When It’s “Okay” to Use Drugs While Pregnant

Earlier this month I did a story on PICC, the Pediatric Interim Care Center in Kent, where newborn babies go to withdraw from drugs their mothers were taking while pregnant. It was a very emotional story and all of us on the show wondered how a mother could put her baby through the pain of withdrawal.

But after the story aired I got a message from the National Advocates for Pregnant Women. They feel my story stigmatizes women who use methadone or prescription drugs during pregnancy. That women are advised to use methadone to treat addiction during pregnancy. Having seen these sweet little babies suffer, I just couldn’t believe it. But I was sent a list of dozens of doctors from around the country who have done research on the subject. So I decided to put my emotions aside and look into the facts.

Micki Kedzierski is a pharmacist, UW professor and Consultant Pharmacist at Evergreen Treatment Services, a methadone based addiction treatment program in Seattle.

“Do I support the use of methadone in moms who are are pregnant? I do. I support the use of methadone in a pregnant mom who is enrolled in a narcotic treatment program where she is getting all these support services. Because if that mom is following all the rules of the narcotic treatment program, that baby has the best chance for having a stabilized pregnancy. It is true that that baby will go through withdrawal but withdrawal is something that can be managed. By no means am I saying that it’s okay for the baby to go through that. But it’s safer for the mom, it’s safer for the baby.”

She also supports use of prescription medications during pregnancy when the woman has a legitimate ailment and is under the close care of a doctor.

“I don’t want, in any way, to imply that it’s okay for any mom to take prescription drugs of any sort, whether they’re opiodes, benzodiazepines, any of those sorts of medications. But I think that there are some times when a woman is on those medications, and has been for a long period of time, for a legitimate treatment of some sort of medical disorder. I think the mom’s health is of critical importance and one thing that we really want to avoid is putting the mom through detox while she is pregnant. If we do that, that is a traumatic event for the mother as well as for the infant.”

Micki says using methadone is much safer than a woman falling back into her old drug habit. There’s no worry of needle sharing, which would expose mother and baby to disease, and federal law requires Americans to get their methadone in a state or federal program. Any old doctor can’t prescribe it.

“When you’re in a narcotic treatment program, like a methadone based program, it’s a very strict program that involves coming into the clinic everyday to get dosed, there’s urine analysis to make sure you’re not using other sorts of drugs. So patients who are on methadone tend to, over time, decrease their use of other harmful drugs. They are also receiving counseling from an addictions counselor and can have mental health counseling. They tend to stay in prenatal care longer. They see a medical practitioner. So they really get comprehensive treatment.”

As far as stigmatizing these women for using drugs during pregnancy, Micki thinks it’s important to point out that these mothers love their babies just like any mother does. She thinks sending a baby to a place like PICC is key.

“I don’t think that’s anything to be ashamed of. That mother gave her best to that child during her pregnancy by keeping herself healthy, keeping that baby healthy. The baby will have to go through some withdrawal but if you’ve got a stable mom she’ll be able to take that baby back.”

She also supports what the director of PICC told me: that these babies can go on to live perfectly healthy lives after the withdrawal process.

Unfortunately not all pregnant moms dealing with addiction can always get help so easily. Micki says Public Health reports about 19,000 injection drug users in King County but there are only enough resources to support about a quarter of them.