I’m pregnant and addicted. What’s better subutex or methadone?
You feel a little off, your period is late so you go to the store and grab a pregnancy test. Chug, chug, chug, you chug some water. You are about to hold the fate of your future in a little stick. You grab a pregnancy test, check out, and head home. You don’t think much about it. Every girl has scare’s like this all the time. You are just a little late, no big deal. You can’t be pregnant, you are physically addicted to opiates, this is the worst possible time for this to happen.
You go into the bathroom, pull open the package and get ready. You pee on the little life-changing stick and wait. As you stare at the counter you see the red plus sign, the word pregnant, the extra line.
No, this is a defective test you think to yourself, you have to be positive that it’s positive. You go to the store and get 2 more different brand pregnancy tests.
“Third test today, Mama Bear. Your eggo is preggo, no doubt about it.”
So you are pregnant. You want to laugh, scream, cry and punch something all at the same time. Excitement, panic, fear, and anger comes over you. Now you must make the choice of the life of your unborn child over your selfish desires. That is just the way it is. Don’t be that girl, or should I say, woman, that uses while pregnant. It’s a disgusting person to be. You will never forgive yourself.
Children that are born to mothers who use drugs or drink alcohol while pregnant have a high risk of having developmental delays, and birth defects.
The problems that can arise from specific substances:
Cocaine/Crack: Can cause low birth weight, smaller head circumference, small birth length, risk of reduced intelligence, risk of reduced social skills, and behavior problems later in life.
Meth/amphetamines: Risk of neurodevelopmental problems, low birth weight, cleft palates, and other malformations.
Opioids: Risk of spina bifida, congenital glaucoma, and hydrocephaly. Also, an extremely high risk of Neonatal Abstinence Syndrome or NAS.
Nicotine: Preterm birth, low birth weight, cleft lip and palate, damage developing lungs.
Alcohol: High risk of Fetal Alcohol Syndrome, low birth weight, failure to thrive, cognitive issues.
There are many more, those are just naming a few, so it is very important that you seek help right away for your addiction during pregnancy. Also, there are more risks involved in using any street drug because you don’t know exactly what you are getting cut into the drug.
Of my research I have found that using a maintenance program drug for opioid addiction is actually considered to be relatively safe for your unborn child. Most mothers have perfectly happy, healthy children born on Subutex and methadone.
Going cold turkey can cause miscarriage or stillbirth, depending how far along you are. This is not recommended. The baby feels what you feel to a certain extent.
So now which one is better?
When you are pregnant you are given Subutex not Suboxone. Suboxone has buprenorphine and nalaxone in it. Subutex just has buprenorphine, because there has not been enough research done on nalaxone on pregnant women. The buprenorphine is what blocks the receptors in the brain and curbs the withdrawal. The nalaxone is just there to deter people from “shooting up” the Suboxone.
There has been a weird rumor that you don’t have to wait the average 24 hours with Subutex because it does not have the nalaxone in it. That you can take Subutex right away and not go into what is called precipitated withdrawal. But they both do the exact same thing, the nalaxone is just a deterrent. Nalaxone is not absorbed sublingually, meaning in the mouth, so it only works when it’s shot IV (intravenous, in the vein) or IM (intramuscular, in the muscle).
With Subutex, you will have to wait until you are in full withdrawal to take. The rule is to wait until you score an 8-12 on the COWS (Clinical Opiate Withdrawal Scale). You can see an example of the COWS here. The 24 hours is just a recommendation, but going by the COWS has always worked for me, because I get very sick a lot sooner. If you take it too soon, you will go into what is called precipitated withdrawal. You will be sicker than you have ever been. That’s why it is best to take small amounts and work your way up over a few hours.
If you feel you are ready to take your Subutex, start with 1mg (using any pill cutter) or les and work your way up with 1mg or less an hour. That way if you have taken it too soon you won’t get as sick as you would if you took the full 8mg pill.
- Causes less distress to babies.
- 50/50 chance baby will go through withdrawal.
- Baby needing less medication, 1.1 versus 10.4 milligrams.
- Baby spends less days in the hospital. 10 days versus 17.5 days.
- You go weekly instead of daily.
- Relatively Safe for baby when taken under proper care.
- Harder to get on, you must withdraw.
- No withdrawal required, get on right away.
- Relatively safe for baby when taken under proper care.
- Higher Distress to baby after birth.
- High dose of medication in baby needed. 10.4 versus 1.1 milligrams.
- Higher days in the hospital required on average. 17.5 versus 10 days.
- Over 90% chance baby will have withdrawal.
Either choice you make is better than the alternative. Don’t let anyone judge you for your choice either. If Subutex is just too hard for you to get on then choose methadone. If Subutex isn’t helping the cravings go on methadone. If methadone is causing you anxiety get on Subutex. There is no wrong choice here.
I had my 2nd child on Subutex. She had no withdrawal at all, and tested negative for everything. Nothing even crossed to her. I had weaned myself down to .25 a day. I tried to completely stop but I started bleeding, went to the hospital and was advised to stop weaning immediately.
At the time I didn’t know that kicking cold turkey could cause a miscarriage. The baby feels what you feel to an extent. That’s why it is very important to get on a maintenance drug as soon as possible, as early in the pregnancy as possible.
Now, I had just got out of detox 6 months earlier at the time I got pregnant. I probably would have gone on methadone if I was at the core of my addiction. So absolutely no judgment here. I know it’s against medical advice, and I am not saying what you should do, but I weaned myself down. If I had got on methadone, I would have weaned myself down too. Not to the point of causing myself or the baby distress, pregnancy is hard enough but just as much as possible.
I would hear about women that weaned themselves off completely with no withdrawal symptoms during their pregnancy but that’s not me. I kick harder than most for some reason, and if I kick cold turkey I require hospitalization. Even weaning myself down to such a low dose I was in agony when I tried to jump. Jump means you just stop at whatever dose you are at. Most people couldn’t believe that, but that is just how I am.
If you have any questions, let me know in the comments. Or you can email me. I am open to anything and always willing to help someone who wants it.