Is it safe to treat opioid use disorder with Methadone while pregnant?

Posted by kaylaslone1213 @kaylaslone1213, Aug 28, 2023

I am 11 weeks pregnant and have been on methadone since week 6. Can I tapper off methadone and start Subutex? Is Subutex safer for unborn babies?

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I don’t know. Congratulations on the pregnancy!

I’d like to offer what I do know: kratom is not recommended for pregnancy and it will affect the baby.

I only replied because a similar question on a kratom chat got some former heroin users asking what happened when they switched to kratom for the pregnancy. “Why was the baby born addicted?” They were very upset about having been told otherwise (at the time, multiples of people claimed their entire families were born with kratom use and no problems).

Use caution with subutex. Although helpful for getting off opiate meds, then you gotta get off this synthetic one eventually and it’s MUCH MORE DIFFICULT for adults to get off the subutex and it’s no free ride with expensive monthly dr bills (to authorize refills) and the meds themselves. I don’t know if it’s safer for babies, but I would HOPE SO for all of the negative effects I’ve heard about with that medication, I have not tried it personally.

I have NOT lived in your shoes.

IF they tell patients about the impending addiction associated with subutex, suboxone, tomato, tomatoe.. and expense associated with the monthly required Dr visits and the cost of the meds themselves, worth looking into.

You AND YOUR BABY deserve real help to minimize possible complications.

But that’s easy to say as someone not in your shoes. 🤗

Sounds like a lucky baby is on the way!

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I believe the OP was asking about methadone, not Subutex and certainly not kratom.
In any case, it's not good for the baby to undergo rapid withdrawal from opioids ("detox") while pregnant. Taking methadone or buprenorphine consistently under medical management is best; the "neonatal abstinence syndrome" is usually not nearly as severe as portrayed in the popular press and has even been managed solely by cuddling, sugar water and frequent nursing without any medication being needed.

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Hi @kaylaslone1213, I join @laurie6 and @trainwreck54 in saying congratulations treating the opioid use disorder and the pregnancy.

You are asking which is safer during pregnancy when treating opioid use disorder: methadone vs. buprenorphine (Subutex).

- Buprenorphine versus Methadone for Opioid Use Disorder in Pregnancy https://www.nejm.org/doi/full/10.1056/NEJMoa2203318
In this recent study from 2022, researchers found that buprenorphine (Subutex) had lower risk of side effects for the baby and that both medications had the same risk for moms.

Excerpt:
"Opioid agonist therapy is strongly recommended for pregnant persons with opioid use disorder. Buprenorphine may be associated with more favorable neonatal and maternal outcomes than methadone, but existing data are limited. ...
The use of buprenorphine in pregnancy was associated with a lower risk of adverse neonatal outcomes than methadone use; however, the risk of adverse maternal outcomes was similar among persons who received buprenorphine and those who received methadone."

Here's more information
- Treatment for Opioid Use Disorder Before, During, and After Pregnancy https://www.cdc.gov/pregnancy/opioids/treatment.html

Methadone treatment was a good choice for treatment. There may be risks to tapering one treatment to start another during pregancy. This is best discussed with your doctor who knows you and who will discuss pros and cons with you. I know you want to do the right thing for your baby. It's a good question to ask.

How are you doing today?

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Yes, please keep us updated on how you are. The beauty of many of these boards is that they have people who actually do care, lurking around.

Hopefully you’re healthy and fine 🙂

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It’s been a few weeks. How are you and baby doing?

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