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Prescription Drug Abuse During Pregnancy

Prescription drug abuse always has the potential to cause physical and emotional harm to an addict and his or her loved ones. This type of substance abuse is serious enough that it often requires professional addiction treatment in order to recover. However, when the addict is a pregnant woman, the risk of harm extends to her unborn child.  If you’re expecting, it’s important to understand the dangers of prescription drug abuse. Prescription drug abuse occurs when individuals take a medication for which they don’t have a prescription, or take a drug more frequently or in higher doses than prescribed.  While the abuse may be intentional (for example, to get high), it’s sometimes a desperate attempt to relieve troubling symptoms.  Many naïve abusers assume that if a little works, more should work even better.  That misguided belief has led many individuals — including pregnant women — down the slippery slope of addiction. While just about every medication has the potential for misuse, some are much more commonly abused than others.  The most frequently abused prescription medications include those used to treat sleep disorders, anxiety or pain. Stimulants, primarily those medications used to treat ADHD and narcolepsy, are also commonly abused. Overall, nearly 5% of pregnant women abuse drugs, including prescription medications. One clinic, in particular, has reported a five-fold increase in the number of pregnant women abusing narcotic prescriptions between 1998 and 2008.

Impact of Addiction on Infants and Mothers

When it comes to the health of mothers and babies, prescription drug abuse is no safer than taking illicit street drugs like cocaine or heroin. Prescription drugs pass through the placenta and are directly “fed” to the developing baby. This can lead to a variety of problems.  Infants born to addicted mothers, regardless of whether it’s a prescription or illicit drug, are at risk for neonatal abstinence syndrome (NAS).  With NAS, the infant is going through withdrawal from whatever drug the mother has been using. Opioid medications, such as Oxycodone, Vicodin, and Percocet, trigger the most difficult withdrawal symptoms. It’s estimated that 55% to 90% of babies born to opioid-addicted mothers will struggle with withdrawal. Babies born addicted to prescription drugs have a constant, high-pitched cry, sensitivity to lights and sounds, and a low threshold for agitation. Other symptoms include rashes, vomiting, and diarrhea. In addition, these babies are prone to seizures. Addicted newborns can require hospital stays that are weeks and, in some cases, months longer than non-addicted babies. However, the risk extends past the withdrawal period. Infants exposed in the womb are significantly more likely to have abnormal brain development throughout early childhood. This can set the child up for a whole host of problems, including serious learning difficulties and poor academic performance.  Children who struggle with learning are often the target of bullies.  They also often struggle with self-esteem issues, which can impact every area of their life. Women who don’t get treatment for addiction during pregnancy also risk harming the child after it’s been born. Studies consistently show that many addicted mothers adopt unhealthy parenting styles that cause long-term harm to a child’s physical and emotional well-being. For example, a mother high on painkillers may hurt a toddler through neglect or unresponsiveness.

Treatment for Pregnant Prescription Drug Addicts

It’s essential for an addicted expecting mother to find treatment as soon as possible. Addiction to these drugs requires professional care. It can be simple for others to look at the addict and say, “Well, if she really loved her baby, she’d just stop.” If it were only that easy.  Addiction changes the way an individual makes decisions, so it becomes virtually impossible for her to stop using through sheer willpower alone — no matter how much she loves her unborn child. Because of the impact prescription drug abuse has on an unborn child, many addiction centers give priority placement to pregnant addicts. Treating this condition during pregnancy is a team effort. The drug rehab treatment team will work closely with her health care providers, including obstetricians or perinatologists (physicians who specialize in high-risk pregnancies), in order to provide the best possible treatment for both mother and baby.  A neonatologist (a physician specializing in newborn health) will treat the infant if it’s suffering withdrawal symptoms in the days and weeks following birth. Addiction specialists have several options for treating prescription addiction in pregnant women. For example, cognitive behavioral therapy (CBT) helps them examine the emotions or events, such as any past trauma, that play a role in their drug abuse.  Therapy will teach them how to cope with negative feelings and thoughts without turning to drugs.  They will also learn to identify and change unhealthy thought patterns and beliefs to ones that are more positive and healthy.  This will help them make good decisions about their health and the health of their baby. Research suggests that contingency management (CM) is also an effective therapy for pregnant drug addicts. Contingency management involves providing tangible incentives for healthy behaviors. For example, an addict who produces drug-free urine samples may earn a gift card to purchase baby items or dine at a favorite restaurant. In some programs, the size of the incentive increases the longer the addict remains drug-free. Rewards may also be given when the recovering addict interacts with others in a positive way or attends a specified number of therapy sessions. Studies show that CM addiction treatment is an effective way to keep pregnant women in therapy longer. Some medications can also help a pregnant woman resist drug cravings. For instance, methadone may be a safe option for some expectant mothers with an opioid addiction. Buprenorphine is another medication option, and some evidence suggests that it produces fewer negative symptoms in newborns than methadone. Additionally, since pregnant addicts are more likely to struggle with a mood or anxiety disorder, treatment should include a full psychological assessment. The presence of untreated mental health issues will sabotage recovery by making a woman more prone to relapse. A physician may prescribe an antidepressant or other medication to help relieve symptoms. It’s imperative that the addict works closely with her entire medical team to weigh the risks and benefits of taking any medications while pregnant. Drug rehab treatment for pregnant addicts may include things specific to their situation, such as prenatal care classes or parenting workshops. Since addiction is an issue that affects the entire family, addiction specialists may recommend family or couple’s therapy.  This allows the addict to address the conflicts that cause stress and contribute to unhealthy decision making. Addiction treatment is critical for pregnant women who are abusing or addicted to prescription drugs. If you’re taking a drug without a prescription or taking a prescribed medication more frequently or in higher doses than recommended, seek help as soon as possible. If you’re not sure where to go, consult your obstetrician or regular physician. He or she will direct you to the resources you need in order to get on the path to recovery.  By taking action today, you and your baby can enjoy a drug-free life in the future.

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