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Detoxing From Drugs While Pregnant

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 10/14/2020

Number of References: 21 Sources

Aside from the obvious risks of drug exposure, detoxing from drugs while pregnant comes with its own set of risks. These can include immediate risks to the mother and the fetus, as well as possible birth defects or complications which can affect a child for the rest of their life. In this article, we will look at specific risks associated with detoxing from drugs while pregnant and the steps a pregnant woman may take to minimize these risks.

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The Importance of Detox

The drug withdrawal process is extremely hard on the body and mind, even in the best circumstances. During pregnancy, this is especially true. The added physical stresses of pregnancy can compound any dangers produced by drug detox and subsequently increase risks for both mother and child. During detox in general and especially during pregnancy, it is crucial to seek medical help.

Aside from risks to the life of the mother, unsupervised drug detox can have extremely damaging, or even fatal, repercussions for the child. This is due to the physical and neurological changes which are produced during acute drug detox. Medical help such as supervision, symptoms reduction, and proper medication may reduce the risks to the mother and the risk of suffering a miscarriage.

A study published in 2015 found that of 152 women who had been using drugs when they discovered that they were pregnant, 83% of these women did quit using drugs for the remainder of their pregnancy. There was quite a delay between them discovering their pregnancy and sustained abstinence. There were differences for specific drugs, but the average times till abstinence were:

  • Marijuana: 151 day average between pregnancy awareness and abstinence
  • Cocaine: 149 day average between pregnancy awareness and abstinence

While abstinence was achieved eventually, prolonged use beforehand certainly increased the risks to the unborn child. Most of the vital organs, including the brain, undergo substantial growth and development in the first trimester, so it is very important to the child’s health to quit drug use as soon as possible during pregnancy. Admission to a professional drug detox facility soon after the awareness of a pregnancy, or ideally prior to conception, may greatly reduce the risks to both the child and the mother.

Complications of Drug Withdrawal During Pregnancy

Drug withdrawal can be extremely rough on the body and mind even in clinically “perfect” circumstances. Detoxing from drugs while pregnant can worsen these symptoms and the consequences can become greatly amplified. While withdrawal symptoms differ from drug to drug, the hormonal and physical changes undergone during pregnancy can make withdrawal more disruptive to both the mother and the child.

Undergoing detox in a medically supervised manner while pregnant may greatly reduce the overall risks to both the mother and child. Continuing to use drugs while pregnant will greatly increase the chances of a negative outcome, and having medical help and supervision throughout the detox process will minimize the risks as much as possible.

Methamphetamine Withdrawal During Pregnancy

While methamphetamines do not produce physical withdrawal symptoms, the mental experience of meth withdrawal can be agonizing. This experience is amplified during pregnancy due to the way meth works and the neurological imbalances which arise from prolonged meth use. Dopamine is the main mechanism by which meth exerts its effects. Meth has been estimated to cause dopamine levels to rise somewhere between 100s-1000% during use. Meth withdrawal symptoms such as deep depression, fatigue, and lethargy are caused directly by dopamine sensitivity being lowered in the brain and body due to the chronically high levels produced through meth use.

During pregnancy, dopamine levels in the amniotic fluid remain very steady for most of the pregnancy and more than double during the 3rd trimester. The dopamine insensitivity during meth withdrawal reduces the brains’ response to dopamine as well as the body’s ability to reliably stabilize these levels during pregnancy. While it takes roughly 10 days for dopamine levels to be replenished in a healthy non-pregnant adult, there are no rigorous human studies as to this timeline during pregnancy.

The normal mood swings and hormonal imbalances which are common during pregnancy may be compounded by the deep depression caused by meth withdrawal. This is very serious, as an already emotionally fluid pregnant woman may tend toward depression and increases the chances of experiencing postpartum depression. This is especially dangerous during pregnancy, as suicide attempts have been directly linked to meth withdrawal in non-pregnant women as well as men. Adding the emotional swings from pregnancy makes this risk greater and the repercussions more serious.

Opiate Withdrawal During Pregnancy

Opiate withdrawal, while not fatal, is an extremely painful and exhausting process. The chaos this causes in the body is profound, and can often require medical treatment. The biggest health risks due to opiate withdrawal are dehydration and insufficient nutrition. When someone detoxes during pregnancy these risks are increased.

There are opiate receptors not only in the brain but also in the gastrointestinal tract which help to moderate digestion in the intestines. During opiate withdrawal these receptors temporarily lose the ability to slow digestion, resulting in severe abdominal cramping, diarrhea, and dehydration. Due to the increased nutritional stresses of pregnancy, this may increase risks for mother and child.

Finally, unmonitored opiate withdrawal during pregnancy can lead to a series of serious conditions that can possibly be fatal for the fetus and mother alike. Some of the greatest risks include premature labor and miscarriage. Due to this, it is highly recommended for someone to enter medical detox if they will experience opiate withdrawal while pregnant. Medications that are safer for the fetus may be used to reduce the severity of withdrawal symptoms and greatly reduce the risks.

Benzodiazepine Withdrawal During Pregnancy

Withdrawal from benzodiazepines may present the most dangerous symptoms out of any of the drugs discussed in this article so far. Under normal conditions, benzodiazepine withdrawal can be fatal if not done in a medically supervised setting. The symptoms of benzodiazepine withdrawal are both physical and psychological in nature, resulting in altered mental states as well as cardiovascular abnormalities.

Benzos work in a similar way to alcohol and therefore have similar withdrawal symptoms. Blood pressure and heart rate fluctuations may pose the greatest direct threat to both the mother and the fetus. During pregnancy, blood pressure is typically heightened. The addition of withdrawal symptoms only heightens the possibility of negative cardiovascular outcomes in the form of stroke, cardiac arrest, or placental abruption.

Aside from these physical conditions, there is a severe risk of seizure as well. A seizure in and of itself may only pose a risk to the brain of the mother, but the unexpected and unpredictable nature of benzo withdrawal seizures can lead to dangerous falls or accidents which can be fatal for the fetus. Delirium is also common during benzo withdrawal and can lead to any number of accidents. Entering a medical detox during benzo withdrawal is by far the safest way to undergo benzo withdrawal successfully and safely.

Which Drugs Are Most Damaging To Pregnant Women?

The risks of detox during pregnancy are often higher than detox without carrying a child, but the exact degree of risk is largely dependent on the drug someone is detoxing from and their use habits. Probably the greatest threats to both the mother and child would be either stimulants or opiates, albeit for different reasons.

Most drugs are able to transfer through the placenta and enter the body and brain of the growing fetus. This can have severe, lifelong repercussions for the child and subsequently increases the risk of miscarriage, fetal growth delays, SIDS, birth defects, and a whole host of health complications for the mother. Some of these risks which endanger the mother as well include premature birth, placental abruption, and heavy postpartum bleeding.

For an in-depth look at the specific risks of detox from different drugs during pregnancy, let’s look at few in turn:

Methamphetamines

Meth is one of the most dangerous drugs known, both from a physical and mental perspective. During pregnancy, meth can be particularly dangerous. In the case of the mother, the usual risks of meth use apply, such as heart attack, stroke, psychosis, overdose, and death. For the child, there are additional risks since their brain is still developing. Meth use causes levels of the neurotransmitter dopamine to increase greatly, and this can produce lasting effects on a developing brain.

Some of the most common effects on the children of mothers who meth use during pregnancy result in:

  • Lethargy and lower levels of stimulation in general
  • Delayed motor skills (children are late to crawl and walk)
  • Increased stress response and overall stress levels
  • Increased risk for ADHD
  • Cognitive and behavioral problems

The issues listed are all neurological in nature, but there is also an increased possibility for physical birth defects as well. Even though meth is sometimes used as a prescription medication in the form of Desoxyn, any levels of meth use during pregnancy will increase the risk of health issues for the child and the mother. The FDA has listed Deoxyn, and methamphetamine in general, as “Pregnancy Category C” which means that it has been shown through animal studies to cause abnormalities and/or death in a developing fetus if taken during pregnancy, although if the benefits outweigh the risks then it may be used.

Opiates

Opiates are some of the most addictive drugs and awareness about their risks have spread due in large part to the opiate crisis in America. This class of drugs can be dangerous if used during pregnancy. Opiate abuse poses certain risks to the wellbeing of the child, but also pose a great danger to the mother as well through an increased risk of birth complications.

Some of the most common issues which have been reported in connection with maternal opiate abuse during pregnancy include:

  • Spina Bifida (spinal cord birth defect)
  • Hydrocephalus (excess fluid, and subsequent pressure, in the brain)
  • Neural Tube Defects (the embryonic form of the central nervous system)
  • Congenital Heart Defects

While these issues are all physical in nature, opiate use during pregnancy is capable of increasing the risk of a variety of mental and cognitive issues in newborns as well. Additionally, opiate withdrawal in newborn babies is very real and unfortunately common and is a horrible introduction into the world. The FDA has classified all opiates, with the exception of oxycodone, as “Pregnancy Category C” which means that animal studies have shown that use during pregnancy results in adverse health effects on the fetus. That being said, if the benefits of these drugs outweigh the risks then use may be recommended.

Benzodiazepines

Benzodiazepines (benzos) are commonly used to treat anxiety disorders and it is known that acute benzo withdrawal can be fatal. They can produce physical dependence within weeks of regular use and the effects of even minor withdrawal are quite unpleasant.

While studies vary greatly, there are several health complications that are frequently seen associated with benzo use during pregnancy. Some of these include:

  • Increased Risk of Spontaneous Abortion (miscarriage)
  • Low Birth Weight (this usually normalizes by 1 year)
  • Small Head Circumference
  • Microcephaly
  • Cognitive Deficits

While diazepam is the only benzo that has been studied exhaustively with regards to pregnancy, it shows some worrying characteristics. Namely, diazepam more easily binds with the fetus’ blood protein than it does with the mothers, leading to higher levels of diazepam in the placenta and fetus’ body than in the mother. This increases the risk of toxicity and further birth defects even when it is administered to the mother in therapeutically safe doses.

The FDA has labeled some of the most commonly used benzodiazepines as a “Pregnancy Category D” which means that there is evidence of risk to the fetus if benzos are used during pregnancy. There are several less commonly used benzos that received the label “Pregnancy Category X” which means that there is clear evidence of fetal risk in humans and that the risks of these drugs clearly outweigh the benefits.

Find a Drug Detox

Detoxing from drugs while pregnant can be a very scary experience. With medical help, this can be done in the safest and most comfortable way possible for both the mother and child. Having competent medical care can also greatly reduce the anxiety and fear involved in detox. Finding a detox center can be a challenge as well, but luckily that is exactly what we are here for; to make the process as easy as possible. Pick up the phone, or just enter a zip code below to start a guided detox search.

References For This Article

  1. 1 Jacobs Institute of Women’s Health: Pregnant Women and Substance Use - Overview of Research & Policy in the United States
  2. 2 Drug and Alcohol Dependence: Perinatal Substance Use - A Prospective Evaluation of Abstinence and Relapse
  3. 3 Neurotoxicology and Teratology: Prenatal Methamphetamine Use and Neonatal Neurobehavioral Outcome
  4. 4 Neurotoxicology and Teratology: Prenatal Methamphetamine Exposure and Neurodevelopmental Outcomes in Children from 1 to 3 Years
  5. 5 Journal of Developmental and Behavioral Pediatrics: The Effect of Prenatal Methamphetamine Exposure on Attention as Assessed by Continuous Performance Tests - Results from the Infant Development, Environment, and Lifestyle Study
  6. 6 Therapeutic Drug Monitoring: Risk for Neurobehavioral Disinhibition in Prenatal Methamphetamine-Exposed Young Children with Positive Hair Toxicology Results
  7. 7 SAMHSA: Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  8. 8 American Journal of Obstetrics and Gynecology: Maternal Treatment With Opioid Analgesics and Risk for Birth Defects
  9. 9 F1000 Research: Substance Use During Pregnancy
  10. 10 Obstetrics & Gynecology: Periconceptional Use of Opioids and the Risk of Neural Tube Defects
  11. 11 Merck Manual Professional Version: Prenatal Drug Exposure
  12. 12 Merck Manual Professional Version: Drugs In Pregnancy
  13. 13 FDA AccessData: Desoxyn (Methamphetamine Hydrochloride) Label
  14. 14 FDA AccessData: Oxycontin (Oxycodone Hydrochloride) Label
  15. 15 FDA AccessData: Valium (Diazepam)
  16. 16 Journal of Pediatric Genetics: Prescription Opioids in Pregnancy and Birth Outcomes - A Review of the Literature
  17. 17 JAMA Psychiatry: Association Between Incident Exposure to Benzodiazepines in Early Pregnancy and Risk of Spontaneous Abortion
  18. 18 Journal of Clinical Psychiatry: Gestational Exposure to Benzodiazepines - The Risk of Spontaneous Abortion Examined Through the Prism of Research Design
  19. 19 Psychiatry Online: Effects of Commonly Used Benzodiazepines on the Fetus, the Neonate, and the Nursing Infant
  20. 20 The Journal of Clinical Endocrinology & Metabolism: Dopamine and Prolactin in Human Pregnancy
  21. 21 American Journal of Obstetrics and Gynecology: Detoxification from Opiate Drugs During Pregnancy

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