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The Risks of Detoxing from Heroin While Pregnant

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If attempted on your own, detoxing from heroin during pregnancy can have negative effects on both you and your unborn baby. Professional treatment can help mitigate these risks.

Research has found that almost half of all pregnancies are unplanned.1 Unfortunately, unintended pregnancies are linked to an increased risk of complications for the mother and the baby, including a higher likelihood of poor maternal health and delayed prenatal care, which could both translate to issues down the line for the baby.1 This is especially concerning for women who may be using drugs, such as heroin. If a woman is using heroin while pregnant, she and the baby could be seriously impacted, especially if she does not realize she is pregnant. Issues such as these make it important for women who are using heroin to quit with the help of a medical professional.

Below you can learn more about the dangers of heroin use and the added risks of detoxing on your own during pregnancy. You’ll receive more information on how you can quit heroin safely with the assistance of professional detox or addiction treatment.

Heroin Abuse, Dependence, & Addiction

Heroin is an illicit opioid that can be injected, smoked, or snorted.2 Approximately 669,000 Americans use heroin, and this number has been increasing since 2007. Heroin use is a major public health issue with serious risks and consequences, including the development of dependence and addiction.3 When opioid dependence becomes significantly severe, you need to continue using heroin to avoid distressing withdrawal symptoms.4 Dependence is an expected physiologic response to consistent drug use, but it doesn’t always indicate that the compulsive patterns of addiction are present. That being said, dependence is a major factor that contributes to a problematic cycle of heroin use and ultimately, the development of addiction.

Heroine in spoon and needle
Those who do eventually become addicted to heroin may spend an inordinate amount of time obtaining and using heroin despite serious negative consequences, such as failing to get or keep a job, failing to maintain relationships, providing inadequate childcare, and experiencing significant financial or legal consequences.4 Someone who has a heroin addiction will almost certainly be physically dependent on the opioid as well.


When someone who is dependent on heroin tries to quit using, especially if they try to quit on their own without the help of a medical professional, withdrawal symptoms will emerge. These withdrawal symptoms may present risks to both you and your unborn child, which is why professional detox support is so crucial. If you are addicted to heroin and are pregnant, think you might be pregnant, or are trying to get pregnant, please seek help from your doctor or an addiction specialist, for both your and your baby’s health and safety.

Quitting Without Professional Help

Man possibly experiencing effects of benzodiazepine withdrawal
Attempting to quit heroin cold turkey poses many risks, including potentially-severe withdrawal symptoms, such as:5,6

  • Restlessness.
  • Agitation.
  • Anxiety.
  • Muscle pain.
  • Bone pain.
  • Sleep disturbances.
  • Diarrhea.
  • Nausea and vomiting.
  • Stomach cramps.
  • Cold flashes and “goose bumps.”
  • Uncontrollable leg movements.
  • Severe cravings.
  • Runny nose.
  • Increased tearing of eyes.
  • Excessive sweating.
  • Increased yawning.

While the symptoms listed above are certainly unpleasant, the acute heroin withdrawal syndrome itself is typically not fatal. However, there are several significant complications that can arise, including:6

  • Aspiration, or inhaling stomach contents into the lungs while vomiting.
  • Lung infection or inflammation from aspiration.
  • Severe dehydration.
  • Electrolyte imbalances.
  • Relapsing to heroin use, which could lead to overdose.

Clearly these symptoms can be problematic for the person who is experiencing them. Yet if that person happens to be pregnant, the concerns may be even greater. This is because the fetus may not be able to handle these severe withdrawal symptoms and related complications, which could result in the death of the fetus.7 However, medical professionals can mitigate these risks to keep you and your baby safe.

Neonatal Abstinence Syndrome

Pregnant women doing heroin
When a pregnant woman uses heroin, the substance does not just affect her; it impacts the fetus as well. This is because heroin passes through the placental barrier to the fetus.7 When this happens, the fetus can become dependent on heroin, which may then result in the onset of neonatal abstinence syndrome (NAS) following delivery. After birth, the baby is no longer exposed to heroin, and will therefore experience withdrawal symptoms.7,8 These symptoms may emerge immediately or up to around 14 days after birth.8


These symptoms can include:8

  • Excessive crying.
  • Blotchy skin coloring.
  • Fever.
  • Irritability.
  • Slow weight gain.
  • Tremors.
  • Hyperactive reflexes.
  • Diarrhea.
  • Profound sweating.
  • Increased breathing rate.
  • Rapid heart rate.
  • Vomiting.
  • Seizures.

Because fetal withdrawal has, in some cases, been associated with seizures and death, a baby born with NAS will need to be hospitalized.7 Treatment typically includes the use of medication—possibly morphine, methadone, or buprenorphine—to reduce the withdrawal symptoms.7,8 The medication is gradually tapered off until the baby adjusts to being substance free.7,8

While the symptoms of NAS are very serious and could be fatal, there are other factors to consider as well. For example, being exposed to heroin in utero is associated with:9,10

  • Increased risk of sudden infant death syndrome (SIDS).
  • Birth defects.
  • Low birth weight and/or premature birth.
  • Small head circumference.
  • Hyperactivity.
  • Inattention.
  • Developmental delays.
  • Behavioral disorders.

Because of the symptoms of NAS, the long-lasting effects, and other risks associated with heroin use during pregnancy, it is important to seek treatment for your heroin addiction as soon as possible after realizing that you are pregnant or after deciding that you would like to try to get pregnant. With appropriate treatment, you can reduce the risks for both you and your baby.

Formal Detox Treatment

It is important to have the assistance of a medical professional when detoxing from heroin. This is especially important if you are pregnant so that both you and your baby may stay safe throughout the detox process. Medical detox and medication-assisted treatment (MAT) are effective ways to manage heroin withdrawal and treat addiction. MAT combines medications and behavioral therapy to treat drug addiction.11 This way, both the substance use and any triggers or emotions that are connected with use can be addressed.

Research has found that methadone maintenance, along with appropriate prenatal care and engagement in a drug treatment program, can decrease many of the risks associated with heroin use, for both the mother and the baby.7 However, babies exposed to methadone in utero will may require some treatment for NAS also.7  Buprenorphine is another medication that is used for the treatment of opioid dependence and is safe for both the mother and the fetus.7 Buprenorphine combined with naloxone helps reduce the side effects associated with it.7

It is important to remember that even if you are receiving MAT, your baby may still experience NAS. However, research shows that with MAT, the symptoms of NAS tend to be less severe, lead to shorter hospital stays, and have better outcomes overall, for both the mother and baby.7,12 So again, if you are pregnant, think you might be pregnant, or are hoping to become pregnant, and are also addicted to heroin, please seek guidance from a physician or addiction specialist. They can help you through the detox and recovery process in a manner that is safe, thereby to ensure the best future possible for both you and your baby.

Sources

  1. Centers for Disease Control and Prevention. (2015). Reproductive Health: Unintended Pregnancy Prevention.
  2. Substance Abuse and Mental Health Services Administration. (2016). Opioids.
  3. National Institute on Drug Abuse. (2018). Heroin.
  4. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Association Publishing.
  5. National Institute on Drug Abuse. (2018). Heroin: What Are the Effects of Heroin?
  6. Medline Plus. (2017). Opiate and Opioid Withdrawal.
  7. National Institute on Drug Abuse. (2018). Heroin: How Does Heroin Use Affect Pregnant Women?
  8. National Institute on Drug Abuse. (2016). Substance Use in Women: Substance Use While Pregnant and Breastfeeding.
  9. Medline Plus. (2017). Neonatal Abstinence Syndrome.
  10. Ornoy, A., Michailevskaya, V., Lukashov, I., Bar-Hamburger, R., & Harel, S. (1996). The Developmental Outcome of Children Born to Heroin-Dependent Mothers, Raised at Home or Adopted. Child Abuse & Neglect, 20(5), 385­­-396.
  11. Substance Abuse and Mental Health Services Administration. (2016). Medication-Assisted Treatment (MAT).
  12. Wiegand, S.L., Stringer, E.M., Stuebe, A.M., Jones, H., Seashore, C., & Thorp, J. (2015). Buprenorphine and Naloxone Compared with Methadone Treatment in Pregnancy. Obstetrics & Gynecology, 125(2), 363-368.

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