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Opioids Help 6 weeks pregnant and addicted to dilaudid want to wean off asap

downtherabbithole5

Greenlighter
Joined
Sep 30, 2014
Messages
18
Hello everyone,

This is my first post so please bear with me, I did read rules and searched but did not find what I was looking for. I am writing about my dear friend who found out last week she is 6 weeks pregnant and has been taking 1-2 8 mg dilaudid daily (railing not IV) for a year off and on, more on than off. Prior to that she was taking roxy and percocet since 2011 when her husband was murdered leaving her with 3 children and no job. She has struggled to get off opiates for 3 years and has tried suboxone, kratom, gabapentin, etc. but she always relapsed after 3-4 weeks because it seemed the physical symptoms, lack of sleep and total lack of motivation was crippling her life more than being on them. I know it sounds bad but she had to work and take care of 3 kids and being on the pills made her feel like supermom. She has since remarried and found out she is 6 weeks pregnant last week. Her husband knows about her addiction (he is not an addict but is understanding) and is supportive of her trying to quit. Since last week she has weaned from 8-16 mg dilaudid daily to about 2-4 mg daily with gabapentin. She will be going to see her OB soon but cannot tell him about the opiates as she was not prescribed them but was getting them off the street and fears he will contact DCF or want to put her on a methadone program. She would prefer to wean with gabapentin if possible but has read that in the first trimester withdrawal is not good on the developing fetus. She says the worst is the lack of sleep and sweats but the gabas help and was wondering if coming off the dillaudid all together and just taking the gabapentin (since this is prescribed to her) will be bad withdrawals and be harmful to baby. Thank you all in advance for your advise and support.
 
Oh that´s bad ...I feel sorry for your friend...opiate addiction is very hard to deal with...myself I tried to quit my morphine habit many times and I always relapsed because life seems empty without the drugs... Tell her to reduce the dose, if she cant quit at all maybe reducing the dose will help her to minimize the WD...if doesnt work unfortunately whe will need to search for medical help, those drugs are not joke and quiting them is a hell of a job, the person needs lots of effort , mind control and help from friends and family,there is no miracle.
 
thanks for the response...yes it is hell and life is cold and empty without them....but she just wants to be done with it and wants to have a healthy baby not to mention cant afford them anymore. Been researching online and it seems going off the opiate totally in the first trimester is not good, but being on them another 6 weeks doesn't seem good either. Since she was only taking 1-2 a day was hoping someone would say oh thats not much just wean off with the gabapentin she will be fine...in a perfect world right.:\
 
Well TBH I think you're doing fantastic from 16mg all the way to 2mg! Big congrats!
How is gabaoentin during pregnancy? Pretty safe?
Dilaudid had the worst and longest WD of any I've been on, and the dilaudid was injected in hospital and I was stupid and naive so thought it was the worst flu ever. I was injected with 4mg every 3 hours.
Jumping off at 2-4 shouldn't be bad at all, especially with gabapentin. Yeah, a huge habit with a CT taper can be hard on baby- for example, even at your old high dose, I think you did the right thing by tapering first. The risk of jumping off that high dose would exceed (IMO) the risk of taking it another week with a good taper).
2mg should be a snap to come down from. 2mg would also be an amount I personally would be comfortable with consuming pg.
I think both options are solid so you should base your decision on which one gives you the lowest chance of relapse. You may have more chance at long term success if you just stop using, get out of the habit, and don't look back.

Good luck! And good health to your baby!
 
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Well TBH I think you're doing fantastic from 16mg all the way to 2mg! Big congrats!
How is gabaoentin during pregnancy? Pretty safe?
Dilaudid had the worst and longest WD of any I've been on, and the dilaudid was injected in hospital and I was stupid and naive so thought it was the worst flu ever. I was injected with 4mg every 3 hours.
Jumping off at 2-4 shouldn't be bad at all, especially with gabapentin. Yeah, a huge habit with a CT taper can be hard on baby- for example, even at your old high dose, I think you did the right thing by tapering first. The risk of jumping off that high dose would exceed (IMO) the risk of taking it another week with a good taper).
2mg should be a snap to come down from. 2mg would also be an amount I personally would be comfortable with consuming pg.
I think both options are solid so you should base your decision on which one gives you the lowest chance of relapse. You may have more chance at long term success if you just stop using, get out of the habit, and don't look back.

Good luck! And good health to your baby!

Thank you!!! Gaba is class c too so she will also have to come off those but one thing at a time and i think she can definitely do it no turning back this time. She has tried before and went through hell of withdrawals but from roxy and perc never dillaudid so not sure what to expect with this one. So far it is bearable just irritable, when she sleeps she sweats and wakes up every 2 hours, and of course the mental hell but not as bad as coming down off the roxy. Unless it will get bad when she comes all the way off next week and onto just the gabapentin. I know she wants to just stop using this time, no need to prolong it if the withdrawals arent too bad. She just doesn't want to hurt the baby by going into severe withdrawals when she stops the dillaudid totally (gonna wean one more week), so if she does get too sick she will just let the Dr. know and take his advise. Only thing to it is to do it....thanks again for the support sis!
 
Methadone is the best option

Holy Shit! Am I really the only person here that understands the acceptable, effective, best practices HR method for handling opioid dependence during pregnancy is the approach used for over 40 years in the US (and beyond) with great success vs. no treatment (tapering) or continuing to use short acting opioids. This is why methadone clinics in the US are required to make room for pregnant patients - b/c it's the best approach for the baby. The mother has to wait until after delivery to deal with her dependence - it's just the way it is - fetal health comes first b/c there is no risk to the mother if she enters and adheres to the clinic protocol for methadone during pregnancy - a stable dose until delivery. Be sure the dose is high enough to hold the mother 24 hours. The constant w/d cycle from short acting opioids, or too little methadone, is potentially very damaging to a fetus at any stage. Why risk it? Read the HR organization in the US write on this issue (harmreduction.org, in particular this reference: http://harmreduction.org/publication-type/newsletter/communication-eleven/ - there's a decent piece on preganacy and drug use in this paper.

For info on best practices and US regulations see: http://www.dpt.samhsa.gov/pdf/FederalGuidelinesforOpioidTreatment5-6-2013revisiondraft_508.pdf
 
Speedballs, the only pregnancy topic I saw in your link was about physical abuse..??
In my opinion, yes methadone stabilization would be a good option IF the OP was about to do a massive CT detox
OR IF OP felt she could not be successful kicking the habit
OR IF OP was constantly up and down in withdrawal.
None of the above are true.
OP feels confidence she can kick, has a solid plan in place , has a support system, and extra incentive with pregnancy.
Additionally, she has already tapered to a very small dose of dilly per day and is not shooting up. I don't think methadone would be an improvement here, or even a lateral move TBH.
What I am wondering ... Just because she's not prescribed dillys doesn't mean that full dose lyrica is a lateral move either.

Rabbit hole , do you know if the gabapentin is less harmful than 2mg dilaudid ? Perhaps it isn't . I have no idea. Maybe a pharmacist could better advise? The pharmacist does not have to know you've not been scripted dilaudid. Or, do you think using low dose dilaudid would be too much temptation to abuse it?
 
yeah, my references may not have been the best ones to use - I thought I pulled the right ones but it's moot now b/c I'll concede that if the OP stays completely out of all w/d symptoms there is little danger to the fetus.

Probably too concerned and conservative. I should have read the thread more thoroughly - I will in the future, Thanks for calling me out.
 
Thank you for your response and the information. I am down the .5 mg daily and have not experienced any withdrawal symptoms (physical) so hopefully I can do this! I have scheduled a dr apt for next Friday and have decided to let the dr. know that I weaned down and need to also come off the gabapentin. I hope that is the right decision and I don't regret it in the long run, as I live in FL and they are INTOLERANT and love to contact DCF down here. I am actually a very good mother who took a wrong turn and just wants to get my life back right for my kids. Thanks again for the information and support guys, will keep you posted!
 
http://www.ncbi.nlm.nih.gov/pubmed/23553472

Gabapentin has been assigned to pregnancy category C, there are possible risks (see above research), but they do not necessarily outweigh the risks of not taking it (i.e. relapsing and having to do this w/d thing all over again, as many find gabapentin to be very useful in w/d). Frankly I'd feel safer knowing someone is on a low dose of methadone than taking gabapentin, like in your case 10 or less mg, but they have similar risk profile (both C).

Pregnancy category C mean that risk of using the drug while pregnant cannot be ruled out, so there are risks but as I've witnessed with methadone over and over again, although with higher risk populations than yourself (it would seem from your positive posts) although that makes no difference here, that woman can safely take methadone while pregnant and give birth to a healthy baby with limited-no complications from weaning child off methadone (in many cases simply via breast milk).

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647150/

What is the MOST important is that you have doctors etc to work with who know what they're doing when it comes to your taper, gabapentin and how it's all related to pregnancy. That will make the most difference right now, so make sure your current docs gives you the support you without a doubt need and make sure you seek out the necessary care if they do or cannot.

How much gabapentin are you taking now? I'd strongly advice you to wait until any w/d is over from the opioid use before attempting to w/d from gabapentin. Any abrupt or intense disturbances like acute withdrawal can produce are MUST be avoided right now. Tapering is the only safe way to get off the opioid, and you must stay off once off. If you relapse, and continue your use at that point, that is when methadone become the real option. You don't need any more stress than you must already have though, I'm just trying to be very frank with you. Highly recommend not w/d from both gabapentin and dillys at the same time, even if you have tapered.

Make sure to taper with gabapentin, although I've never had any problems with c/t high doses of it, I've never been pregnant (nor am I a woman), and if you've been taking it for any long period of time, especially if it's been at the 1g+/day dose, you will also need to taper off that once you've been completely off the dillies for two weeks or so.

Talk to your doctors and get the help and support you need. You can do this. There are always options and the support that can provide you with success out there and help you have the beautiful, healthy baby you deserve.
 
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today she didn't take any dilly because she woke up without chills for once and wanted to see if the wd would progress before taking any (which says a lot for her bcuz mentally is hard just to not take it for the ritual of it). It's now 6 pm and she took a nap woke up and have slight goosebumps but no other physical withdrawal symptoms. I'm wondering if maybe it's done it's been 18 hours since last took about .5 mg. should she be sick by now? No Gabapentin today only my prenatal vitamin and some melatonin last night to sleep. If this is the worst of it SHE IS DONE AND READY TO THROW HERSELF A FUCKING PARTY...if not well at least it's getting easier. She is 7 weeks today and feeling very pregnant and that is enough to make her throw away the rest she has to wean off if it's not going to get worse. Does anyone know how long after railing like .5 mg dilly she would start wd?? I can say that before she couldn't go to sleep even for a 2 hour nap without waking up sick and she slept like 5 hours last night and took a two hour nap today and only goosebumps no sweats no chills no nothing. Is this the light at the end of the tunnel guys??????
 
Doing really well by any standards. Dillies have such a short half life that one would be in w/d without their normal dose within hours. That is, IV/IM. Don't know much about oral, although it shouldn't be as bad w/d wise. If you're doing that well. Skip every day or cut down to 0.25mg if possible. What I always did in w/d when tapering was seeing how long I could keep myself from feeling like absolute horse shite before taking any more, whether it be 12hrs, 24hrs, 48hrs etc.

Don't give up the gabapentin yet as it's probably making this process much easier on the body. Definitely work to eliminate the opioids first, but don't rush too much as the idea is to avoid anything trauma ensuing.

Railing 0.5mg should set one into w/d fairly quickly if they have any kind of habit. Like well within 24hrs. If it's at the point where you're sleeping 5+ hrs/day, cut down the dose and frequency of your dilly dose and KEEP on the gabapentin. Give it a week or two of feeling comfy taking 0.25mg dillies every other day or at most only once per day intranasal. Then once you cut off all the dillies keep on the gabapentin at the same dose you have been on for another 7 days (after which acute w/d from the dillies will be more or less over as it's pretty short acting) then see how you feel and SLOWLY cut down on the gabapentin.

Remember we're not doctors here thought. I really hope you can find someone in your area whom you can talk to who is, or at least a counselor or someone who could actually help you. Like you could stop at a needle exchange if they have them in your area (illegal in FL?) or some other harm reduction organization and speak to someone about where you can help your friend find the help she needs. Or have someone else go for you if you're worried about family service bullshit (HR orgs are pretty good about that though, although again I have no exp with FL).

Priority right now (given you've made SO MUCH progress): Get off the dillies and stay off them for 7+ days
Priority then: Once you're off dillies for 7+ days and you begin to feel okay, taper off your gabapentin (which if you haven't been taking grams of it a day for years will be much easier).

Best thing you can do to help yourself: don't drink any alcohol, eat as much as your can (for two, ya) as healthy as you can, take your vitamins and everything else you should be taking given the circumstances, and get as much rest as possible. Exercise will make the w/d process go fast and help everything along, sleep included, but you want LOW IMPACT stuff. That is something that would be good to talk to a personal trainer or your doctor about actually, what kind of exercise you can safely do and then do that as much as you can. Exercise, food and rest are the biggest help in w/d. People tend to forget to eat considering how shitty they feel and it makes the process soooooo much worse.

Check into the recovery forums and the dark side or whatever for more help about this process. They'll be able to help you more than OD perhaps? Also check out healthy living forums on food and dietary info as well. There is a lot of support your can find here on BL, but you should get out of OD and link to your thread here, perhaps give a few details about your friend's current situation. But remember, you need real help in real life, and what we can help you with on BL is limited.

However, given that you do seem to be pretty well and stable, it sounds like your friend can do a lot for herself, in which case BL can be of good use. But you'll still have to seek it out. Try posting around.

EDIT:

From a health professional (nurse? I forget now) whom I would trust with my unborn baby... and whenever you see the words heroin or iv, replaced them respectively with dilaudid and intranasal.

See these posts:

Flip hon you were right, I was gonna definately pop in on this one.

Trying to detox while pregnant at any point in the pregnancy can result in miscarriage. If you are pregnant and using opiates, the best treatment is Methadone Maintenance(MMT).
It has been shown that babies born to a mother taking Methadone have only mild to moderate discomfort and are usually fine within a few days and can go home unless other problems arise.

Research with mothers on methadone has shown that the fetus only becomes dependent on the Methadone and not addicted. I know some may disagree and not believe so, but I work with pregnant mothers as a case manager and this is the protocol of pregnant women addicted to opiates.

If anyone tells a pregnant woman it is OK to detox or go cold turkey is an idiot. No one should give a prenant mother advise that could be harmful, unless it is a doctor or nurse or someone else who is experienced in this area. I hate to sound harsh,but a detox or cold turkey approach can lead to miscarriage, which in turn can lead to hemmorrhaging in the mother and often this can lead to hysterectomy, or even death if the mother does not receive medical attention immediately. The uterus has a rich blood supply and a woman who is hemmorrhaging can bleed out or lose a very large blood supply in very little time.

If you are pregnant and on opiates, part of getting good prenatal care is being on Methadone. Continuing to use Heroin while pregnant will make it that much harder on your baby and they will go through withdrawals when born and often they are born prematurely.
Don't be afraid to go to a methadone clinic because you are worried about what people will think. There are counselors who are often trained to only work with pregnant mothers and will help referrals for prenatal care, medical insurance through the state, and other programs for pregnant women.
I would certainly be more imbarrassed to be seen buying dope pregnant than I would being seen at a methadone clinic.....And I speak for myself only!

While I did not use during my pregnancies, I know it can be difficult to where to turn and what to do in this situation. If keeping the baby is the option you choose, get the best care you can. Especially if you want to keep your baby once it is born. If you tested positive for heroin, Social services will get involved and most likely take your infant. But, if you are involved in Methadone Treatment and have a doctor and others working with you to avoid this, your worst issue would be monitoring you for the use of illicit drugs and other opiates and to monitor the baby for weight, and other issues related to the needs of a newborn.

I know my post was long, but this is an area I do have experience in as well as working with other IV drug users and if anyone needs help, you can send me a PM and we can help to work this out.

I won't judge anyone, I am an addict myself on Methadone, but this is an issue that I am very involved in and don't want to see anyone go through the hell of losing their baby and to get the help they need during pregnancy and the help to stay clean after.
http://forum.opiophile.org/showthre...hiles-Pregnant&p=153253&viewfull=1#post153253

I just wanted to put that out there about going cold turkey while pregnant. To answer that guys question about his gal getting off of everything early in her first trimester was fine.

Methadone is used to women who are using other opiates with a history of addiction. Because of the ups and downs of opiate use, many pregnant mothers will find themselves in withdrawal often during pregnancy due to lack of drugs availability, or lack of money to buy there drug of choice; Oxycontin, Vicodin, or any other opiates used. Because Methadone lasts for 24 hours, it is a better choice for pregnant women so they do not experience w/d that can lead to stress on the baby and increase the chances of miscarriage.

In women addicted to cocaine and methamphetamines, it is found that stopping the drug and good prenatal care is about the best way to help maintain them throughout their pregnancy. While it is still a chance that these babies may be born premature, or low weight, they can still be healthy at birth with intervention and good prenatal care. They are tested during the pregnancy and then at delivery for meth or cocaine.

What is sad, that many women will avoid treatment due to fear or they are unable to give up their addiction. While they may want to have a healthy baby, they often find that they are just unable to stop and are afraid of the reaction of others if they did seek help.
http://forum.opiophile.org/showthre...hiles-Pregnant&p=153449&viewfull=1#post153449

So moral of the story?

Practice good prenatal care and see that doctor and keep seeking help whenever you need it.

Noticed in the ways the people Candy is talking about in these quotes applies and does not apply to you. If you've only been using for a year or two (under like five I'd say), methadone almost certainly isn't a good idea for you unless it's for the length of your pregnancy, and even then I can't be sure. From what we've been told your friend doesn't sound like she fits the build of someone who is unable to give up their addictions. I hope this is true, as your certainly can make it so, if you haven't already! <3

Funny thing is, like 25-40mg of methadone, 25mg once w/d comes on, assuming it does and you're not out of the woods, then another 15 if you feel it coming on again (25mg may very well be all you would need, just once and never again) a couple days later and that would get you through the rest of your taper in an extremely smooth way. And gabapentin wouldn't be so much of an issue then either. Not suggesting it necessarily, iono if I'd do it myself in the situation, but funny in a way considering some folks on maintenance take 4-8 times as much on a daily basis. Kinda sad imo, but if they need it and their lives have improved, who am I to judge. Besides, that's not the topic here.
 
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update <3 down to just a lil crumb every other day.... probably could just stop any day now. only thing that gets me is the lack of sleep because my body temperature rises so dang high as soon as i fall asleep!!! so i sleep for an hour at a time and then have to wait for my temp to adjust and goosbumps to stop for like 15 mins before i can fall back asleep. now, i could just deal with this and stop c/t cause its really not that bad, not as bad as i want to just quit but i dont want the baby to feel any discomfort. seeing the dr this friday so i have to stop completely this week.
 
now, i could just deal with this and stop c/t cause its really not that bad, not as bad as i want to just quit but i dont want the baby to feel any discomfort. seeing the dr this friday so i have to stop completely this week.[/COLOR]

The important part is in bold. And frankly it's not about your baby feeling any discomfort, it's about keeping her alive and healthy. Be realistic. How'd the doctor go?
 
Eeeeeekkk...........I've already been down that path. It's a rough road.
I was on dilaudid for back pain and pregnant.
And had a previous opiate addicted as well.
It's challenging but you have to quit or your baby will be messed up (mine turned out okay but it doesn't mean the same for everyone)
I used dilaudid at the beginning and the end of my pregnancy.
Be careful and try not to use it too often.
Best of luck
 
Eeeeeekkk...........I've already been down that path. It's a rough road.
I was on dilaudid for back pain and pregnant.
And had a previous opiate addicted as well.
It's challenging but you have to quit or your baby will be messed up (mine turned out okay but it doesn't mean the same for everyone)
I used dilaudid at the beginning and the end of my pregnancy.
Be careful and try not to use it too often.
Best of luck

The use of potent (or any) opioid is generally okay as long as it's under a doctor's orders during pregnancy, especially at the beginning and the end, or in other words when there is a legit need. However, to quit using while pregnant when there is a long standing history of use and dependency on them is NOT a good idea. A developing fetus/child will suffer infinitely more from the shock to the system that is the acute withdrawal from opioid dependency than the effects of the opioids on the developing child (other than causing dependency in the child, which is easily treated after birth, very, very limited and few and far between).

Of course using a shit load of opioids while pregnant is obviously a bad idea, but I'd rather see an expectant mother on a steady, controlled and regular supply of opioids than bouncing around taking a lot one day and not taking any another. A taper is a possibility, but given the VERY real danger w/d can pose to the developing fetus, this must be handled with the absolute utmost of care. This is why a methadone regiment is the most advisable course of action when it comes to expectant mothers who are dependent on opioids.

When the expectant mother's habit is small, as in the OP's case (or so it would certainly seem), a taper becomes a much more reasonable option, but that doesn't change the fact that it must be managed with the UTMOST CARE.

I have known a LOT of mothers who have used while pregnant, some who have used street opioids while living that life of ups and downs as well as those on methadone programs (specifically tailored and designed around protecting their baby). Even when it comes to those who haven't had any significant support with their habit while pregnant, I haven't seen much damage.

Actually, when *knowledgeable*, *sympathetic* and *caring* doctors are involved, and the mother has sought out and put the necessary treatment is in place to ensure the safety of their baby (and these aren't necessarily even methadone or ORT treatment based programs that are the evidence based standard with the highest rates of success among expectant mothers who continue using opioids), I have not seen any significant problem of any kind at birth or throughout the development of their child in adolescence and their teenage years.

It's a shit situation, I can't imagine how scary and stressful it must be for the mother without the support or help with this stuff, but it is far from a death sentence for their future child. It ABSOLUTELY DOES NOT mean the child will end up messed up, deformed or handicapped in any way - like the kind of stuff that is much more likely to happen when an expectant mother drinks herself into oblivion while pregnant and refuses to seek or even receive help. That's when it's more appropriate to freak out and expect the worst for the baby.

At least with opioids they're infinitely less damaging on the body. The only danger when it comes to opioids practically speaking is the shock to the system that discontinuing their use abruptly like when one quits cold turkey can have on the unborn baby.

Even when a baby is born technically dependent on opioids, there are proven effective well known protocols for "detoxing" and weening the new born off whatever opioid(s) which prevent any injury whatsoever, let alone even any stress to the baby in most cases. One of those areas of medicine that is extremely well established and well known, where any doctor even half worth their salt knows exactly what to do.

Don't get me wrong. It's not easy. For the mother, or the child. But it's super, super far from the death sentence that the sensationalist media likes to make it out to be like with the so-called "crack baby" scare (which, just in case we didn't know, turned out to be a total fabrication by the medial and bullshit medical "professionals" and absolute bullshit lies).
 
Try methadone.. most pharmacies will do it. It's helped me, even though I'm not pregnant its the safest option for you.
 
sorry i posted update last week but it must not have registered. So was able to wean completely off the dilaudid by the Wed. before dr. apt. Still taking the gabapentin and have had very little discomfort other than raise in body temp at night and easily stressed but that could have a lot to do with hormones. Went to see an amazing OB and found out was further along than expected did sonogram and baby is healthy and active. Chose not to tell OB about the weaning off dillaudid but did tell him about the gabapentin which he wants me to stay on until second trimester then we can wean down if necessary. He really said with medications like gabapentin it is better to remain on it at low dose but I really want to get off all the crap and get back to being healthy. One thing can say that since getting off the dillaudid (been about 3 weeks) feel better mentally and it gave me a new outlook on life. It is possible....thanks for the help
 
Well done and congrats! Hope you have success putting the dilaudid behind you through the rest of your pregnancy. And that is good to hear about the gabapentin, as it should help with any craving or whatever and just make your life a little easier for a while without having too many bad side effects (or, in all likelihood, any bad side effects on you/baby).

Good luck and keep up the good work.
 
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