Pregnancy and substance use are usually not associated with each other. But they do cross paths when substance users become pregnant. The National Institute on Drug Abuse (NIDA) cites research that says about 5% of pregnant women use one or more addictive substances. It may be surprising to learn that some who are expecting knowingly use substances while carrying an unborn child to term.
According to the Merck Manual’s report, “more than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy, and use of drugs during pregnancy is increasing.”
In many of those cases, expectant mothers have moderate-to-severe substance use disorders, which means they will struggle with stopping their use, no matter how much they try. This happens because their bodies and mind have become physically and mentally dependent on substances. These substances can be illegal, prescription, or sold over the counter, and it is possible for people to become addicted to them.
Substances commonly used during pregnancy include:
- Stimulants (such as cocaine, methamphetamine)
- Opioids (including the illicit drug heroin and illicit fentanyl)
- Nicotine (including e-cigarettes, vapes)
- MDMA (ecstasy)
Substance use can bring complications for the person who is pregnant and the unborn child. Among them are:
- Spontaneous miscarriage
- Deep vein thrombosis (the forming of a blood clot deep in a vein in the lower leg, thigh, pelvis, or arm)
- Premature membrane rupture
- Placental abruption and other placenta complications
- High blood pressure
- Antepartum hemorrhage (bleeding from the birth canal prebirth)
- Maternal migraines and seizures
- Fetal addiction
Just about anything a pregnant woman puts into her body will affect her unborn child, whether the child is in her womb or out into the world. Substances the mother ingests travel across the placenta, which provides essential food, oxygen, and nutrients to the baby.
The adverse effects of substance use during pregnancy range in severity. Per the National Institute on Drug Abuse, “Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth.”
Any substance use a pregnant woman engages in can cause the child problems, possibly for their entire lives. Unfortunately, many of these consequences can’t be undone. However, detoxing while pregnant is one option that can help pregnant substance users get help for themselves and their babies.
If you are pregnant and using substances regularly, you may have a substance use disorder (SUD) that is harmful to you and your unborn child. This guide will explain the benefits of detoxing while pregnant, but you are advised to speak with your doctor or healthcare provider for guidance that is tailored to your condition and situation. This guide is not intended to replace advice from a medical professional.
Help for Maternal Addiction Can Start with Medical Detox
Once a substance use disorder affects a pregnant person who uses substances and their unborn fetus, it is critical that both get medical care that can prevent further harm. Medical detox can help pregnant women end their substance use and approach the process of prenatal withdrawal safely. Health care professionals know how to address the unique needs of people who are battling maternal addiction and can facilitate patients’ safe withdrawal from addictive substances. They also will know how detox withdrawal can affect the fetus.
What Happens During Detox?
Medical detoxification is the first step of a continuum of addiction care. Many people think this phase is the beginning and end of addiction treatment, but that is not true. Detox alone will not treat a substance abuse problem. However, it is a critical step in addiction recovery. One goal of detox is to help a patient regain medical stability. It involves removing an addictive substance from the body as well as any toxins. The process can last several days or longer, depending on the person’s condition.
During this time, the patient receives 24-hour care and monitoring from medical professionals. These professionals may also administer medications to keep the patient as comfortable as possible while their withdrawal symptoms occur. A tapering schedule may also be used to help the body adjust to lower amounts of a substance it is used to. Tapering also treats a patient’s physical and psychological withdrawal symptoms that come about as the body adjusts to the drug leaving its system. Detox patients also receive essential nutrition that aids in their recovery.
Detox reduces patients’ cravings, which, in turn, reduces their chances of having a relapse. Both conditions are common in active addiction. According to NIDA, relapse rates range from 40% to 60%, which is on par with relapse rates for other chronic illnesses, such as hypertension, diabetes, and asthma.
Medical detox can also uncover the deeper issues that often lie at the root of active addiction. Detoxing while pregnant can bring a special set of challenges because withdrawal symptoms could also affect the unborn baby. This is why it is important to receive medical help from professionals who understand the nuances of this recovery for both individuals.
If you or someone you know is pregnant and wants to end their substance use, please seek help from an accredited facility that specializes in treating substance use disorders. Once a substance user is pregnant, the aim is to minimize harm as much as possible. The outcome can be unpredictable, but getting care sooner rather than later is important. Doing so can save lives.
Why Detox at a Treatment Facility?
A treatment facility’s staff is equipped to properly monitor medical detox and respond appropriately should any emergencies arise. Staff members will also assess the needs of each patient and recommend action based on the results of what they find. These assessments cover physical and mental health needs. If a person has a mental health disorder, this will also be addressed in the treatment plan. Treatment center staff will know what path to take once a patient regains medical stability. As mentioned earlier, detox alone is not enough to bring about recovery from addiction. It is merely the first step.
Detoxing while pregnant can take place in an inpatient (residential) setting or an outpatient setting. It depends on the patient, but an inpatient environment is ideal, particularly for substance users who are withdrawing from alcohol, benzodiazepines, opioids, and other substances that could bring about life-threatening symptoms.
Do Not Attempt to Detox Outside of a Professional’s Care
Pregnant substance users are strongly discouraged from quitting their use of any drug abruptly as this is dangerous for both them and their babies. This is not a process anyone should attempt on their own. Suddenly stopping long-term or frequent substance use can shock the body and increase the risk of:
Incorrectly detoxing while pregnant can cause complications that most people are not trained to deal with or prepare for when they happen. Whether a person is pregnant or not, cutting back or stopping long-term alcohol or drug use can cause uncomfortable withdrawal symptoms. These symptoms can prompt a relapse that leads to an overdose. Such overdoses can be fatal or cause permanent injuries.
Taking a break from substance use and going back to using substances increases the risk of someone overdosing, even on a small amount, because the body isn’t used to the substance anymore. This return to using substances after a break is known as a relapse, which is common in people with substance use disorders. This is among the reasons why professional medical detox is recommended.
Detoxing During Pregnancy Can Come with Some Risks
While professional help is recommended, detoxing while pregnant can come with risks and concerns that require a careful look. Various factors shape each individual’s withdrawal process. They include:
- The type of substance(s) used
- If more than one substance was used at the same time
- How the substance was used (was it smoked, swallowed, inhaled, injected?)
- How long the substance was used
- The size of the dosage used
- A person’s medical and mental health history
- Age, weight, genetics, dietary habits, lifestyle
All of these factors vary across individuals, but each patient will be assessed so that their care team will know how to approach their specific treatment plan. The kind of substance used during pregnancy can affect how a person’s medical detox will progress. How long it will take withdrawal to start once substance use stops will also depend on the factors listed above. Alcohol and opioid withdrawal symptoms can start within a few hours to a few days, while withdrawal for other medications, such as barbiturates and benzodiazepines, can start within days. Much depends on the half-life of a drug, which is the time it takes for the drug to reduce to half its concentration in the blood.
If medications are used while detoxing during pregnancy, medical professionals will look at each case to determine if that is the way to go. They also should explain the risks and side effects of any medications that are used and make sure the person in recovery understands what they are taking. Keeping the mother and child safe during this delicate time is the main goal.
Below are a few substances and how they can affect the pregnant user and child.
As the Centers for Disease Control and Prevention shares, “There is no known safe amount of alcohol – even beer or wine – that is safe for a woman to drink at any stage of pregnancy.” While alcohol is a legal substance that is easily accessible to the general public, it is highly dangerous when abused, and this is true for people who use it while pregnant, as well.
Per a NIDA report, “children born to mothers who both drank and smoked beyond the first trimester of pregnancy have a twelvefold increased risk for sudden infant death syndrome (SIDS).” As with other drugs, a person who drinks regularly should not stop their alcohol use abruptly. It could harm them and the baby.
The health consequences of stopping alcohol “cold turkey” include life-threatening seizures, confusion, hallucinations, and the possibility of developing delirium tremens (DTs), a severe and possibly fatal condition for a mother and her unborn baby. Alcohol withdrawal can cause other physical and mental side effects that are best handled with professional treatment.
Babies exposed to alcohol use can go on to develop disabilities that affect their physical, behavioral, and mental health. These are known as fetal alcohol spectrum disorders (FASDs).
- Low body weight
- Memory problems
- Coordination problems
- Speech and language delays
- Poor reasoning
- Attention span issues
- Learning disabilities
- Intellectual disabilities
- Shorter-than-average height
- Hyperactivity (overactive)
- Vision or hearing problems
- Sleep and sucking problems as an infant
It can be difficult to diagnose an FASD as there are no tests that can be used to detect them. Treatment can be given once it is determined what FASD a child has and what their needs are.
Stimulants (cocaine, methamphetamine, Adderall)
Stimulant drugs, often called “uppers,” speed up the body, making a person’s breathing rate and heart rate faster and giving them more energy. When the high wears off, stimulant users can experience anxiety, fatigue, mood instability, severe depression, strong cravings for cocaine, and thoughts of suicide. A person can even experience paranoia, confusion, and psychosis during stimulant withdrawal.
Pregnancy can further complicate these symptoms, which can be difficult to manage on their own. During this time, women experience stress, mood swings, and hormonal imbalances can make it challenging to manage these changes. The Food and Drug Administration (FDA) has not approved any medications to treat stimulant withdrawal. Still, medical professionals at a treatment center will know the best way to treat it based on the patient’s condition.
Benzodiazepines (Xanax, Valium, Klonopin)
Prescription medications used to treat anxiety and insomnia slow down the central nervous system. This is how they help users relax, feel calm and get to sleep. However, these medications can be highly addictive in a short time, which makes it difficult for people to stop using them. A person who uses them longer than prescribed can become dependent on them. If they cut back or stop their use of these medications, they could experience stronger symptoms of the conditions they were trying to treat. This is known as rebound anxiety and rebound insomnia. In addition, they may have shaking, sweating, headaches, mental confusion, panic attacks, and other problems.
Stopping the use of these medications can cause life-threatening seizures that can be dangerous to a mother and her fetus. Medical detox can help pregnant women with benzodiazepine dependence address withdrawal symptoms, including depression and irritability.
Opioids (heroin, oxycodone, fentanyl)
Opioid misuse, as well as prescription opioid use, can be dangerous during pregnancy, according to the CDC. Opioid withdrawal symptoms are usually compared to those of a bad case of the flu. Nausea, vomiting, chills, fever, sweating, pain, insomnia, and other effects are common when withdrawing from these medications and the illegal narcotic heroin.
Withdrawal effects are especially dangerous for babies. Suddenly cutting back or cutting out opioids can cause a fetus to suffer breathing problems that could threaten their lives. Babies exposed to opioid use can experience withdrawal from these substances within the first 72 hours of their births, according to this study. This takes place because the infants are trying to adjust to the lack of the drug in their system. This adjustment process affects their brains and central nervous systems.
Per the CDC, long-term exposure to opioid use can cause poor fetal growth, preterm birth, stillbirth, congenital abnormalities, and neonatal abstinence syndrome (NAS).
Instead of withdrawing from opioids, pregnant substance users with OUD may be put on an opioid maintenance program to help them safely reduce their dependence on these powerful drugs. A medication-assisted treatment (MAT) program can help reduce chances of relapse and overdose, making it easier to focus on recovery. MAT programs use FDA-approved prescription medications to help people reduce their opiate use. Participants in this program also receive behavioral health therapy and counseling to treat their disorders. MAT is also used to help people who are dependent on alcohol, nicotine, and depressants.
Nicotine (cigarettes, e-cigarettes)
Smoking may be seen as harmless, but it, too, can harm and even kill an unborn child. Per the American Pregnancy Association, between 12% and 20% of pregnant women smoke, causing the deaths of more than 1,000 babies every year. Nicotine in any form, whether it is in traditional cigarettes, electronic cigarettes (e-cigarettes), or other devices used to smoke, should be avoided. Even flavorings that are used with e-cigarettes can harm a fetus. Smoking can also cause:
- Premature birth
- Low birth weight
- Congenital disabilities
Addiction treatment facilities usually do not treat people for nicotine addiction, but if you smoke in addition to using other substances, you can address this with your health provider. In any case, speak with a doctor about the health effects of smoking.
Treatment Options for Pregnant Women After Detox
Another benefit of detox is that after patients regain stability, they are directed to a program that can help them pursue recovery. If you have a SUD and are pregnant or just had a baby and are seeking postnatal treatment, look for a treatment facility that is accredited, reputable, and staffed by medical professionals who understand addiction recovery. Also, confirm if the facility specializes in helping pregnant mothers or new mothers in recovery.
Such a facility should educate patients and give them the tools they will need as they prepare for and/or start the journey of being a parent. Classes should cover various topics, including pregnancy, breastfeeding, nutrition, parenting, and early childhood development. Programs may also include mental health treatment and counseling, child care, and assistance with housing, transportation, and other needs.
If a full-time program is recommended, the patient will stay on-site at a facility for at least 30 days or longer. Research suggests that 90 days (three months) is the ideal length of time to receive rehab services for substance misuse or addiction. Some in the medical community believe that the longer a person stays in treatment, the better their chances of sticking with their recovery program once they exit their program. Aftercare services can assist them as they rejoin society. Life after treatment can be overwhelming, but many treatment facilities have support in place to help make the transition easier.
Outpatient programs allow patients to live off-site at home or another residential setting while they receive treatment for a specific number of hours a week.
Inpatient and outpatient programs provide the following, among other services:
- Substance abuse education
- Cravings and triggers management
- Individual, group, and family therapy
- Treatment for co-occurring disorders
- Life skills training
- 12 step programs
- Relapse prevention training
All of these offerings can help the goal of recovering from substance use attainable. Various behavioral therapies are used in addiction treatment. Behavioral therapy used in addiction treatment can help pregnant mothers rebuild their lives after substance addiction.
Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) both help people identify and address negative thought patterns and replace them with habits that can lead to desirable outcomes that move their lives forward.
Looking for Addiction Treatment? We Can Help
We at Family Recovery Specialists believe in treating the whole person when treating addiction. We also believe recovery is accessible to everyone, even substance users who are pregnant. It is often difficult for people to seek help for a substance use disorder when they are pregnant or have children. There is a lot of judgment and stigma attached to using substances while carrying a child to term. Unfortunately, this means many will pass up the chance to get the help they need.
We are a judgment-free zone and welcome anyone to come into our facility so that we can see how we can help them start their journey to sobriety. Give us a call today to learn how we can help you or a loved one find the right medical detox and treatment program for their needs. Our staff speaks English and Spanish in our Miami facility. We will evaluate your needs and help you find the treatment program that works for you.