©Pregnancy bliss 2008
Drug abuse during pregnancy: Heroin
Heroin is one of the most abused drugs in the world. It is an opiate narcotic synthesized
from Morphine, one of the most powerful pain-killers which is itself derived from
the opium poppy. Heroin was first synthesized in Germany in the late 19th century
and was aptly named 'heroisch' (powerful). Heroin acts on the central nervous system
and is highly addictive. Dependency develops rather quickly.
Surveys in different areas show that between 1 and 2% of pregnant women abuse opiates. In some areas, the prevalence of abuse is as high as 1 in 5, that is 20% of all pregnant women!
Most of these users will be aware that heroin does cross the placenta and therefore
will have a variety of effects on the baby. Heroin users have an overall increase
in complications by a factor of six. In other words, their chances of having some
sort of significant complication is increased six-
Some of the known adverse effects include:
- Low birth weight
- Antepartum hemorrhage
- Fetal distress
- Meconeum aspiration (which can have serious consequences for the baby)
- Malpresentation
- Neonatal opiate withdrawal (will usually require hospitalization)
- Poor neonatal growth
- Microcephaly usually with learning disabilities
- Neurobehavioral developmental problems
- Increased neonatal mortality risk. Risk of cot death is increased more than 70 times the general average
Alternative to heroin in pregnancy
If you are already addicted to heroin and you find yourself pregnant, the advice is to switch to methadone, which is a related drug.
Methadone is administered at scheduled intervals (as opposed to haphazard heroin use). This helps to keep blood levels of the drug relatively stable. This helps minimize withdrawal, which is the scourge of heroin addiction for both mother and baby.
To stop or not to stop methadone when pregnant
It is preferable not to stop Methadone if already on this when you fall pregnant. If you stop, you are likely to unleash withdrawal in the fetus, which could be disastrous.
The advice is to continue taking methadone as per schedule and, with expert help, careful attempts to reduce the amounts taken could be started, if this is desired.
Attempts to quit altogether, though noble, should ideally be made after delivery.
Withdrawal problems for a baby whose mother was on Methadone
It is inevitable that a baby born to the mother who has maintained on Methadone will suffer some degree of withdrawal.
The degree of withdrawal symptoms will depend on the dose of methadone she was maintained on i.e. the higher the dose, the more severe the withdrawal symptoms.
