recommended for pregnant women with this type of substance use disorder for this reason.
One study looked at the safety of this drug during pregnancy. The research concluded that Suboxone was considered to be generally safe. After birth, babies born to moms who used Suboxone during pregnancy had relatively mild fetal distress and other symptoms. Any opioid withdrawal that they experienced was also relatively mild in most cases.
Methadone is an alternative to Suboxone for pregnant women. However, the same study determined that it was safer for pregnant women to take Suboxone compared to methadone. Methadone is also classified as a Category C drug during pregnancy.
It can be more difficult to obtain methadone since doctors cannot prescribe it in the same way as Suboxone. Women have to receive their daily dosage at a federally regulated facility. This can be inconvenient, especially as a woman gets further into her pregnancy.
The one exception would be for women who were chronic and heavy opioid users before pregnancy. Methadone is considered to be the better option in this instance for many women.
Ultimately, you will need to talk to your doctor about what is best for your situation.
Be honest about how long opioid abuse has been ongoing and how much of the drugs you have been taking.
The doctor will review your medical history and take into consideration your past opioid use and/or substance use. This makes it possible to determine if Suboxone or methadone is the best choice.
How to Stop Suboxone Use During Pregnancy
Suboxone should never be stopped during pregnancy unless a doctor is strictly supervising the woman. Continued use is often a safer choice for the baby. Abruptly stopping the drug could result in significant withdrawal symptoms that could impact the health of both mom and baby.
In cases where stopping use of this drug is in the best interest of the mother and baby, the doctor might recommend a slow taper. This is generally very slow since the goal is to prevent withdrawal symptoms as much as possible during the process.
Tapering will not work for all women. There does not appear to be any research about whether a slow taper is ideal or how it should be done for the best results.
Dangers of Withdrawal
Stopping use of Suboxone can cause withdrawal symptoms to occur. The symptoms can last a month, or for some women, they may continue for longer.
The following are possible symptoms of Suboxone withdrawal:
- Nausea and vomiting
- Muscle aches
- Lethargy
- Anxiety
- Irritability
- Fever
- Sweating
- Headaches
- Insomnia
- Digestive distress
- Depression
- Drug cravings
- Chills
- Headache
- Trouble concentrating
During pregnancy, some of the medicines used during opioid detox are not a good choice, so choosing to withdraw from Suboxone when pregnant may require the woman to experience the full effects of the withdrawal symptoms. This is not considered safe.
NAS
Taking Suboxone during pregnancy may cause the baby to experience neonatal abstinence syndrome (NAS) to some degree once they are born. The symptoms of this syndrome may persist for up to six months after the baby is born.
The following are symptoms of this syndrome:
- Body shakes
- Overactive reflexes
- Seizures
- Tight muscle tone
- Poor feeding
- Sweating or fever
- Slow weight gain
- Blotchy skin
- Vomiting or diarrhea
- Fussiness, high-pitched crying, or excessive crying
- Breathing issues, including a very high respiration rate
- Trouble sleeping
- Sneezing or stuffy nose
- Excessive yawning
If you become pregnant while using Suboxone, it is important to alert your obstetrician right away. Everyone can work as a team to help you maintain sobriety while making the best treatment choice for you and your baby.
