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Can You Safely Go Through Heroin Withdrawal During Pregnancy?

Heroin addiction is a disorder that can afflict anyone who experiments with the drug. It is a highly addictive opioid that can cause addictive behaviors to form within just a few uses. People who use heroin are typically in search of the euphoric and energizing high that comes in one big rush.

Using heroin while pregnant is incredibly dangerous for both mother and child. A woman who has used heroin while expecting needs professional assistance to safely get through the withdrawal process.

Heroin Abuse

Heroin is most commonly injected, smoked, and snorted, and each route of administration comes with its risks. Injection is the most dangerous way to use the drug, as it exposes users to the possibility of contracting serious diseases, such as HIV and hepatitis B and C. Many heroin users also experience bacterial infections of the skin, blood, and heart. 

According to the U.S. Centers for Disease Control and Prevention (CDC), people often use heroin alongside other drugs and alcohol. Almost all heroin users report using at least one other drug concurrently, such as cocaine. Most heroin users use up to three different drugs at one time.

Using multiple drugs at once is particularly dangerous, as it greatly increases your chances of experiencing severe adverse side effects and overdose, which can be fatal. 

Heroin addiction has been a growing problem in the United States for many years and plays a significant role in the current opioid overdose epidemic that was declared a national health emergency in 2017. Since 2010, heroin use has increased dramatically among all demographics, including men, women, all age groups, and all income levels. 

Unfortunately, as rates of heroin use increases, so do the rates of heroin-related overdoses, many of which are fatal. In 2017 alone, 15,482 people died from an overdose related to heroin use. From 2010 to 2017, the country saw a 400 percent increase in the number of fatal heroin overdoses.

Heroin Use During Pregnancy

Using heroin during pregnancy is very dangerous, as heroin passes through the placenta and affects the baby. Unborn babies can become dependent on heroin while still in the womb, and they face difficult withdrawal symptoms once they are born.
The National Institute on Drug Abuse (NIDA) explains that using heroin when pregnant can cause neonatal abstinence syndrome (NAS) in the baby. Symptoms of NAS in a baby include:

  • Disproportionate crying
  • Elevated body temperature
  • Irritability
  • Seizures
  • Inhibited weight gain
  • Vomiting
  • Tremors
  • Diarrhea
  • Death

If a baby is born with NAS, it will require hospitalization and treatment with medications, such as morphine, to relieve withdrawal symptoms. The baby is then gradually tapered off the medication so that it can slowly adjust to being free from opioid dependency.  

Although the risks of opioid use during pregnancy are high, the rate of pregnant women in the United States who are dependent on opioids has steadily increased over the past 10 years. It is estimated that up to 22 percent of pregnant women are prescribed opioids to treat various conditions during pregnancy, per a 2016 study. Such prescribing practices have likely contributed to the increase in NAS in the U.S. in recent years.

Detoxing From Heroin

Understanding the gravity of heroin addiction may encourage one to get sober as soon as possible. Because of the addictive nature of heroin, the detox process is likely to be physically and psychologically challenging. Withdrawal symptoms are inevitable if you have a history of chronic heroin use, but they can also occur after a short period of heavy use. 

The common symptoms associated with heroin withdrawal are:

  • Heroin cravings
  • Changes in mood, such as depression, anxiety, or irritability
  • Body aches and pains
  • Increased production of bodily fluids, such as sweat, tears, and runny nose
  • Stomach pain
  • Diarrhea
  • Nausea and vomiting
  • Fever
  • Restlessness
  • Insomnia

For someone with a dependency on heroin, withdrawal symptoms usually start within six to 12 hours after last use. Physical symptoms usually peak within one to three days and then gradually dissipate over five to seven days.

Physical withdrawal symptoms can be extremely uncomfortable, but they may be easier to manage than psychological withdrawal symptoms, such as cravings and mood changes that can last for months.

Is Withdrawal Dangerous for the Mom or Baby?

Pregnant women who are dependent on opioids, such as heroin, are encouraged to seek help for their dependency. The dangers to mother and baby of remaining dependent on heroin greatly outweigh the dangers associated with opioid withdrawal during pregnancy.
Certain medications can be used to help an opioid-dependent pregnant woman safely detox. NIDA recently supported a clinical trial that showed buprenorphine could be used safely during pregnancy.

Babies born to mothers who detoxed using buprenorphine during pregnancy required less morphine and shorter lengths of hospitalization following their birth than those born to women who did not receive any medically assisted detox services. Other studies have shown that buprenorphine administered in conjunction with naloxone can be highly effective in minimizing symptoms of NAS.

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How to Minimize Risks During Withdrawal

Taking advantage of medically assisted detox is the best way for opioid-dependent expectant mothers to minimize the risks to themselves and their babies during withdrawal. While some doctors recommend quitting heroin use cold turkey to prevent unborn babies from developing NAS, most doctors recommend using medically assisted treatments

In addition to managing uncomfortable symptoms, studies have found that pregnant women who detoxed without any medical assistance were more likely to relapse during pregnancy. The result was then exposing the baby to an even greater amount of opioids. 

To avoid high rates of relapse and women who drop out of detox programs before they are complete, experts recommend medically assisted treatment combined with personal therapy to properly address opioid dependence. 

Substance abuse experts argue that pregnant women who are dependent on opioids need to be treated the same as anyone who is dependent on opioids regarding addiction. A pregnant woman forced to go through the detox process without any medical assistance is just as likely as anyone else to relapse and not make a full recovery.
Detox alone will do little to help her beat her opioid dependency and remain sober during pregnancy and following the birth of her baby. Following up medically assisted detox with proper behavioral addiction treatment is the best way to ensure a full recovery from opioid dependency.

Withdrawing During Different Stages of Pregnancy

Research has found that it is safe to withdraw from heroin during all stages of pregnancy. The sooner a pregnant woman can stop using heroin, the greater the chances that her baby will not be born with NAS or that NAS will be far less severe. If she can receive medically assisted detox treatment, withdrawal symptoms for both her and the baby will be greatly reduced. 

When left untreated, heroin use can lead to many complications during pregnancy. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that between 70 to 95 percent of babies born to opioid-dependent mothers are born with NAS. An untreated heroin use disorder can lead to increased risks of placental abruption, preterm labor, obstetric complications for the mother, and the death of the unborn baby. 

Treatment for opioid use disorder during pregnancy is vital in helping to reduce the serious risks posed to the mother and baby. Mothers who receive medically assisted detox services while pregnant experience much better treatment outcomes for themselves and their babies than mothers who do not receive any treatment during this time. 

In addition to receiving help for opioid use disorder, pregnant women who receive medically assisted detox treatment are more likely to receive routine prenatal care throughout their pregnancies, which is essential for the health of the mother and baby.

Pregnant woman sobbing in bed

Safe Heroin Withdrawal

The safest way to withdraw from heroin is under medical supervision, whether you are pregnant or not. Participating in a well-rounded treatment program will give you the best physical and mental support to see you safely through the challenging detox period.

Particularly for someone who is also managing the symptoms of pregnancy, detoxing under close and constant medical supervision is the best way to ensure one’s safety. Comprehensive medical care will include detox services as well as referrals for appropriate prenatal care. Combined with sufficient therapeutic services, medically assisted withdrawal from heroin can play an essential role in establishing a happy and healthy life for the new mother and child.

Sources

(January 2016). Concerns Over Prescribed Opioid Use Among Pregnant Women. Science Daily. Retrieved January 2019 from https://www.sciencedaily.com/releases/2016/01/160112214407.htm

(November 2018). Coping with Heroin Withdrawal Symptoms. Verywell Mind. Retrieved January 2019 from https://www.verywellmind.com/what-to-expect-from-heroin-withdrawal-22049

(June 2018). How Does Heroin Use Affect Pregnant Women? National Institute on Drug Abuse. Retrieved January 2019 from https://www.drugabuse.gov/publications/research-reports/heroin/how-does-heroin-abuse-affect-pregnant-women

(May 2019). Pregnant Women on Opioids Shouldn’t Go “Cold Turkey” to Protect Their Baby. Healthline. Retrieved January 2019 from https://www.healthline.com/health-news/pregnant-women-on-opioids-should-not-go-cold-turkey#1

(December 2018). Today’s Heroin Epidemic. Centers for Disease Control and Prevention. Retrieved January 2019 from from https://www.cdc.gov/drugoverdose/opioids/heroin.html

(January 2017). Women of Childbearing Age and Opioids. The Substance Abuse and Mental Health Services Administration. Retrieved January 2019 from https://www.samhsa.gov/data/sites/default/files/report_2724/ShortReport-2724.html

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