How to stop Heroin safely during pregnancy?

Question

Hi doctor,

My niece is pregnant and taking Subutex. She just confided to me that she has also been using Heroin, along with Subutex for the last one month. She is afraid to ask her primary care doctor for advice. Her doctor told us in the beginning that it is more harmful to the fetus if the mother were to abruptly quit using opiates. Now, my niece is afraid to stop the heroin use even though she also has the Subutex, which I thought is supposed to help with this type of situation. How can she safely stop using Heroin? Can she continue her regular dose of Subutex daily and just cut out the heroin all together at once?

Answer 1

Hi,

Welcome to icliniq.com.

Please ask her to stop taking Heroin over a due course of time by tapering the dose. Tapering the dose gives her minimum side effects, easy to withdraw, cope up with symptoms and less harm to the baby, rather than suddenly withdrawing Heroin, which may increase withdrawal symptoms and worsen the situation. Please ask her to taper the dose of Subutex (Buprenorphine) as well. Consult your specialist doctor, discuss with him or her and get the dose altered. So, when she is near her delivery time, she would have almost quit both the medications and her breastfeeding is safe. To summarize, slowly lower the dose and duration of Heroin and eventually quit both Heroin and Subutex before delivery.