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Detox and Pregnancy: Worth the Risk?
Detox (detoxification) is the common first step in dealing effectively with alcohol and drug abuse/addiction. It requires you to halt your uncontrolled substance intake and go through a gradual withdrawal process as drugs and/or alcohol leave your system. If you’re pregnant, you may wonder if the stress of detox will put you or your developing child at undue risk. Experts agree that pregnant women can successfully complete this process as long as they and their doctors take certain precautions.
Generally speaking, a woman can go through drug or alcohol detox at any stage of her pregnancy, the World Health Organization (WHO) reports. However, in order to safely detox while pregnant, an expectant mother must have access to the proper treatment setting. If your doctor identifies any medical issues that could alter the course of your pregnancy, you should go through detoxification in a hospital or inpatient facility whenever possible.
Doctors sometimes use medications that increase the speed of the withdrawal process during detox. This method can provide good results in a controlled setting if you’re not pregnant. However, pregnant women should avoid any method of rapid or accelerated detoxification.
Detoxing From Specific Substances
When you attempt to detox while pregnant, you and your doctor should be aware of the special considerations associated with different types of substances. For example, if you have alcohol-related problems, WHO guidelines recommend that you:
- Seriously consider detoxing in an inpatient facility
- Receive a short-term dose of a long-acting benzodiazepine sedative/tranquilizer if you go into withdrawal
- Receive thiamine or vitamin B1 while detoxifying (in most cases)
If you have opioid-related problems, WHO recommends that you avoid detoxing immediately from all opioid substances. Instead, whenever possible, you should receive inpatient opioid maintenance treatment based on the medication buprenorphine or the medication methadone. Studies indicate that buprenorphine poses lower risks for a newborn than methadone.
If you have benzodiazepine-related problems, WHO recommends that you:
- Consider going through detox in an inpatient facility
- Detox gradually by taking reduced doses of a long-acting benzodiazepine
- Receive psychosocial interventions as part of your withdrawal treatment
If you have stimulant-related problems, medication is only required during the initial stages of the detox process. Beyond this initial use, medication has no proven benefit for pregnant women. The World Health Organization recommends that you consider receiving inpatient treatment while detoxing from any kind of stimulant.
World Health Organization: Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy http://apps.who.int/iris/bitstream/10665/107130/1/9789241548731_eng.pdf
Partnership for Drug-Free Kids: Choosing Treatment for Pregnant Women Addicted to Opioids http://www.drugfree.org/news-service/choosing-treatment-for-pregnant-women-addicted-to-opioids/