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Quitting Heroin While Pregnant
 
If youíre pregnant and using heroin and want to stop using heroin then donít panic and donít despair, for there is still much hope yet.

It is still very possible for everything to turn out well and for you to give birth to a strong and healthy baby. And the best time to do something about it is now.

DISCLAIMER: Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should always consult a physician in all matters relating to yours and your baby's health. Any action taken on part of the reader in response to the information on this website is at the reader's discretion.
 
  Step 1. Tell your doctor
The first thing to do, the right thing to do, and the best thing to do, for you and for your baby, is to tell your doctor right away, (if you already have a doctor. If you donít have a doctor then don't worry, you will be seeing one shortly).

Let your doctor know that youíre addicted to heroin but that you want to quit heroin and stay clean for good.

Let them know that youíre serious about quitting and that you never want to touch this drug ever again.

You wonít get in trouble. Theyíre there to help you and to help your baby as well. They want to help you come off of the heroin and have a smooth and safe pregnancy. But the only way that they can help you is if you come clean and reach out for help. Here's what one girl had to say:
 
  "Hi Jorge, I'm writing to tell you that I finally did go to my doctor yesterday and came completely clean with her and she was so supportive! I wanted to thank you for your advice to go and tell her because I'm not sure I'd of had the guts without your encouragement and the support of my family. Thanks,.." SR (female)

So please, donít wait any longer and donít let another day go by. The best time to tell your doctor is now. No matter where you are in your pregnancy, the time to reach out for help is now. And the sooner you do so then the better off youíll be.

In many states, cities, counties and provinces and in most countries as well, there are government programs that will pay for or help pay for the care and delivery of the baby if you're income is low or non existent. If you have a job with insurance, then your insurance company may pay for it. If youíre married and your husband has insurance then his insurance may cover it. And if you're a minor and your parents have insurance, then their insurance may cover the costs as well.
 
If you have no money, no job or nothing at all, then contact and/or visit your local DHS (Department of Health and Human Services). You should be able to find a listing and contact information for the DHS within the government pages of your local phone book. You can also search online for the Department of Health website for your state, county, province or whatever region you reside in. Contact them and ask them for step-by-step instructions on how to obtain state or government funded health care insurance in order to start seeing a doctor for your pregnancy and begin to receive prenatal care.

Once you have insurance and/or have access to medical health care, then tell your doctor or attending physician that youíre hooked on heroin but that you want to get clean and stay clean for good. They will help you in every way possible, and then the rest is up to you.

Coming clean to your doctor and to your loved ones is the best way to successfully quit heroin and stay clean for good. Those who come clean and reach out for help are more likely to quit heroin and remain clean as well. So if youíre going to reach out for help, then the best time to do so is now.
    
  Step 2. Choose your method for quitting
Although there are several ways to quit heroin, most doctors will either place you on a methadone maintenance program or on a Subutex program. And your doctor will most likely choose what they think is best for you or what their normal procedures are for pregnant women addicted to heroin and opiate drugs.

It is not safe to quit heroin cold turkey when youíre pregnant as the effects of the heroin withdrawals can endanger the life of your unborn child. Furthermore, the Center for Substance Abuse (CSA) also confirms that heroin withdrawal for pregnant women is especially dangerous because it causes the uterus to contract and may induce miscarriage or premature birth.

Suboxone is not a good choice during pregnancy either because Suboxone contains Naloxone and Naloxone can sometimes cause side effects such as headaches and nausea as well. Naloxone can also cause strong precipitated withdrawals when taking Suboxone for the first time. It should also be noted that exposure to naloxone in the womb may also produce hormonal changes in the fetus. The effects of fetal exposure to sublingual naloxone used in the buprenorphine-naloxone combination tablets (Suboxone) have not been studied sufficiently.

Furthermore, the manufacturer for Suboxone does not recommend that this medication be used during pregnancy. However, there have been many expectant mothers who have used suboxone to come off of the heroin during their pregnancy and have continued to use suboxone during the remainder of their pregnancy with little to no complications at all. Be that as it may, studies and evidence still show that Methadone or Subutex may be the best and safest options for heroin addiction during pregnancy, both of which will be discussed below.
    
  Methadone and Subutex
At this time, the standard procedure worldwide for quitting heroin and opiate drugs while pregnant is to place the patient on a supervised methadone maintenance program for the remainder of the pregnancy, while other doctors and private clinics may recommend Subutex as well. And some doctors may even give you a choice between the two, (depending on availability).
 
  Methadone however, has been used for over 25 years and has been scientifically tested and medically approved for pregnant women on heroin and other opiate drugs. And when administered under medical supervision, this can very well be the way to save your life and your babyís life as well.

Furthermore, the National Institute of Health has also recommended methadone maintenance for pregnancy as well. ďNot only is pregnancy loss prevented by methadone, but by ensuring a safe source of narcotics for the mother, the fetus is protected from acquiring blood-borne diseases through needle sharing, a common practice among addicts.Ē

NIDA, (the National Institute on Drug Abuse), has reported that methadone maintenance while pregnant is "strongly advised" over any attempt to go through heroin withdrawal cold turkey.

Methadone maintenance treatment (MMT) allows you to conduct yourself with clarity and without a compulsion to use heroin or other opiate drugs. One dose of methadone suppresses heroin cravings and withdrawal symptoms for about 24 to 36 hours.
 
Methadone is a synthetic opioid and a controlled pharmaceutical drug. At least you know whatís in it for sure. You never know what's been cut into your heroin in order to give it more volume and more profit for the dealers. Street heroin is sometimes cut with impurities such as coffee, quinine, talc powder, sleeping pills, lactose, brick dust, and sometimes even glass particles which can become deadly.
 
  Sometimes, drug dealers cut bleach into their heroin as well. Even the most reputable drug dealers generally cut their heroin with substances such as powdered milk, sugar, starch, or coffee. So no matter how you look at it, you'll be far better off getting off of the heroin and onto a safe methadone program than to continue to live the risky and dangerous lifestyle of using heroin day in and day out.

If you do get on a methadone program, then most likely, you will be visiting the local methadone clinic, the hospital, or a clinic recommended by your doctor. Youíll be traveling there every day, first thing in the morning in order to obtain your daily methadone dose in liquid/juice form. But donít worry, and donít let that trouble you. Youíre doing this for your baby and for your own sake as well.

Make sure that youíll have a means of transportation available. If not, then let your doctor know that you have no transportation and they will make arrangements for free or provide state funded transportation. And in time, many clinics will allow you to take home your methadone supply for the week once you've proven to them that you're going to stick to the program and stay clean for good. But right now, your main goal is to get off of the heroin right away and get onto a supervised methadone program, (if methadone is what youíre going to use for the remainder of your pregnancy).
 
Subutex (Buprenorphine) is a semi-synthetic opioid drug used to prevent and/or reduce heroin withdrawal symptoms. And for pregnant women, Subutex is preferred over Suboxone.

Subutex is a small white tablet which is placed and dissolved under the tongue and is absorbed and delivered to the opioid receptors in the brain through the blood stream...
 
  Once the Subutex (Buprenorphine) reaches the brain then it binds itself to those receptors and begins to relieve and decrease heroin withdrawal symptoms within 40 to 60 minutes or less. After the first dosage, the patient can continue to take the Subutex daily with no problems at all and even every other day as well.

Subutex is the same as Suboxone, yet contains no Naloxone, only Buprenorphine and therefore reduces the possibilities of unnecessary side effects from the Naloxone. Suboxone however, contains Buprenorphine and Naloxone which is added in the Suboxone to deter the user from crushing the tablet and injecting it. However, as mentioned above, Naloxone can sometimes cause side effects such as headaches and nausea for example, not to mention the possibilities of strong precipitated withdrawals. And for this reason, Subutex is preferred and recommended over Suboxone.

Furthermore, a study conducted in 2012 by the Maternal Opioid Treatment Human Experimental Research group (MOTHER) has found Subutex to be a safe and effective alternative to methadone for treating heroin addiction during pregnancy.

ďOur findings suggest that buprenorphine treatment during pregnancy has some advantages for infants compared with methadone and is equally safe,Ē says Dr. Hendrťe Jones, who led the multicenter study while at the Johns Hopkins University School of Medicine.

However, after birth, infants may experience various degrees of NAS, Neonatal Abstinence Syndrome, (withdrawals in infants from methadone or Subutex, (Buprenorphine). And symptoms of NAS can include tremors, vomiting, respiratory difficulties, poor sleep, and low-grade fevers.

Newborns with NAS often require hospitalization and treatment for a few days, during which they receive medication (often morphine) in tapering doses to relieve their symptoms while their bodies adapt to becoming opioid-free. And many infants with NAS (from Subutex) need only a few days of additional cuddling, attention and quiet time as well.

Yet it should also be noted that infants whose mothers were treated with buprenorphine experienced milder symptoms of NAS than those infants exposed to methadone. Furthermore, after birth, it is easier for the mother to taper down and come off of the Subutex than the methadone. And therefore, Subutex may be a better choice for both the mother and the baby if indeed Subutex is available in your country.
    
   Pros and cons on Methadone vs Subutex 
Methadone is more widely used and available in most countries than subutex is when it comes to pregnancy and heroin addiction. And most doctors will still recommend methadone over Subutex as well mainly because itís been standard procedure for over 25 years and has been tested and proven to be a safe and successful method for treatment.

Subutex (Buprenorphine) for pregnant women addicted to heroin is not standard procedure (as of yet) and may not be made available by some doctors, clinics and hospitals. But you can still ask your doctor to be prescribed and be placed on Buprenorphine instead as Buprenorphine is indeed available in most countries under the name Subutex and as generic Buprenorphine. NOTE: In India for example, Buprenorphine is sold under the brand name ďQudictĒ.

With methadone, the transition from heroin to the methadone is a smooth and painless transition. Simply wake up in the morning, sick or not, take your methadone dosage and youíre fine. No withdrawals. No cravings, no nothing.

With Subutex (Buprenorphine) you have to be in withdrawal from the heroin from anywhere between 12 to 24 hours or more before taking that first Subutex dosage. However, when taking subutex under medical supervision your doctor will most likely evaluate your symptoms and the severity of your withdrawal symptoms using the COWS Test (Clinical Opiate Withdrawal Score). Your doctor will be able to tell you when itís safe to take that first Subutex dosage. And once you do get that first dosage in your system effectively then youíre fine.

Itís important to be placed on a methadone or subutex program under medical supervision where your methadone or subutex dosages are guaranteed. The last thing you need is to get methadone or subutex from the street and then run out of medication and become dope-sick with no other solution in sight.
 
With methadone, you may have to go to a clinic every day to receive your daily dosage, (at least for a while) and you may have to come into contact with other heroin users while youíre there. However, this is not a problem. All you have to do is get in, get your dosage and get out and go home. In and out.

Subutex however, can be dispensed in the primary care setting rather than requiring daily visits to a methadone clinic, thereby potentially reducing the stigma associated with methadone treatment and the frequency of social contacts with other opiate users. Furthermore, eventually, youíll be able to take your subutex medication home to be administered by yourself within the privacy of your very own home.

Methadone relieves all withdrawals and cravings and can give you a slight buzz and a feeling of warmth just like heroin which will help you to beat the cravings for using heroin. And in some cases, methadone may be a better choice for hard core junkies/users.

Subutex does not give you a buzz or any feeling of warmth and may have to be adjusted in order to find a ďcomfort levelĒ for you. With Subutex youíll be feeling quite normal, alive and well, which is great. But youíll also have to try much harder to battle those thoughts of getting high each and every day. But all you have to do is think about your baby and your future in order to beat those cravings and keep yourself clean.

Coming off of methadone for the mother is a little more difficult than coming off of Subutex. Methadone withdrawals can be pretty rough and can last for a long time even after a safe and careful taper. With methadone, you'll have to taper down slowly, or as directed by your doctor. And if the option is available, (after the baby is born) then you can also switch from methadone to Suboxone as well and then taper down from the suboxone in a safe and steady manner. And coming off of Suboxone is indeed a lot more easier than coming off of methadone.

Coming off the subutex for the mother is a lot easier and less painful than coming off of methadone. The taper is easier and can be done from home. Yet all of this can be done under medical supervision as well.
  
With methadone, NAS (Neonatal Abstinence Syndrome), can be a little more harder on the baby than with Subutex. And again, as mentioned above, symptoms of NAS include tremors, vomiting, respiratory difficulties, poor sleep, and low-grade fevers.

Yet with subutex, symptoms of NAS are less severe than those of methadone. According to a study published in the New England Journal of Medicine, Buprenorphine was better than methadone in reducing withdrawal symptoms with the newborns.

A study conducted by the Maternal Opioid Treatment Human Experimental Research group (MOTHER) concluded that babies treated for NAS from withdrawals from Subutex required less medication and less time in the hospital.  
 
    
  Conclusion
Methadone maintenance has been used as a standard treatment procedure for pregnant women addicted to heroin for over 25 years and has been proven to be safe and effective for both the mother and the baby as well. The only down side to methadone treatment is the side effects of NAS on the baby and the difficulties of coming off of the methadone for the mother after the baby is born.

However, it is also important to remember that the doctors will treat your baby for NAS and help your baby come off of the methadone as safely and as smoothly as possible and that NAS is only a temporary, short term side effect of the methadone. And you and your baby will be able to go home shortly.

Furthermore, you can begin to be weaned down from the methadone safely or switched from the methadone to Suboxone in order to come off of the methadone. The doctors will also help you to come off of the methadone as well, (possibly with morphine or other types of narcotics).

Needless to say, Methadone works. It works well both for the mother and for the baby. And if methadone is the only choice you have then donít worry, and donít panic - just do it. (Itís better than putting street heroin into your body and living the life of an addict). Talk to your doctor. Get off of the heroin and get onto a medical supervised methadone treatment program and enjoy the rest of your pregnancy in peace. For more information on Methadone Maintenance Therapy (MMT), talk to your doctor or attending physician(s).

NOTE: If youíre on methadone at the moment then you may want to stay on the methadone if the methadone is doing itsí job in keeping you clean from heroin and other opiate drugs.

Subutex (Buprenorphine) as a first choice: If youíre still using heroin then you may want to get off of the heroin and get on to a Subutex program as a first choice, that is of course if Subutex or generic Buprenorphine is made available to you. Ask your doctor what your options are and if Subutex is an option for you. Subutex is easier on you, the mother, when it comes time to wean yourself down from the Subutex. And it is also easier on the baby as well, in regards to symptoms of NAS.

Most doctors however, will still recommend methadone over Subutex simply because methadone has been used, tested and proven for over 25 years. But if Subutex or generic Buprenorphine is available then your doctor may prescribe you Subutex instead. And if not, then you can ask him or her to place you on a subutex program. But of course, thatís up to you and your doctor.

If youíre on Suboxone at the moment then you may also want to talk to your doctor about switching you from Suboxone to Subutex instead. Subutex does not contain Naloxone and may have less side effects upon you and your baby as well. And the transition from the Suboxone to the Subutex is a simple and smooth transition. But whatever you do, donít sit still and don't keep using heroin. The best thing to do is to take action right away so that everything can begin to work out for both you and your baby. 
    
  Step 3. Cut off your drug dealers and drug using friends 
If you want to quit this drug and stay clean for good, then the next best thing to do is to cut off your drug dealers and drug using friends. Even with subutex or methadone and a baby on the way, you will still have to battle temptation, each and every day. Yet by cutting off your dealer(s) and friends who use drugs then it will become much more easier for you to quit this drug and stay clean for good.

If they want to quit heroin then help them. Show them my website, show them how to quit, and then the rest is up to them. But if they donít want to quit and have no intension to do so then the best thing to do is to separate yourself from them, and quite possibly for good.

And you can start by deleting their numbers, one by one. And for close friendships, you can let them know that youíre going to lay low for a while and youíre going to go off the grid. And for some of you, changing your cell phone number may be the best way to go in order to burn all bridges and never look back. If you want to quit this drug and stay clean for good then a total separation will be necessary. 
    
  Step 4. Destroy and throw away all drug paraphernalia 
If you havenít done so already, then the next thing to do is to destroy and throw away all of your drug paraphernalia, once and for all. Get rid of your drug kit, get rid of your foil, get rid of your straws, and get rid of your empty baggies and empty balloons.

And if youíre shooting up then break your needles, all of them, and get rid of them too. Get rid of your spoons, get rid of your tie belt, and get rid of your cotton balls as well. Destroy and get rid of everything, once and for all. All of this is necessary, and all of this will help you to quit heroin and stay clean for good.
    
  Step 5. Start your program and quit all drugs 
Once youíre ready to begin; once youíre ready to put this drug behind you for good; and once youíre ready to start a whole new life for yourself and for your baby as well, then start your program, just as soon as you can.

If youíre going to do this with methadone, then go to clinic, go to the hospital or go to wherever youíre going to get your methadone from and take your first dosage, (under medical supervision), and continue to do so for the remainder of your pregnancy or as directed.

If youíre going to do this with Subutex, then go to your doctor, go to the clinic or go to wherever youíre going to get your subutex from and then take your first subutex dosage, (under medical supervision).

And you can mark this day as a beginning of a whole new life for you.  
 
  IMPORTANT NOTE: Itís also important to remember that if you're going to use Subutex, then itís best not to take other pharmaceutical drugs while youíre on the subutex without checking to see if those other drugs can cause a negative drug interaction. For example, taking subutex while taking Mobic and/or Seroquel can cause a negative interaction and can cause the subutex to have a weak effect while also causing you to feel sick as well. And the same is true for most pain medications. Subutex should not be taken with opioid pain medications as this can cause a negative drug interaction. However, when in doubt, donít just ask your doctor, but Google and research it as well. For example, Google "Subutex and Mobic interaction" on Google.com, "Subutex and Seroquel interaction", "Subutex and ďdrug in questionĒ interaction". The best way to take Subutex is to take the Subutex all by itself, with no other drugs involved. 
 
Aside from the heroin addiction, there may be other unhealthy habits that you may need to give up as well; such as smoking cigarettes, drinking and the use of other drugs. There may be no need for me to mention these things seeing that most women realize that smoking, drinking and using drugs can be very harmful to the health and development of the baby. But sometimes, itís good to understand and be reminded of these things just as well.

If youíre using heroin then thereís a good chance that youíre smoking cigarettes too. And if you are smoking then itís imperative for yours and your babyís health that you quit smoking as soon as possible.

"Smoking cigarettes is probably the No. 1 cause of adverse outcomes for babies," says Dr. Robert Welch, who's the chairman of the Department of Obstetrics and Gynecology at Providence Hospital in Southfield, Michigan. He's seen the complications far too many times: babies born prematurely, babies born too small, babies who die before they can be born at all. And when a pregnant woman smokes, he says, nothing can protect her baby from danger.

Cigarette smoke contains more than 4,000 chemicals and at least 60 cancer-causing compounds. Nicotine and carbon monoxide account for almost every smoking-related complication in pregnancy including stillbirth, premature delivery, and low birth weight. Nicotine and carbon monoxide work together to reduce your baby's supply of oxygen and choke off that oxygen by narrowing blood vessels throughout your body, including the vessels in the umbilical cord. So it's like forcing your baby to breathe through a narrow straw. Even just 1 or 2 cigarettes a day will significantly tighten blood vessels, and a shortage of oxygen can have devastating effects on your baby's growth and development.

Smoking cigarettes during pregnancy can stunt your baby's growth within the womb and can have many other negative consequences as well, such as heart defects at birth and insufficient lung function after birth as well. Smoking during pregnancy can also have lifelong effects on your baby's brain as well. Studies have shown that kids of pregnant smokers are more likely to have learning disorders, behavioral problems, and relatively low IQs.
 
Smoking marijuana during pregnancy may also affect your baby's growth and the development of his or her nervous system. Studies have also shown that kids who were exposed to marijuana during pregnancy sometimes have difficulty focusing their attention and solving problems. Children of weed smokers may also have problems with short-term memory, concentration, and judgment.

Using Benzodiazepines during pregnancy such as Xanax, Valiums and Klonopin for example affects NAS, Neonatal Abstinence Syndrome, making it longer in duration and more difficult to treat.

Drinking alcohol during pregnancy also endangers your growing baby in a number of ways as well. When you drink, the alcohol travels through your bloodstream, crosses the placenta, and reaches your baby. Your baby breaks down alcohol more slowly than you do, so he or she may end up with higher levels of blood alcohol than you have. Drinking alcohol during pregnancy increases the risk of miscarriage and stillbirth as well. Even one drink a day can increase your chances of having a baby with a low birth weight and can raise your childís risk for having problems with learning, speech, and attention span. Studies also show that children born to mothers who drank alcohol during their pregnancy later exhibited aggressive and delinquent behavior and are more likely to have mental health problems.

As you can see, smoking, drinking, weed, and pills are all bad for you and even more so for your baby as well. But by quitting cigs, weed, pills, drinking and all of that stuff now, you will save yourself and your baby too. You will ensure a brighter and a healthier future for both you and your baby as well. 

And if your boyfriend or husband is using heroin then now is the best time for him to quit as well. In fact, it is absolutely essential that he quit too in order to increase your chances of quitting this drug and staying clean for good. Because itís just about impossible for one person to quit heroin and stay clean while the other keeps using. Furthermore, with heroin in the picture itís going to become very difficult for him to provide for you financially during your pregnancy and after the pregnancy as well. And if heís not ready to quit, or simply doesnít want to quit heroin, then you may need to separate yourself from him and leave the premises for some time and move in with a family member or friend. But hopefully, you can both quit this drug and stay clean for good and have a new and better life, together.

Everything changes now, and everything has to change. You now have a baby growing inside of you and now you are responsible for another life other than your own. But this can also be a blessing in disguise as well. Your baby can change your life. And this can become your chance to quit drugs and have a new and better life. So whatever you do, donít let this opportunity pass you by. Grab it, take it and use this opportunity to quit drugs and change your whole entire life.
     
  Staying clean 
Getting clean is one battle. Staying clean is another. You may feel well on the methadone or on the Subutex as well, but the temptation to use heroin will be there and will come and go from time to time. But there are some things that you can do to help you fight temptation and stay clean for good.

Use your mind: You canít stop temptation from coming into your mind, but you can sure begin to war against it. Whenever those thoughts of using heroin come into your mind you can begin to battle against those thoughts by telling yourself, ďNo, no , noĒ repeatedly and literally tell your brain to ďshut upĒ. You have to actually tell yourself, ďno, donít think about thatĒ, in order to help you counteract temptation. And then keep battling those thoughts over and over again until they begin to fade away. And when those thoughts come back again, (and they will come back), then start battling them and keep battling them until they go away. Because the only way that those thoughts are going to leave is if you start battling them and keep battling them until they do.

No one can fight the battle for you. You have to do it yourself. And for the most part, the biggest battle will take place within your mind. But as long as you keep fighting those thoughts and your own desire to use then you can help yourself beat this drug and stay clean for good.
 
  Take action: If at any time you become overwhelmed with the urge to use heroin, then as fast as you can, you can get up, take action and do something different right away in order to help deter yourself from going out to use. You can get dressed and go out for a nice long walk. You can go to the park and do some people watching from a park bench. You can go to the beach if you have one nearby. You can go to the mall and buy something nice for yourself. You can go out and find some of your favorite chocolate. Or you can stay home and take a long warm bath while listening to clean, decent, relaxing music. But whatever you do, donít just stay there and allow yourself to be attacked and beaten down by temptation. Instead, get up, take action and do something different right away.

Reach out for help: If youíre having a hard time with temptation, then donít be afraid to reach out for help. You can reach out and call a friend, (a drug-free friend) and/or go visit them as well. You can call a family member and talk to them until the urge to use slowly goes away. And you can always find and attend a local NA meeting to be around others who are trying to quit heroin and stay clean as well. (www.NA.org).

Build a support group: Make a list of family members and friends who you can call and visit at any time and keep that list on your person at all times. If you have a facebook account then you can reach out for help on facebook as well. And if you donít have a facebook account then you can easily create one and start adding family members and friends, (drug-free friends). And you can also find a drug counselor to visit on a weekly or bi-weekly basis. You can do this alone, just as well. But whatever you do, donít be afraid to reach out for help. Help is just a visit, phone call, text message or email away.
    
  Take care of yourself
Your main responsibility during this time will be to stay clean and take care of your health, for your babyís sake and for your sake as well. The best way to increase your chances of giving birth to a strong and healthy baby is to do everything you can to take care of your health.

The best thing to do is to refrain from junk foods and fast foods as well, as eating such foods can become detrimental to your babyís health, growth and development.

The best thing to do for both you and your baby is to eat healthy foods from here on out, or at least try your best to eat as healthy as you can. And if youíre thin then you may need to eat more than usual as well. Healthy eating is important, but it's even more important to eat healthy and take care of yourself when you're pregnant.


During this time, you can begin to do as much research as you can on healthy foods and healthy diets for pregnant women. For example, avocados, broccoli, carrots, eggs, salmon, nuts, oatmeal, pumpkin seeds, spinach and yogurt are all healthy choices for foods. Beans such as navy beans, lentils, black beans, pinto beans, and chickpeas contain more fiber and more protein of all the vegetables as well.
 
   Each color group of fruits and vegetables provide different vitamins, minerals and antioxidants. And eating a variety of green, red, orange, yellow, purple and white fruits and vegetables will help to ensure that you and your baby receive a variety of nutrients. Furthermore, during the later stages of pregnancy, your baby is going to actually start tasting the foods you eat through the amniotic fluid, and if your baby is exposed to a variety of healthy fruits and vegetables within the womb then he or she is more likely to accept those same flavors after birth and on throughout the growing process as well.

And if your finances allow you to do so, then you may want to go out and do some health food shopping to start eating healthy, each and every day. You can create a well organized menu for each day of the week so that you won't have to worry about trying to figure out what you're going to eat for the day.

You can start taking extra prenatal vitamins, minerals and herbal supplements and you can start drinking a minimum of 7 water bottles per day as water is the most important element that your body and baby will need from here on out. The best thing to do is to do everything you can to make sure your baby is getting the best and the most nutrients possible. And the healthier you are, then the easier it will be to come off of the methadone or Subutex when and if the time does come to do so.

NOTE: When buying fruits and vegetables (if at all possible) try to find and buy certified organic foods and/or foods which come from local farmers. Because unfortunately, most stores today are selling GMO (Genetically Modified Foods) which are bad for both yours and your babyís health. But the best foods to eat for both you and your baby are genuine, certified, organic foods that are grown and raised in the sun.

Your main responsibility during your pregnancy will be to take care of yours and your babyís health, by quitting all drugs, cigarettes and alcohol; eating healthy foods, drinking plenty of water and taking vitamins, minerals and herbal supplements and doing everything you can to take care of yourself.
    
  Tapering during pregnancy
Most doctors and clinics may not recommend nor even consider reducing your methadone or subutex dosage during the time of your pregnancy. However, it is still possible to wean yourself down slowly and safely during your pregnancy (under medical supervision) without you or your baby ever noticing the difference so that when the time does come to give birth, you will already be on a low dose of methadone or subutex, and the effects of NAS, if any, may be reduced to a greater degree.
 

 
And if youíre going to taper down from the methadone or subutex during your pregnancy, even to a slight degree, then it would be best to taper down during your 2nd trimester.

1st Trimester:
Your first trimester of your pregnancy is the most delicate time for your unborn child as this is a time for major growth and development. Quitting heroin, methadone or subutex during this time can result in spontaneous abortion of pregnancy.


2nd Trimester: Your second trimester can become a window of opportunity for your doctor or clinic to reduce your intake of methadone or subutex since this is the time when heroin, methadone or subutex withdrawal can become least harmful to your baby. So if youíre going to taper down from the methadone or the Subutex to any degree at all, then this is the time to do so.

3rd Trimester: Your third and last trimester can very well become the most dangerous time for your babyís health and birth, as going through withdrawal during the last few months of pregnancy is when the risk of premature birth is at its highest. And under normal circumstances, this is the time to remain stable on your dosage of methadone or subutex.
 
  As is the case with all matters concerning your health, you need to do what you feel is best for you or whatever your doctor or nurse instructs you to do. It's also important for you to be able to decipher the difference between discomfort and withdrawal as well.

If you feel any discomfort which feels like withdrawal then you need to have your dosage adjusted in order to feel normal again and then proceed accordingly. You need to be able to feel comfortable and remain stable on that dosage level.


However, if you want to taper down from the methadone or subutex to any degree at all during your pregnancy then talk to your doctor about doing so in a slow, safe and supervised manner.
    
  In the mean time, enjoy your pregnancy
During your pregnancy, there are plenty of things that you can do to help keep you busy and enjoy your pregnancy as well. You can go out for brisk walks each and every day as exercising helps you to keep your energy levels up and stress levels down. Exercise can also be great for swelling and can help to get circulation moving as well. There are however right and wrong ways to exercise during this time so be sure to seek out specialized pregnancy-fitness instructions, books, or videos before you begin to do so.

You can also take a dip in a nice clean pool. Being in water can become very liberating during pregnancy. Youíll feel weightless, and your legs and feet become free from their supporting role. You can swim, play and have fun in an indoor or an outdoor pool. (Avoid hot tubs, as becoming overheated can become dangerous for your baby.)

You can go out to the mall and buy yourself some pregnancy clothes and comfortable shoes. You can get a footstool to ease the stress on your hip joints and lower back. And you get a body pillow to make side sleeping more comfortable as well. And with the money you save from not having to buy drugs any more, you can start buying all kinds of stuff for your baby; a little here, and a little there as your finances allow you to do so. And towards the end of your pregnancy, you can also plan on a baby shower as well and this will help you greatly with all of your baby needs.
 
NOTE: If times are hard financially, or if you just want to earn an extra or a full time income, then you may want to consider working from home and/or working online; finding work that you can do from home, on the internet, or starting your own business, website, web store, blog, etc.. For example; you can buy items from Goodwill stores, thrift stores, yard sales and garage sales and sell them on eBay.com for a profit. You can dig up unused and unwanted items in your own home and sell them on eBay as well. Just about anything and everything sells on eBay. If youíre into arts and crafts then you can create and sell arts, crafts, gift baskets, handmade jewelry, clothing accessories and more on eBay, Amazon and Etsy.com. If you like to write, then you can write, publish and sell eBooks on Amazon.com. You can build a personal online blog based upon a popular topic and then post banner ads and Google Ads on your blog to get paid for clicks and sales made from your blog. If you are knowledgeable on a specific subject matter then you can get paid to be an online guide, write articles and maintain a blog for About.com. And there are plenty of more ways to earn a decent income from home to help you provide for both you and your baby, and to create a better life for yourself as well. It can become stressful working a regular job while pregnant and working from home may be the best thing to do for both you and your baby.ďGoogleĒ these topics, do some research, make a plan and then put your plan into action. And before you know it, you could be making money from the comfort of your own home in no time at all.

During your pregnancy, you can also visit with friends and loved ones as often as you can. The more friends, family and loved ones involved in your pregnancy, then the more rewarding it will be for you and everyone else involved. And during this time, you can also take pictures to document each month's changes to your body with a photo as your baby grows. You can also get a massage every so often in order to reduce the tension on your back. Be sure to get plenty of rest as well.

You can watch some good, family, inspirational movies and listen to good, clean, uplifting music. You can use this time to start picking out baby names as well. You can also begin to do research online on the subject of health and pregnancy. There are a lot of things that you can do to keep yourself busy and enjoy your pregnancy as well. But for now, just take it one day at a time.
    
  After birth
There are some other matters that may become a concern for you as well; such as breast feeding for example.

Can a Mother Breastfeed on Methadone?

Yes. According to studies, it is safe to breastfeed your child while you are taking methadone. While methadone is found in the breast milk, only a small amount of methadone is passed along to the baby.

Furthermore, the nutrients in the breast milk will also help your baby to cope with any mild discomfort and will help to nourish and strengthen your baby as well.

However, as with most pharmaceutical drugs, it will still be best for both you and the baby to taper down from the methadone as soon as you can, in a slow, safe and supervised manner. But of course, thatís up to you.

Can a Mother Breastfeed on Subutex?
 
  SAMHSA (the Substance Abuse & Mental Health Services Administration), has looked into the matter and has said that since buprenorphine is not well absorbed in the stomach, babies getting it through breast milk seem minimally affected by it, and that women using Subutex can breastfeed.

As with most pharmaceutical drugs, it would be best for your baby and for yourself to be off of the methadone or Subutex or begin the process of tapering down before, during, and/or while breastfeeding. The less medication being passed through the milk then the better off your baby will be.

Coming off of methadone
After the birth, the best thing to do is to come off of the methadone just as soon as you can (but in a slow, steady and safe manner) in order to avoid a prolonged addiction and to have less methadone flowing through the breast milk., (if youíre going to be breastfeeding your baby). Furthermore, the sooner you come off of the methadone then the sooner your brain and body can begin to heal. However, some of you may have to stay on the methadone for some time as well in order to keep yourself from using heroin and to help you to get through the first few months of taking care of your new born baby.

If you were on a short term methadone plan (without the baby) then you could speed up the process of tapering down. But if youíve been on it for 3, 4, 5 months or more then it would be best to come down from the methadone slowly and safely without feeling too much discomfort if any discomfort at all.

A 2mg to 3mg reduction of methadone per week may allow you to taper in a safe and comfortable manner. However, it would be best to talk to your doctor and allow him or her to place you on a tapering program that works best for you. Ask your doctor or the nurse at the clinic to begin to taper you and wean you down in a safe, slow, and comfortable manner, again, when youíre able and ready to do so. No one is going to rush you. And if you want to stay on the methadone for a little while longer then that is entirely up to you.

NOTE: Methadone binds itself to the fat cells on your body prolonging cold chills and discomfort. However, to speed up the detoxification process, you can find and use a sauna, daily if possible, as the steam from the sauna will help detach the methadone substance from your fat cells and help remove other toxins from your body as well.
 
After birth, you can also switch from the methadone to Suboxone as well for an easier taper and weaning process. And to do so, all you have to do is work your way down, (taper down) to 25mg to 30mg of methadone per day and continue on that dosage for 5 to 7 days and then stop taking the methadone completely for 48 to 72 hours or more, (72 hours may work best) (or when in full withdrawal from the methadone), and then take that first 4mg or 8mg suboxone dosage under the tongue. You should begin to feel better within 40 to 60 minutes or less.

However, this too should be done under medical supervision as well, as taking suboxone too soon can cause you to go into precipitated withdrawal. But switching from methadone to suboxone and then tapering off of the suboxone is an option to consider if suboxone is available.

You can also taper down to as low as you can go on the methadone, i.e. 15mg, 10mg to 5mg and then wait 48 to 72 hours before jumping onto another opioid pain medication for 3 to 4 days such as Tramadol for example. And then you can taper down from the Tramadol and jump off of all opioid medications with the help of cold and flu medications such as Nyquil for example, if necessary.

Coming off of Subutex
When youíre ready to do so, you can begin to taper down from the Subutex in a safe and steady manner. Subutex, (buprenorphine) comes in 8mg and 2mg tablets making it easy to split 8mg tablets into 4 2mg pieces and 2mg tablets into 4 small .50mg pieces. And a person can reduce their subutex dosage by .50mg to 1mg per week or bi-weekly while feeling little discomfort if any discomfort at all.

For some of you, it may be better to stay on the subutex for some time in order to keep you off of the heroin and allow you to enjoy the first few months with your baby in peace. However, the less subutex youíre taking into your body, then the less subutex is passed through the breast milk, (if youíre going to breast feed your baby). But sooner or later, it would be best to taper down from the subutex as well, in a slow, safe and supervised manner when youíre ready and able to do so.

Talk to your doctor or attending physician about tapering down from the subutex whenever youíre ready. They will place you on a supervised tapering program or you may have to do it yourself as well. And you can easily taper yourself down by reducing your subutex intake by .50mg to 1mg weekly or bi-weekly all the way down to .25mg or less if possible. But of course, thatís entirely up to you.

But whatever you do, once you have the baby and youíre both back home, do everything you can to refrain from using heroin from here on out. And it would be best to refrain from using any mind altering drugs as well. And if you managed to quit smoking cigarettes, then the best thing to do is to stay clear from cigarettes just as well in order to have a new and healthy life.
    
  This is your chance
This is your chance to quit heroin and stay clean for good. This is your opportunity to quit this drug, once and for all. And you can use this opportunity to change your whole entire life, starting now.

I'm not a doctor, nor a pregnant woman, but I will say this:


If you try your best to take care of your health by eating extra healthy, taking extra vitamins, and drinking plenty of water then your chances for having a successful pregnancy and birth will increase greatly.

If you try your best to come off of the heroin, get onto a methadone or subutex program, and stay off of the heroin for good, then itís quite possible that life will show you mercy and allow you to give birth to a strong and healthy baby.
 
If you try your best to continue to stay clean for the rest of your life, and dedicate yourself to turning your life around and become the best mother that you can possibly be, then it's very possible that you and your baby can live a long, healthy and happy life together, for the rest of your lives.

Many mothers have done it. Many mothers have quit heroin, stayed clean, and turned their lives around. And you can do it too.

If you really want it, then you can do it.

Do this for your baby.

And do this for yourself.

Good luck. And may the good force be with you.
 
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