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 Post subject: 4 weeks preg
PostPosted: Fri Oct 16, 2009 7:01 pm 
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I am currently 4 weeks pregnant. I've been on Suboxone for about 6 months, my doctor put me on a 12mg dose, 8 in the morning 4 in the evening. Throughout the past 6 months i been messing with my dose on and off because honestly I hate being on this medication. Anyway about a month ago I kinda had an idea that I was pregnant so I cut my dose down to 4mg's, needless to say last friday I had a positive pregnancy test. I completly freaked out and decided to take it upon myself to get off my meds, I lasted about 4 and half days and seriously thought I was dying! I wanted so bad to keep going because I really hoped that maybe the worse was over but I just couldent take it anymore, I cracked and took 4mgs. Yesterday I took another 4 and today I plan on cutting it down to 2. I'm hoping within the next week or 2 I can ween myself off this medication. I really want to get through my pregnancy being unmedicated. Now I have heard of plenty of women that continued thier suboxone, switched to subutex or methadone and their babies came out fine. Some babies went through the withdrawls and some didnt, those that did only lasted a week or 2 and they were mild withdrawls. But this just is not an option for me. I guess my question is that does anyone think I can kick this within a couple of weeks? If I am able to stop my meds within the next couple of weeks will my baby go through withdrawls when its born?


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PostPosted: Sat Oct 17, 2009 12:01 am 
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Dear needadvice-

Welcome to the site.Let me first inform you that I am not a medical professional and anything I offer is strictly my advice based on my own personal experiences or those of others. You should discuss thi with your doctor to be 100% sure.
Normally, when a woman becomes pregnant she is switched to Subutex. Here is a link to a wide array of information about Sub and pregnancy:
AS Pregnancy and Suboxone

Trying to taper and quit while pregnant is dangerous without a doctor's care. The stress that it causes could be harmful to the pregnancy, again I strongly urge you to not leave this in your own hands. I totally understand wanting off the meds, but your overall mental health and well being is so important on so many levels.
I miscarried last year due to stress.I had switched to Subutex and was just under a great deal of stress while planning a wedding,work, etc- don't make that mistake.This is a time to make sure you are comfortable.

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"It is never too late to be what you might have been!" - George Eliot


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 Post subject: 4 weeks preg
PostPosted: Sat Oct 17, 2009 12:13 am 
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Thank you so much for your reply. I know your right, I know I'm being stubborn. My biggest issue is I dont want to pass withdrawls to the baby after he/she is born. Having the guilt of that would be really hard for me. Thank you so much for the link, I will definatly check it out. I'd also like to say I'm so sorry about your loss, theres nothing worse than losing a pregnancy.


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PostPosted: Sat Oct 17, 2009 2:52 am 
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I've read that its considered safer for the baby to go thru withdrawals after it is born than to go thru them in utero.

I definitely second shel's advice. Dr Junig has also written on his blog about pregnancy and suboxone. Good luck.

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 Post subject: Some support...
PostPosted: Sat Oct 17, 2009 2:41 pm 
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I am new to this site and not a medical professional. I want you to know I did the exact same thing as you when I was in my first few weeks of pregnancy. I tried to wean off but went absolutely crazy! It was really difficult for me but I made the decision to continue on Subutex after much research and discussion, with my husband and medical professionals who are familiar with the effects of this medication. I can say that it is of the utmost importance to only speak to people who know what they are talking about. This is a decision only you can make, afterall is you who has to deal with the consequences of the decision. I have the same concerns regarding the health and wellbeing of my baby that you have expressed. I wish you well and just wanted to let you know there are other women out there dealing with the same issue! Hang in there and I know you will get through this.


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PostPosted: Sat Oct 17, 2009 3:15 pm 
Congratulations on your pregnancy! What an exciting (and anxious) time this is for you! I was an RN for nearly 20 years - all of my experience was in women's health/labor and delivery. However, I am not an expert in issues related to addiction or problems associated with newborns of addicted mothers. Having said that, I will strongly suggest that you work closely with your Sub doctor and your obstetrician to work out a plan of action regarding your medications.
As far as stress causing miscarriage - This has been a controversial issue for many, many years. One school of thought says that stress absolutely has no adverse consequence on pregnancy outcomes, while the other says that yes it can lead to poor outcomes. Many studies have been done on the matter - none that I'm aware of with any conclusive results. Suffice it to say that stress + pregnancy is simply not good. Whether it actually can cause you to lose your pregnancy is highly debatable. We do know that the vast majority of early miscarriages are caused by a failure of proper development in the embryonic stages having to do with genetic issues over which we have zero control.
I can tell you that from my experience as a nurse, I have seen beautiful outcomes even when babies have been exposed to drugs/alcohol, trauma and stressors of huge proportions at different stages of pregnancy. On the other hand, I have seen sad outcomes when everything should have been "perfect" - no stress on mom, great nutrition, etc etc. There are just some things we have no control over and that we will never understand.
In any event, you now know that you are pregnant and you are seeking to do everything within your control to ensure that you have a healthy baby. Good for you! I understand how much you would like to be off all medications, but that seriously is not likely in the best interest of you and the baby. You will not be doing that baby any favors by going cold turkey off Subxone and being a basket case for the next several weeks or months. Consult with your doctor and get switched to Subutex (I believe that is the standard of care), look at getting yourself down to maybe 2mg/day (you'll probably do fine on that dose) and maybe you'll be able to taper even further over the next couple months. If you are down to a nice low dose by the time you deliver, it is my understanding that w/d in the newborn should be minimal. Hopefully, you'll be able to taper and maybe even wean off completely before the baby is born.
The most important thing is that you take care of yourself - this baby needs you for everything! You have to be healthy and feeling good in order to grow a good baby and in order to take care of him/her after birth. Pregnancy and postpartum is an emotional roller coaster even when it's a planned and happy thing. So the last thing you need is to throw yourself into a mess by quitting your Sub. Just take a deep breath and have faith that everything will be alright.
I'll be praying for you and your little one! Feel free to PM me any time.


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PostPosted: Thu Nov 05, 2009 3:14 am 
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I weaned down and stayed on three mg Subutex. I quit cold turkey when I discovered I was pg and it was really stupid. When I called my doctor, sick as a dog, delirious from insomnia, he yelled at me for doing something so dumb. He researched it and said Subutex was the best thing. I never took even a Tylenol with my first two pg. I felt soooooo guilty. However, the stress of withdrawal on your body is pretty severe and it got me to wondering how a pregnancy could even survive such intensity. I worried my whole pg and then had a perfect baby, who had no w/d. It was as if she hadn't even gotten any of the Subutex because she was actually the happiest of my three babies. She's also the smartest, but I don't let that slip out ;-) Now that she is two and speaking sentences and obviously so normal, I believe I made a really wise decision and I wish I had enjoyed my pg instead of letting it become the longest and worst nail-biting months of my life. I've read and read and asked questions and I'm starting to see that more and more women are being placed on Subutex when they get pg, instead of Methadone. And I have only heard positive reports. I did space my three 1 mg doses 8 hours apart and drank a lot of water. Good luck. I am very skeptical typically but I truly believe Subutex in reasonable doses is ok in pregnancy and I hate that we women torment ourselves so badly.

Laddertipper


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PostPosted: Wed Nov 11, 2009 12:48 am 
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Congrats on the pregnancy!! It looks like you and I are about at the same point in our pregnancies which is cool :D I agree with everyone else...and went through these same worries as well. I was going to get off of opiates cold trkey, and planned on having my husband locking e upstairs, bring me food, etc.etc. Then my psychiatrist told me absolutely NO. He said whatever withdrawl I feel will be 100 times worse for thr baby. When he told me to do opiates for another day, and then come in in two days to start subutex, I looked to my husband and asked him if it was ok with him bc we had planned on me stpping cold turkey the next day...not go home that night and do opiates and then do opiates all day the next day. Then the psychaitrist asked us "Do you WANT this baby or Not?" and I could see the seriousness in his eyes so we opted for subutex. He specializes in addiction which I think is some kind of miracle since I only started seeing him for depression. He just about jumped out of his skin when I found out I was pregnant and I told him sobbing that I had been heavily addicted to opiates for 3 years.

Anyway, try not to worry and try to find a good ob-gyn that specializes in adddiction and high risk care. I have to deliver at a hospital that I absolutely hate, but they specialize in this kind of thing, and I was told that the other hospitals are only good at taking care of preeclamsia and things of that nature as far as high risk is concerned. So I am giving up on this hospital stay as being the magical time that it should be, and I am doing it all for the little baby. It will be worth it in the end, and after he/she is here, I will ween down off of the subutex very slowly. Then I will avoid opiates in all shape and form like the plague!

Good luck and keep us posted. PM me if you ever want to compare pregnancies or talk about what is going on with each other. I have an appointment at the high risk addiction clinic on the 18th of November, and I will let you know how that goes. I am not too worried about it though, I am not expecting them to find anything abnormal.


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PostPosted: Sun Nov 15, 2009 1:53 am 
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Good answers all around. I have a few articles about pregnancy on my blog (Suboxone Talk Zone) that you will find by searching under 'pregnancy' on there-- but understand that there are no true 'studies' in the sense of randomizing women to one group or another group; such a study would never be deemed ethical. So instead we have retrospective studies, which are never as accurate or as good at finding answers that are not 'biased'. For example, if you look at pregnancies of women on bupe vs those not on bupe, you will always have socioeconomic differences and other differences between the groups besides the bupe. The addicts who are on bupe, for example, have things 'going for them'-- they are doing the right thing, so they are probably more likely to be eating right and sleeping right. On the other hand, you could guess that women on bupe are more likely to have been at a rock bottom of some sort, and so have been through worse situations in life overall, including going through things that may have left them more likely to miscarry. So we try to do 'matched control' studies where the bias is removed, but just doing that introduces even more bias, as now you have a human adding an opinion to the study that may or may not be valid. The bottom line is that there is no way to get good research on the issue.

On the other hand, most untoward events during a pregnancy is recorded and collected and huge databases of information are set up that look for connections between fetal abnormalities and medications. Who collects the data? Many different agencies and systems. Some are voluntary-- any doc can go on the FDA site and register a concern. Others are automatic; hospitals collect numbers on complications and on fetal abnormalities. The result is that if something happens in significant numbers it almost always gets noticed pretty quickly. If there was an increase in fetal malformations, for example-- which now are pretty uncommon-- someone would be looking for the reason by now.

Remember that w/d is not so much PHYSICAL discomfort, as it is mental thoughts and feelings that the baby will NOT have. You feel ashamed for using, and you feel guilty and afraid when you are in withdrawal... your baby feels no shame or guilt, as it knows nothing about society's attitudes about drug addiction. The most important thing you can do after delivery is keep your cool when someone tries to make YOU feel guilty because your baby is crying. ALL NEWBORNS CRY! I have seen cases where the baby from a mom on buprenorphine is doing the 'best', and everyone goes 'tsk tsk' whenever the baby cries! Try to realize that you didn't ask to be addicted to opiates. Yes, you may have made mistakes-- but everyone makes mistakes, and you have already paid for yours through hours of sickness and days of self-disgust.

To be a good mom, you will want to search out your demons and deal with them-- that includes facing up to any shame you are feeling and dealing with it. Find someone-- a therapist, a friend, or a tele-psychiatrist like me :D --talk out those feelings. If you feel ashamed of yourself, you will have a harder time giving your child the love that he/she deserves.


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

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