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PostPosted: Sun May 01, 2016 6:41 pm 
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I am new to this forum, so first here is what is going on. I am 17 weeks pregnant and have been addicted to opiates before pregnancy for many years. This pregnancy was unexpected, but my bf and I are very excited and happy. Before I found out at around 8 wks, I was still using so I of course felt horrible and guilty, and immediately made an appointment to get on subutex. I didn't want to go back on methadone, although it had helped me in the past, it was so hard and miserable to get off of. Also, it is so expensive and more convenient compared to the once a month office visit to get a script for subutex. I had tried suboxone in the past too, an didn't have much luck staying clean but I figured I would try the subutex. Since I have been on the subs, my bf and were doing pretty good. I still have cravings pretty bad, and drug dreams,etc. I am also on permanent disability for chronic back and neck pain, after a car accident, migraines, bipolar disorder, panic disorder, fibromyalgia,etc. I stopped taking all my meds also, when I found out I was pregnant. I didn't reaize how hard this was really gonna be! I have been severely depressed, and constantly lethargic and exhausted all the time. My migraines and back pain are ruining my life! I don't know what to do! We also have a lot of financial issues, and are both living at my parents, trying to save up in the next few months, so I am super stressed out too. I feel like I can't even function day to day!! I feel useless and lazy and basically uninterested in life, and can barely get out of bed! How am I gonna care for a newborn? I know my hormones are making it worse too.I made an appointment for a new intake at my old psychiatrist and therapist for next week. I just feel so hopeless, and I am so afraid of relapsing. I also wanted to taper off the subutex, before I deliver as my ob and Dr said it is better to stay on it, but I don't want cps or dyfs involved. Does anyone know the laws in NJ, if they can take your baby, or even get involved if I am trying to do the right thing and havea legit script? I have also been sharing my subs with my bf, because we cant afford two dr visits. I am now on 4-6mg a day. Does anyone have any input or advice? Please help! Thanks


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PostPosted: Sun May 01, 2016 8:22 pm 
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The chance that you are going to stay completely clean if you taper off buprenorphine is very low. I can't imagine CPS getting involved if you are following a doctor's care-- although they WILL get involved if they learn you are sharing your script, and your doc will likely discharge you. So your bf should be doing everything he can to find a job, and to get his own doctor. Over the next few years you are going to develop protective feelings toward your child that will be far-stronger than anything you've felt for a partner... and you will understand that you don't need extra mouths to feed or to leech off your medication. If he is working already, that's good for him-- and hopefully he will help support your family.

One of the biggest challenges for people on disability is that they have way too much free time. The baby will help with that-- but before the baby comes, you will drive yourself nuts if you don't find things to do. Since you are on disability, you have less obligation to earn an income-- but that income becomes a trap, since virtually every psychiatric disorder gets worse when a person is off work. People also have more migraines when they don't have a regular routine that gets them out of bed each morning. So while you will likely get a lot of advice about working a program, avoiding triggers, dealing with cravings, etc, the thing that correlates the most with positive outcomes, from all I've seen, is whether the person is getting out of the house each day, facing challenges, standing up to her fears, etc. THOSE are the things that keep a person from a life of despair.

As for buprenorphine, it will protect you from bad behavior for the most part. But don't expect it to do everything. When your mind turns toward using, quickly take on some other task. Pull your mind away for 5 or ten minutes.

CPS is there to help your child. They don't collect them and give them away! If you are honest from the start, you have nothing to fear.


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PostPosted: Sun May 01, 2016 9:25 pm 
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Welcome to the forum, Dawn. You just received awesome advice from Dr. Junig, who created our forum. He has helped thousands of addicts over the years, including pregnant addicts, so please take what he says seriously.

I'm going to play bad cop. Just know that I do have empathy for your situation, but I am about to advocate for your child.

First, your boyfriend needs to be working. Not just to get his own sub doctor, which you desperately need him to do, but to start getting ready for the work it takes to raise a child. He needs to get into a sacrificial mindset before he becomes a father. Raising a child is hugely difficult even when you feel totally prepared. The child deserves the best you have to offer.

Secondly, you should be thinking about what is best for the baby, not what is best for you. You've made awesome first steps toward this, but I see some potential trouble spots. You can not be sharing your sub with your boyfriend! If you are having cravings for your drug of choice, you should be on a higher dose. Right now it's more important for you not to relapse than it is for your boyfriend to have part of your medication.

Addicts are used to having the world revolve around them. Your desire to taper off sub before you have the baby isn't about what is best for the baby. Because staying on a steady dose and not having a relapsing mom is what is important to the baby. If your baby has a case of withdrawals after being born it will be put on a dose of opiates and then slowly weaned off according to how the baby is handling the detox. Dr. Junig is correct. If you are adhering to your doctor's recommendations CPS doesn't have a leg to stand on to take the baby.

If you aren't willing to put the baby first in these ways, maybe you should really consider whether you are actually ready to be a parent. There are plenty of great, loving adoptive parents waiting to raise a baby. Now, if this thought horrifies you, then be prepared to do something about it! If I'm wrong, prove me wrong! Start living for your baby as much as you can by considering what the doctor and I am saying. I'm being provocative on purpose. I want you and your boyfriend to be awesome parents!

I hope that you're doing well and feeling better. Please up your dose to stop your cravings. And I hope your boyfriend is ready to be a father to his child.

Amy

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PostPosted: Mon May 02, 2016 12:00 pm 
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Hi Dawn, I am new here but I thought I would chime in because I am a NICU nurse in the highest level NICU in our state. I say that to say we see it all on our unit. While I can not speak for your state specifically, in my state as long as the mom is honest from the very beginning - meaning making everyone aware that she is on subutex, and can provide documentation of that, as well as proof of working a program of recovery; while they may monitor, they will not take your baby away, AND may even be able to provide additional resources to help you while you are figuring out life with a newborn. Dr J is so right, it is only when moms are not forth coming, or participating in illegal activities (giving/selling their script to someone else) does CPS get majorly in mom's business big time, and start considering placement for the child. They are only looking our for your child's safety and as long as you aren't doing anything to raise red flags, are completely honest, and not using you should be fine. Dr. J is right, weaning now only increases you chance of relapsing. Also another thing to consider, the hospital will test your urine and the baby's urine. Additionally the hospital will test the baby's meconium which will tell if you've taken ANYTHING from 20 weeks on. I definitely don't want to scare you, because I can almost guarantee if you are completely honest, you won't have issues. However, since your at 17 weeks, use this information as motivation to do whatever it takes to not relapse, especially if you need to stay at your current subutex dose or even higher. Also, another reason to be completely honest is so the baby's doctor knows beforehand and is prepared to treat a withdrawal your baby. It's not as horrible as its portrayed to be - as long as the physician knows. Otherwise, a baby left to withdrawal on its own is horrible. Please whatever you do, and im not saying you would, but just because ive seen this attempted before, don't even consider trying to see if you can just go have your baby and not mention the subs. That never works out well for mom or baby, and usually results in CPS having a lot of questions and lack of trust that mom can take care of baby.
I hope I haven't overstepped my boundaries, and I hope this gives you direction, not fear. Stay on your sub, talk to your doc if you need a higher dose, don't relapse, and be completely honest with all involved when you deliver. They can treat your baby, which depending on the symptoms shouldn't take too long and provide resources that will be so beneficial to you as a new mom. God bless you and congratulations!!!


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PostPosted: Tue May 03, 2016 11:49 am 
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p4p-- is that right about testing the meconium? (for people who don't know, that's the stuff in the baby's intestine-- called 'poop' after delivery!) I was never part of the process at the NICU, and I've been out of hospitals entirely for over 15 years, so I have no idea what they do these days...
Do they test it routinely, or just in certain situations? And what do they generally test for-- drugs of abuse? And you said it goes back all the way to 20 weeks?

Is testing meconium done only in the referral centers, or is it part of the routine for all hospitals these days?

Thanks!


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PostPosted: Tue May 03, 2016 12:03 pm 
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http://ltd.aruplab.com/tests/pub/0092516
http://www.wardelab.com/22-1.html

I learn something every day I come here. I haven't delivered babies or been around a nursery for 25 years, makes sense since a fetus starts forming meconium during the 2nd trimester and stores it until delivery, or shortly before. Shortly before means stinky dangerous mess. thanks P4P


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PostPosted: Wed May 04, 2016 6:23 pm 
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Welcome to the forum, this is a great place to get support and talk to others that have been through the same situations.

Did you come off all your medicines without consulting with your doctor? Sometimes the positive effect on the mother out weighs the negatives from the mother not taking the medicine. For example, my cousin is on a high dose of Prosac and if she comes off of it she can't leave the house, obsesses, and doesn't act rationally. Because of what happened the last time she came off her doctor said her health outweighed the risk. My cousin had to do some extra ultrasounds and some tests to make sure that the baby was doing okay and healthy. She delivered a beautiful baby boy and there were no problems.

As for the Subutex, if you are already feeling this way while you are on the subutex then how do you think you will be if you come off of it? I agree with everyone that raising your dose might be needed, please tell your doctor's your fears and concerns and then he can help you.

I go to a suboxone doctor, a psychiatrist specializes in addiction, and my counselor is a substance abuse counselor. They are all in the same office and compare notes, without those 3 doctors I know that I would not be where I am today. Please open up to your doctors and do what is best for the baby.


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PostPosted: Wed May 04, 2016 11:49 pm 
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Dr. J, yes and no on routinely testing. Usually we will test if the birth was rough and/or very early and other obvious reasons (maternal hypertension, incompetent cervix) are ruled out. Erratic disruptive behavior, no hx of prenatal care and in some cases homelessness is often a clue as well. We are a teaching hospital in an area where methamphetamine abuse is high. Additionally usually on the second or even third day a baby will "come alive" when they are in full withdrawal. The nurses will do NAS as part of their assessment, it's pretty easy to pick out a baby in withdrawal, and bring the NAS results to the physician or NNP. Usually the baby is still passing meconium when they go into withdrawal and the provider can order a drug screen so we can collect the "goods." And yes, the meconium will tell us from approximately 20 weeks to birth. I wish more mom's knew this. I feel like it would help them to stand up to their cravings and ask for help sooner.


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PostPosted: Mon May 09, 2016 12:47 am 
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Thank you so much for all of your advice! I know it is better to stay on the subs, and better for the baby. At my last visit with my sub Dr, he cut me from 16mg a day to 8mg a day! I told him that I was still having cravings,etc and asked if that was too much to cut down half my dose at once and he said I would be fine. I go back this Friday, so I am gonna talk to him a bout going back up. My bf has found a job, 20-30hrs a week, ( not a great job, but certainly better than nothing!). I have been mentioning to him again and again that we really need more money, and he needs to man up, and try to get more hours or find a better paying job. He has only been working for a few weeks, and it was difficult for I'm to even find this job, so I don't want to constantly nag him. Also, I feel bad because I get disability and this is a high risk pregnancy, so I am no working at all right now, except selling a few things here and there on ebay,garage sales,etc. We have a great relationship, and he is my best friend in the world but we have had our issues, like any couple. I know this is all new and scary for him, so I don't want to nag him to death where he wants to run for the hills either! I know that he is excited about becoming a father, but I don't think the reality of it all has really sunk in yet. He is very immature and many ways, but also very intelligent and kind, and has a lot of potential to be a great father. He is also only 30, and I am 36, and is very good looking, which in my head makes me insecure that there are so many hot young women out there, why is he with me? (Sorry I am getting off topic) He wants to get his own script for subs because they have also helped him stay clean, but we just haven't had the money, and my car just broke down. Also I have an appointment to go for an intake with my old psychiatrist and therapist. I think it would help if I went back to individual therapy, or groups. Since I have been off my psych meds ( I have bipolar disorder, anxiety,etc) I find myself a lot more isolated, and anti social, and I know this is not healthy. I recognize that I need help, and knowing my history and myself better than anyone maybe the risk of me not taking meds outweighs the risks. (I have had several past suicide attempts, relapses when I had gone off my meds in the past) It is so true that most psychiatric disorders get a lot worse, since on disability and not working. The chronic pain and migraines make depression so much worse, and make it impossible to function, but since I have been on disability, I have no daily structure or routine, which does give me way too much free time for my mind to wander. I try to distract myself and keep busy. I am so grateful to be getting disability, because I can't imagine working the way I feel most days, so its a catch 22. The migraines have been getting so much worse lately too, since the pregnancy. I have a script for fioricet, but I only take it if I really, really need it. I know that in general addicts are almost always extremely entitled and selfish, and I have been very selfish. I want what is best for my baby, and I know I need to be realistic and take care of myself in order to give my baby everything I can, to give her a good life, and I pray that she won't make all the bad decisions I did! I already have a 15 year old son as well, so this is not my first rodeo. I was a single mom, and very young and not prepared to be a mom when I had him.I luckily had a very supportive family who helped me a lot with raising him. I feel so blessed to have even gotten pregnant this time, because I didn't think I could get pregnant. I just want my baby to healthy, and happy! Although this pregnancy was not planned, my bf and I planned on getting married and having a family, in the future and I am certainly not getting any younger so now is as good a time as any! Thanks again and it helps a lot to get honest advice! I have an ob apt tomorrow am so I will keep you guys posted! :)


Last edited by Dawn0813 on Tue May 10, 2016 9:04 am, edited 1 time in total.

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PostPosted: Mon May 09, 2016 1:07 am 
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Just a quick note before I go to bed!

You sound like you have really thought things through and have a good head on your shoulders. I feel a lot better about your future. :) I just wanted to let you know because I was pretty hard on you. I'll comment again soon more specifically!

Amy

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PostPosted: Tue May 10, 2016 9:29 am 
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Thanks Amy! When I first found this forum, I was overflowing with so much guilt and shame, and it helps a lot to receive honest advice from other addicts. I don't think you were being harsh, and I know that everything that you said is true. I would rather get an honest opinion, than just have people sugarcoat the situation and tell me what I want to hear. Being a parent is a huge responsibility, even for parents who totally prepared financially and mentally. I realize that my bf need to sacrifice our own needs, and try to be the best role models we can for this baby, so our lifestyles have to change. This disease has already destroyed so much of my life, and I wouldn't wish it on my worst enemy. I am trying to take it day by day, and made up my mind that using is not an option. I also know that as hard as it may be, if my bf isn't ready to grow up, and make the right decisions that I may need to also separate myself from him as well. So far, he has been doing good, but like I said before I don't think the reality has sunk in yet to him. I am hoping for the best, and of course I want us to be together, but I have to put myself and my recovery first, so that I can be a good mom.I made the decision to have this baby, and it is my responsibility be the best mom that I can be. I appreciate your honest advice and support and I am grateful that there are others who can relate and share their experiences and relate. Thanks again! :-)


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PostPosted: Tue May 10, 2016 4:02 pm 
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I tear up when I read your post. (Which makes it very hard to take my bupe and breathe through my nose at the same time!!!)

Dawn, you have the exact right attitude about your situation. I understand the feelings of guilt and shame, but I hope you are ready to forgive yourself. You are a wonderful mama already!

Amy

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PostPosted: Tue May 10, 2016 8:24 pm 
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The exchange between you and Amy was awesome! I feel like I really learn a lot on this forum.


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