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 Post subject: Subs and Labor???
PostPosted: Sat Jul 02, 2011 12:16 pm 
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I wanted to know how going through labor and having to go on pain meds or using the epidural can work if im on 2mgs of subutex. I havnt decided if im going to ween off the sub completely or stay where im at with the 2 mgs. please let me know about your experiences with pain management during labor while taking sub. Thanks!


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PostPosted: Sat Jul 02, 2011 12:30 pm 
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Sub should have NO effect on an epidural, but it might block IV pain meds or at the very least you will have a higher tolerance for IV pain meds because of the Sub.

One point of concern could be if you need a C-section, what you will do for post-op pain management. You are on a fairly low dose, so you might be fine. Your doctors should know about the Sub though so they can give you an adequate amount of pain medication should you end up needing it.

Good luck and congrats!

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PostPosted: Sat Jul 02, 2011 2:45 pm 
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Hi Liz!

Glad to see that you got moved and that your stress level has come down some (even if just a little). As far as your taking Sub and your approaching labor.....I don't think it'll be a problem (as long as all of your Doctors and the Anesthtesiologist know about your Sub, so that you ALL can come up with a game plan).

To be honest with you Liz.......I was petrified about the birth of my son!! I was CONVINCED that it would be very difficult to get adequate pain control, and that my epidural may not be effective......due to my taking Subutex. Im SOOOOO happy to tell you that I was completely wrong!! The birth of my son (12 weeks ago) went GREAT!!!

I'll admit, I was quite disappointed about not being able to have a vaginal birth (my body just didn't progress enough, even after being induced, so they had to perform a c-section).....but, with all the circumstances, I don't think it could've turned out better than it did.
I took my last dose/6mg Subutex at about 10 30am.........our son was born via c-section at 7 30pm that night. My subutex DIDN'T interfere w/my spinal AT ALL. BTW, I had a spinal (WHICH I HIGHLY RECOMMEND), not an epidural. There's a difference........the spinal is more localized, I was completely numb from the wate-down. Also, I was fully alert during the birth of my son (not all groggy like w/the birth of my daughter, when I had a regular epidural).

I spoke with the Anest. beforehand and informed him about my Subutex. I requested that they NOT use Fentnyl (just b/c I personally didn't wanna take a chance of feeling euphoric during the surgery). I need to request my hospital records, so that I can post EXACTLY what my spinal consisted of.........I think it was mostly local anesthetic, a small amount of DuraMorph, and a little bit of Propofol towards the end. I had my O.B place a Q-Pump at the surgical site (this is just a rubber ball containing local anest, which is pumped into the site for a few days post-partum).......I think the Q-Pump worked WONDERFULLY!!

The ONLY other meds I had post-partum were....... I.V Toradol (which I also HIGHLY recommend), 800mg IBprophen.....and my Subutex. I dose twice daily. So, I skipped my evening dose when my son was born, and just began dosing again the next day.
Amazingly, this was ENOUGH for me.......at least while at the hospital. After the Q-Pump ran out, and my I.V. was taken out, I did start hurting. After we we're discharged, I was prescribed Toradol tablets, and the 800mg IBprophen.........I hafta say that the Toradol tablets did not work very well FOR ME. I was in a good amount of pain those first few days, being home.....TOTALLY my choice though. My O.B offered to give me Ultram while at the hospital and once we we're discharged, but I refused it.

PLEASE don't think Im suggesting that you should do the same (if you end up having a c-section).......IM NOT.......I just know how I am, and I was really, really scared to feel any kindof opiate-like feeling. Ultram is NOT an opiate, I just didn't wanna take any chances. Looking back, I may have benefited from a little more pain control post-parum......but, the pain was only temporary.

Hopefully, you'll be having a vaginal birth, and you won't even hafta worry about recovering from a surgery. Do you know if your chances for a vaginal birth are favorable? Honestly, if I were you.....I'd just remain on your Subutex. You're only taking like 2mg/day, right? Look at the threads about pain-management and planned surgery/Subutex. Dr. Junig goes into detail about what to discuss w/your doctors. It should'nt be too hard for you to get adequate pain relief if your doctor prescribes a high enough dose of pain medication for you.

Good Luck Liz!! If you have any questions, feel free to PM me also


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PostPosted: Sat Jul 02, 2011 5:30 pm 
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The link below is to several different blog posts that Dr. Junig has written about pregnancy/addiction/sub. I'd recommend you read some of them. The more you know and understand the better.

It's my understanding that it's safer to stay on sub during your pregnancy than to go off and go through withdrawals and risk miscarriage. I'm sure Dr. Junig discusses this. So do many of the other forum threads here on pregnancy.

Also, there are great articles under the "Links" section. The first one is a "sticky" about treating acute pain in sub/methadone patients. It's an excellent read and can also be given to your doctors. It comes from a very reputable sources (NIH). Many of us have used that paper when having surgery.

Congrats on the pregnancy and good luck with everything. :)


http://suboxonetalkzone.com/category/pregnancy/

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PostPosted: Thu Jul 14, 2011 12:22 pm 
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This is great information....as I am going to be giving birth in November, I am trying to be as educated as I can! I don't have a strict plan for where I will be when I get to that pooint, so it makes me a little nervous! I am at 3-4 mg now.....

Marie,

I did just want to add that even though ultram is not an opiate , I was addicted to it before moving onto H, so I would remember to be just as careful. I sware I got the SAME exact effects from it as I did vicodin or oxy's. But thank you for posting your experience!

And Hatmaker,

you always have great advice! I am trying to find some articles where Dr junig talks about "safer to stay on sub during your pregnancy than to go off and go through withdrawals and risk miscarriage"........I have read this MANY times and would like to bring in something to my sub Dr. It seems like they were thinking I would go down 1mg every month from now (I am at about 3.5) and be completely off before baby is born. I am REALLY scared and don't feel comfortable with this...I would rather go off a few days before and believe that would be best for me and the baby. I am shy about speaking up sometimes, so I think it would help to show where I get my info!!

Thanks!!!

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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