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PostPosted: Fri Mar 05, 2010 11:00 am 
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I'm new to this forum but I have been reading a lot of posts this morning trying to find a similar situation to my own. I am currently 25 weeks pregnant. I have been on Subutex (2mg/day) since October 09 when I found out I was pregnant. Before that I had been on 4mg-8mg/day of Suboxone since March 2009.

I have had problems with pain medication and addiction since I injured my back in 2004. I got addicted to narcotic pain killers (Vicodin, percocet, loratab, etc) and eventually had to go to rehab in 2005 because I was seeing several doctors to get different prescriptions and it got terribly out of control. In rehab I was put on Methadone for the purpose of tapering off slowly. BUT In 2006 I was hospitalized for Methadone withdrawal because I tried to stop taking it cold turkey. I went from 30mg/day to nothing and I nearly died. In the hospital I was given Methadone again and released. After that I stopped cold turkey again (I'm a persistant & possibly very stupid person!) That was the summer of 2006.

I started back taking meds again when I had my first baby in 2007. I had a very serious car accident and was prescribed pain meds again. They made me feel like "super-mom" because of the energy and euphoria they gave me when I was exhausted and depressed. Looking back, I know that I had post-partum depression.

In 2009 I got back into therapy and started the Suboxone treatment which led to my current situation.

I had severe hyperemesis during this pregnancy and have been hospitalized for severe dehydration. During the worst "sick" times I was able to stop taking Subutex completely because I couldn't stomach it. However my doctor kept encouraging me to start taking it again! Granted, I only stopped for a few days at a time but still he insisted that I would eventually go through withdrawal if I continued to abstain.

I had no noticible difference when I stopped for a few days at a time. Of course I was so sick from my Hyperemesis that it's possible that the symptoms were all mixed in together.

I am SO confused now because I believe my doctor just wants to keep me as a patient (he is an addiction specialist) and that is why he continues to advocate my use of Subutex during this pregnancy. Again - I am currently at 1-2mg a day and 25 weeks pregnant. I want to QUIT. I have the opportunity to have my toddler stay with family for a week visit and I'd like to take that chance to get this stuff out of my system.

I know it's dangerous to withdrawal, but I feel as if it's what I NEED to do for me and my well-being. I'm having severe anxiety over the thoughts of taking this every day. I would feel SO much better if I could get off of it soon.

I have had bad withdrawal from a fair amount of Methadone in the past... it was horrible. I am wondering how much this will compare - probably not as bad? I am pretty SET in my mind to come off this Subutex this week. I am going to start by skipping a day (1-2mg every 48 hours). I'm wondering if this is the best way or if cutting the dose is better (.5mg every 24 hours).

Thanks in advance to any replies!


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PostPosted: Sat Mar 06, 2010 12:42 pm 
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I am going to STRONGLY suggest that you do not quit while you are pregnant. My husband quit Suboxone after cutting down to about a quarter (2mg.) a day for a long time. He was VERY sick for at least 10 days, you do not want to put this kind of stress on your baby and on yourself for that matter. I can totally relate to you as I had just gotten out of detox when I found out I was pregnant with my first so fortunately I was clean for the first 4 months of that pregnancy, after that I started to dabble again in Oxy's and tiny bits of heroin justifying it by convincing myself that oxy was prescribed to pregnant women in severe case of which I was not one! Thank goodness I was able to pretty much control myself and my daughter was born healthy and not addicted to anything. After her birth I too had postpartum and my heroin use skyrocketed! it made me feel like supermom too! I had energy and felt wonderful and it made it so easy to take care of my daughter, except when we had no money and I was sick and then I wanted to run away and basically kill myself so what kind of mother was I then? I thank god I found a good sub doctor when she was four months old. It changed our lives. I am a GOOD mother and it is because of Suboxone/ Subutex. If I wasn't on it i'm sure I would of found my way back to heroin or oxy because truth be told, I still wanted to get high!! After almost 2 years of clarity I can see how bad it was and the high is just not worth the trouble anymore. Will I ever get high again?? I don't know but my life is good. I have a great Sub doctor. Your doctor is not keeping you on Sub to keep your money or you as a patient they are doing it for your own good. If you truly want to stop because you want to be fully off everything just wait until after the baby is born, this is my advice. Good luck to you and let us know how your doing.


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PostPosted: Sat Mar 06, 2010 3:09 pm 
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I am NOT a doctor nor expert!!!!

I have heard and read online that quitting is worse because it puts a lot of stress on the baby and it is not the norm. Please, look into that more, I will too. If you think about it, your body goes threw a lot of garbage while w/d, I doubt it is good to subject the baby to that.....but that is MY opinion...

I think you are supposed to get to a low dose that holds you and stay there. They normally use Subutex instead of Suboxone for moms-to-be. I am sorry I do not have a link handy for you, but I assure you I will post back with a link so you can read yourself. Best of luck to ya(s) and I am sure everything will be great!! Take Care

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"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Sat Mar 06, 2010 3:30 pm 
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Ok, well, I know I read all of the following at one time or another, but today I just gave them a quick skim. I do not know if it states anywhere in the following about quitting subs while pregnant. There is, however, a wealth of information provided by a REAL DOCTOR, Dr. Junig, the creator of this forum. He IS an expert and you can take what he says much more to heart. In my last post I just gave MY opinions and advice that I remember from reading online. Obviously, in the following links is where you should concentrate on, not what I said. I would still do a google for more info. about quitting sub while preg., it won't hurt to find other sources.

These are reliable sources, links to blog posts from Dr. Junig about pregnacy:

Withdrawal in newborns: Lay off the guilt trip!!


Suboxone and Epidural Anesthesia; pregnancy, delivery, and C-sections on Suboxone


On Suboxone, Confused, Wanting to be Pregnant


Suboxone (buprenorphine) and Opiate Withdrawal in Newborns




Again, best of luck, and take care!!!

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Sat Mar 06, 2010 7:23 pm 
That was so nice of you BigRed to look that up and post the links for Sunshine and anyone else who comes along!
Sunshine - please read what BigRed found for you. Please, please give yourself a break! You're doing fine. It sounds like you have good doctors who really are tryiing to look out for you and your baby.
I totally understand how you feel. I know when I was pregnant many years ago, all I thought about was doing the best I could to ensure a healthy baby. The thing is.....you're already pregnant. You can't go back and undo your addiction history. You have to work from where you're at. You're 25 weeks along.....everything with the baby has already been formed, and now it's just a matter of you staying healthy and providing the proper growth environment to get this baby to term.
You have already suffered enough because of your addiction. You've been to treatment, you've relapsed and gotten back into treatment that seems to be working now. Please don't do anything to mess that up. Going off Subutex now could set you up for all kinds of trouble. To me, your biggest risk of harming your baby would be to force yourself off your medication and run a huge risk of relapse. The thing is.....you could get off the Subutex, sure. But then what?....you and I both know that's when the trouble starts not when it ends. In all liklihood, especially in light of being pregnant and then immediately postpartum, you'll end up depressed and in trouble if you go off Sub. Not a good plan!
Plus, you're on a nice low dose of Sub anyway. You've done well.....be proud of the fact that you're doing pretty good on such a low dose. I think it would be a mistake to not take the advice of your doctors. You'll be putting yourself and the baby at risk if you stop your meds. Don't be fooled either by the fact that at times you've managed to miss some doses and keep your doses low. Bupe takes a long time to diminish low enough in your body for you to really "feel" it.
From what I can see, you've got nothing substantial to gain by quitting Sub right now and potentially a whole lot to lose. So give yourself a break, listen to your doctors, read the research that's been provided for you, and try to just enjoy the rest of your pregnancy knowing you're doing all you can to do what's right!
I'm not a doctor, but I was an RN practicing labor and delivery and women's health for almost 20 years. Although I don't have a lot of experience or firsthand knowledge about pregnancy and addiction, I do know a good bit about pregnancy, labor and delivery and postpartum. So I'm coming from that background and from the perspective of a mother and as an addict in recovery on bupe. Maybe you can trust me at least a little bit. Also, listen to what the other's have said here about their recent experiences with their pregnancies. We all want to help and see you do well! So keep posting here and let us help you in any way we can!


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PostPosted: Mon Mar 08, 2010 4:04 pm 
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I really hope you decide to stay on Subutex until after delivery.

I am also pregnant and on Subutex. My pregnancy was as planned as it could possibly be. I spoke with my addictionologist AND a high-risk specialist before we ever started 'trying' to ensure that me being on Subutex was NOT harmful for the baby. Both docs gave me the green-light and both said the same thing...being on Sub or starting sub while pregnant is not the problem---but being on Sub, getting pregnant and then going OFF of Sub CAN be a problem.

If you think that it is time for you to get off of Sub, that's great---but why not do it after your baby is born?

You are already at such a low dose--and I know it can be frustrating to feel like you "have" to take a medication that you don't want to, but I can only parrot what the docs have told me---and that is that stopping while pregnant is a risky thing.

Another thing to consider, as others have mentioned, is that you may not have noticed any discomfort before b/c it can take a good 3-4 days before the last dose of sub clears your system.
That's not to say that you will experience any discomfort, but you might, and god knows withdrawal and pregnancy are not a good mix.

Good luck!


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PostPosted: Wed Mar 10, 2010 9:45 pm 
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I sympathize with your desire to stop taking buprenorphine while pregnant. When I became pregnant the second time, I had strong feelings of not wanting to be on this medication. Although I previously had a healthy, thriving child while taking sub. I did not want to add any risks to my pregnancy and my baby. During the morning sickness phase of the pregnancy it was very difficult for me to take the medication, the taste made me feel extremely ill. This added to my desire to end sub treatment. My family was also concerned and commented on how I should try to stop so the baby doesn't suffer from withdrawal, even though my first child did not experience any w/d symptoms. Just simply as a mother I naturally worried about the long-term effects if any to my unborn baby and did not want to do anything that could possibly harm him. I wanted to be the healthiest I possibly could be. My baby was recently born, and after much worry, debate, and research, I decided to stay on the buprenorphine. Thankfully neither I nor my baby had any complications. The hard part now is the normal day to day caring for a newborn. It is a stressful job in these early days. You will have to make your own decision about whether or not to discontinue your subutex, I just wanted to share with you a bit about my experience. You will find support and pertinent information here. Good luck with your decision making, and the remainder of your pregnancy. I know that a healthy baby is your goal.


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PostPosted: Thu Mar 11, 2010 12:47 pm 
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Thank you for the replies. (Esp to Bigred for the links) I am also encouraged by hearing your stories regarding your pregnancies and use of Subutex. I am still very anxious about my situation though.

I'm seeing an addiction/behavior specialist for the Subutex BUT my OB is not any sort of specialist. Even when I have asked for advice/help from my OB he looks puzzled and says I should talk to my Sub doctor.

I've never been given ANY advice about my use of Subutex except by the OB I saw in the hospital (when I was hospitalized for dehydration from Hyperemesis) and other than that my regular OB says he doesn't know anything about Subutex. The OB in the hospital only had the information that he gleaned from a medical book AFTER he found out I was taking the Sub. One day I asked him about the Sub and he told me he'd have to get back to me the next day. When he advised me was a single sentance that he READ in some book. "It is not recommended that Subutex be discontinued during Pregnancy".

No reasons. No explaination. No NOTHING.

Because he knew NOTHING else about it, and it wasn't that GD important to him to find out any more.

So my OB (and the OB I saw at the hospital) is clueless about the Subutex and my Sub doctor doesn't know much about pregnancy. I feel like anything I do is unsupported and unregulated. I'm FRUSTRATED.

I HATE THIS CRAP. I hate that nobody in my immediate medical support group knows any more than I do about this drug! I'm pissed off that I have to come to an internet forum to be told ANYTHING about this medicine that I'm taking! I don't know what to do.


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PostPosted: Thu Mar 11, 2010 2:16 pm 
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Unfortunately I think that is more the norm with this medication, although it is not a new drug, it has been used for many years, but this particular use, for opioid addiction treatment is fairly new at least in the U.S. I believe. I was the first person on suboxone that my ob/gyn encountered. I had an amazing doctor who prescribed the sub. for me, who was extremely knowledgeable about it. Since he retired, I had to go to a family physician who was certified to prescribe buprenorphine, but does not know much about it. He also suggested that I quit taking it when I first told him I was pregnant, but when I spoke with my old Doc he advised me not to once again. I have also found that there is conflicting info. written in drug and medical books. Most don't even mention buprenorphine, but rather explain methadone, which to my knowledge has a much different effect on neonates than buprenorphine, with a much higher probability of NAS to a much greater degree. Most books say that methadone is the standard of care for a pregnant woman and that breastfeeding is contraindicated, but then the studies that have been done don't show any problem with breastfeeding.
Still, it doesn't make it any easier to be going through your situation and I understand your frustration. I do think you're doing the right thing by learning about it for yourself and of course carefully. I'm sure there is a lot of shady info. on the internet about this medication.


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PostPosted: Thu Mar 11, 2010 4:50 pm 
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Hey sunshine,

I wish I could have provided more info....no need to thank me, but your welcome!

I could only imagine how frustrated you actually are. By now, e.r. doctors, specialists, and others we would have figured would know a bit more about buprenorphine. It is not a relatively new drug, as said the use of it is new the use for opiate dependacy. I am sure it is not the best idea to keep a woman on say 300mgs of methadone during a pregnacy. I am no expert but would guess that, that would cause problems with the infant and w/d. I could be wrong. Bupe is only equal to about 20-30mgs of methadone at bupe's (by bupe I mean buprenorphine, main drug in suboxone and subutex) ceiling effect. So on a low dose of suboxone/subutex you might be equal to someone who is on ABOUT 20mg methadone give or take. That really isn't that much. As Dr. Junig says, babies go through a lot more discomfort if you want to call it that, and other procedures that they seem to do fine with. I wish I could find more about the pros and cons and reasons to quit or not quit while pregnant. Dr. Junig DOES say that one of the reasons why it is better to stay on low dose methadone or bupe treatment while pregnant is so the mother does not go back to harder drugs that are more harmful to the baby {and the mother?}, (my guess would be so no needles and such as well???). I am not saying that you plan to or will relapse or anything but, MY PERSONAL ADVICE would be to stay in treatment.

The doctors simply need to invest a little time (a fraction of a fraction of the time of what Dr. Junig puts into his field, addiction treatment/bupe forum and his blog and etc..). Not just your doctors, but many others out there. I really hope that you can find the answers that you need and get the advice that you need so you can get the best treatment (with the pregnacy......and bupe treatment too of course) that you, and your baby, deserve. It says so much that you are trying to find more info and educate yourself so you and especially your baby are ok. I am sure that you will do great, both of you, but I just hope that the doctors don't hassle you too much. Please take care and keep us updated if you can!

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Thu Mar 11, 2010 9:21 pm 
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UPDATE:

After posting here today I called my OB and asked to come into the office. There I asked him to refer me to an OB that possibly had some experience with a situation such as mine. Monday I will travel to the nearest large city to a group of specialists that will hopefully be able to advise me further.

I didn't realize earlier in my pregnancy that I just had to ASK for more help. I just assumed that I would be given help.

I will update frequently with whatever information that I get. Thanks to everyone here.


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PostPosted: Fri Mar 12, 2010 3:51 pm 
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I'm so glad that you are going to find yourself a more knowledgeable doctor! I was very lucky, my Sub doctor is very well informed and has had numerous pregnant patients and she was able to refer me to a great OB that also had experience with Suboxone patients. Even though I researched before I got pregnant and spoke with my Sub doctor about getting pregnant I still was nervous about taking Subutex while pregnant. At my last visit I spoke with both my OB and Sub doctor and they both reassured me I'm doing the right thing and the baby is going to be perfectly fine. You just need to find yourself a better doctor with a little bit more experience and it's great that you are educating yourself as well. Good luck, you are going to do great.


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PostPosted: Sun Mar 02, 2014 5:02 am 
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sunshine--I'd love to speak with you privately over email if possible..i'm in a very simlilar situation and want/NEED to be off completely by delivery..now at .5 mg daily please email me shane.schweigert@gmail.com


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PostPosted: Sun Mar 02, 2014 11:48 am 
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anxiousmomma2be-
Not sure if you'll see this or not, but thought I'd reply anyway..
Although many doctors don't recommend coming off subutex/suboxone during pregnancy, my OB and my Sub Dr both recommended I try to wean down/come off the subutex by 28 weeks. They said that once in third trimester babies, don't do well with tapering.
Unfortunately, I was not able to come off the subutex by then, so they wanted me to stay at a stable dose until delivery.
Now, I am not a Dr and would never suggest you take the advice of someone who isn't one.. I just thought I'd share with you what I was told.
Please talk with your doctor about this. Only they can give you accurate information.
Good luck! :)


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