Monday, April 30, 2012

Stigma of Methadone Treatment and Pregnancy

The NCHRC, North Carolina’s only comprehensive harm reduction program, recently published an article on the stigma of methadone treatment while being pregnant.  NCHRC has witnessed a lot of misinformation and stigma surrounding the use of methadone as treatment for opiate addiction, but they found that the problems are even more apparent when the patient in the treatment program is pregnant.

The goal of methadone treatment for pregnant women is to help them avoid the negative consequences of illicit drug use, including overdose and withdrawal, both of which can jeopardize the pregnancy.  Without having to worry about illicit drug use, a woman is in a better position to engage in prenatal care.

Katie Clark, a research assistant at the Yale School of Public Health, began to notice the stigma surrounding pregnant women through her work at an opiate treatment center. “While I was working as a counselor I started to tailor my caseload to work with predominantly pregnant and parenting women. They shared with me that they were looked down upon, by other people in their lives and people in treatment, because they were in methadone treatment during pregnancy. Even though medically, they were doing the best thing for themselves and their pregnancies, this was not the message they were getting from those around them.”

As Katie explains, even within hospitals and drug treatment programs, pregnant women are often judged for methadone use. “People see an infant in withdrawal and start making comments like ‘how could you do this to your baby.’ In one case, a social worker tried to charge a mother with child abuse because she was in treatment during her pregnancy.”

Just as women are cautioned against alcohol use while pregnant, many people assume that women should immediately stop using opiates as well, but actually, quitting opiates can be very dangerous. “Opiate withdrawal can jeopardize the health of the baby and the mother and even cause miscarriages,” says Katie. “Methadone has been used as treatment for pregnant women for 30 years to keep mothers and babies stable during pregnancy.”

In her work, Katie also challenges that myth that babies are “born addicted” to opiates. “There is no such thing as a baby born addicted to opiates, but babies with opiate-dependent mothers can show withdrawal symptoms once they are born, such as diarrhea, stiffness, or not eating or sleeping well,” says Katie. “A baby experiencing withdrawal is usually kept at the hospital and, if clinically indicated, put on medicine to make them comfortable. Doctors will keep the babies in the hospital until they are weaned off the medicine.”

Katie created a website, to answer questions about methadone, pregnancy and opiate addiction.  Voices from the Harbor is an audio documentary Katie created about women’s experiences with pregnancy, opiate addiction and methadone treatment. In the documentary, four women speak of their experiences with addiction, pregnancy, stigma and recovery. Visit to hear their powerful stories.


jennifer whitehead said...

I am so glad this issue is being addressed. I just wanted to clarify one thing...babies who require medication weaning are not routinely kept in-hospital until they are weaned from the medication (not in this area anyway). Proper weaning takes months, and babies are often sent home after a week or two with their mothers, who are able to provide dosing on schedule. There is no reason to believe mothers who take methadone aren't competent enough to care for their own babies through this process. If there are areas of the country where doctors make babies stay in the NICU for the entire weaning process, then perhaps this issue should be addressed. That is barbaric. Infants need the constant attachment that a mother provides, especially in this situation. It is unfair to the baby to have to spend that important bonding time in a NICU when it's really not necessary. And it is unfair to the mother that she is being looked at as incompetent to care for her child through this process. Mothers who take methadone love and care for their children just as much as anyone else. They shouldn't be chastized for making the brave decision to get clean. Mothers who get clean with the help of methadone maintenance should be commended, not stigmatized. It's a shame women are made to feel like they've done something wrong by utilizing the best treatment we have so far for opiate addiction. It is unfortunate that babies have to experience symptoms of withdrawal at all, but if you're at a good hospital with caring, experienced doctors, your baby will be cared for in a way that produces the least amount of discomfort at the first signs of withdrawal. It is time to give these mothers the recognition and encouragement they deserve. Kudos to all of you for making the decision to stay clean, whatever it takes. Never let anyone tell you you're recovery isn't legitimate beacuse you take methadone! And never, ever let anyone tell you you're a bad mother.

Kelly Jones said...

I am glad I came across this site. My sister is going through a methadone detox and just found out she was pregnant. Doctors have given her contradicting advice with one saying she should stop treatment all together with another saying it is safe to continue. I am glad to see that it is possible to stay on it. I will have to pass this along to her. Do you know of anywhere else I could get information to educate both myself and her? I would greatly appreciate it.

Rodney Knight said...

Thanks for sharing this informative blog. I am aware that methadone treatment is a controversial thing. However, I was not aware of how things are when this treatment procedure is applied on pregnant woman. Read More