Is Opioid Detoxification in Pregnancy Safe?

Doctors use the term detoxification to describe a quick treatment program that moves you from opioid use to sobriety, usually without providing medication for addiction treatment (MAT). While quitting “cold turkey” in this way is an option, it does not address an individual’s opioid use disorder long term, and evidence shows that many individuals will simply relapse to use after detoxing.

Instead, Medication for Addiction Treatment (MAT) offers a more long term solution to help prevent people from returning to opioid use, including pregnant women.[1]

MAT drugs such as buprenorphine and methadone are safe for pregnant women, and are particularly helpful in keeping pregnant women away from opioids and supporting them in recovery during pregnancy which can be a very high risk and vulnerable time. 

Treatment Is Safer Than Opioid Misuse for Pregnant Women

Misusing opioids during pregnancy comes with a number of incredibly serious risks for both mothers and babies.

For mothers, opioid risk increases risk of maternal infections, injuries and respiratory depression and overdose.

Opioid use disorder (OUD) has been linked to these serious problems in babies:[2]

• Poor or slow growth
• Early birth
• Stillbirth 
• Birth defects

In addition, opioid drugs pass from a mother's body to her baby during pregnancy, leaving babies at risk for also being chemically dependent on opioids after birth. This is a condition called neonatal abstinence syndrome.

Experts from major authoritative bodies recommend MAT for the treatment of OUD in pregnant women. 

How Pregnancy OUD Treatment Works 

No woman should stop taking opioids abruptly during pregnancy. Instead, they should be offered MAT treatment to help control cravings and prevent relapse. [2] In addition to medication, they should be offered to counseling and support groups to learn more about cravings, building a sober life, and staying healthy.[3] Your work here could help you avoid relapse.

Moving through medically supervised detox might seem quicker (and easier), but studies show that women often drop out of these programs or relapse when they’re done.[4]

Pregnancy is a particularly vulnerable time, so the more support available - both psychosocial and medication - is ideal to support you during a pregnancy. 

What Medications Can I Use for OUD during pregnancy?

Experts study prescription medications carefully before recommending them during pregnancy. At the moment, two therapies have been approved for pregnant women.

Methadone and buprenorphine are considered first-line treatments for pregnant women.[5] They are safe to use during pregnancy, and they're not associated with serious problems in developing babies.

Historically, combination medications like Suboxone were avoided in pregnant women because it was unknown if the Naloxone component could be dangerous in pregnancy. [6] More recently, however, the U.S. Food and Drug Administration has approved Suboxone use during pregnancy as the risks of Naloxone seem to be negligible. [7]

If you are pregnant and struggling with an OUD, talk to your doctor about finding MAT treatment that is right for you.

Sources

1. Opioid Use and Opioid Use Disorder in Pregnancy. The American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08/opioid-use-and-opioid-use-disorder-in-pregnancy. May 2012. Accessed July 2022.
2. About Opioid Use During Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/opioids/basics.html. July 2021. Accessed July 2022.
3. Overview of Management of Opioid Use Disorder in Pregnancy. UpToDate. https://www.uptodate.com/contents/overview-of-management-of-opioid-use-disorder-during-pregnancy. November 2021. Accessed July 2022.
4. Opioid Detoxification During Pregnancy. Obstetrics and Gynecology. https://journals.lww.com/greenjournal/Abstract/2018/05000/Opioid_Detoxification_During_Pregnancy__A.8.aspx. May 2018. Accessed July 2022.
5. Treatment for Opioid Use Disorder Before, During, and After Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/opioids/treatment.html. July 2021. Accessed July 2022.
6. Naltrexone Use in Pregnancy: A Time for Change. American Journal of Obstetrics and Gynecology. https://www.ajog.org/article/S0002-9378(19)31055-5/fulltext. January 2020. Accessed July 2022.
7. Prescribing Information Suboxone Film. U.S. Food and Drug Administration. https://www.suboxone.com/pdfs/prescribing-information.pdf. June 2022. Accessed July 2022.