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PostPosted: Fri Jun 10, 2016 1:09 am 
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I'm 29 weeks pregnant. I've been on suboxone for about 5-6 years. I've always been prescribed it legally and when I got pregnant they switched me to subutex. I would really like to be off of subutex all together by the time I deliver. But I feel like I'm having a hard time getting lower than 1mg. I've tried to take .5 and I can't sleep. Feel like my insides wanna jump out. I just could really use some advice on how I could taper down by 35-36 wks so I'm off by due date. I don't wanna deal w the stigma in the delivery room of being on subutex while pregnant. And I'm also scared that cps is going to get involved. My ob/gyn knows I'm on it. They also communicate w my subutex dr. Any advice would be greatly appreciated. I'm just super nervous as this is my first and I wanna do what's best for my baby girl.


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PostPosted: Fri Jun 10, 2016 2:02 am 
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Well I can't speak much to the pregnancy but as far as the taper goes if your having trouble going from 1.0 to .5 then just try and do .75 and once u are ok there then try going to .5 or even less of a jump if that's a problem. Like .9 then .8 and so on. I had a lot of trouble getting from 1.0 to .5 myself and lowest I think I got before I jumped was around .6 but some people are able to get a lot lower just depends.


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PostPosted: Wed Jun 15, 2016 12:38 pm 
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I know you want something else.... but this is just not the time to go off buprenorphine. Right now your baby's brain is developing at a very fast pace... and his/her need for nutrition will never be more important than it is now. You need to have steady levels of glucose, essential amino acids, fats... and you just can't do that in the middle of opioid withdrawal. There may also be an increased risk of preterm labor if you go through withdrawal.

I've written this before--- but CPS has no interest in raising a child in place if the child's mom, as long as the mom isn't actively abusing drugs. If you are in withdrawal and then out of desperation use oxycodone, and THAT shows up in your urine, you will have real problems. Understand too that at 29 weeks, you may still be in withdrawal when you deliver, since it takes 2-3 months to get back to normal.

At a low dose of buprenorphine, your baby has less than a 50% chance of having withdrawal symptoms-- and those symptoms are almost surely going to be mild, if they do happen.

Of course the issue will then become, 'so when DO I stop?' I don't have a good answer to that question. Ideally the stopping would have happened before the pregnancy-- but now that you are pregnant, you are committed to providing a healthy environment for your baby-- both before and after you give birth.


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Dr. Jeffrey Junig, M.D., Ph.D.

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