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Suggest Ways To Wean Off Heroin

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Posted on Tue, 17 May 2016
Question: What is the best way to detox from opiates (heroin) while pregnant without having a positive drug test? And is it better for baby to wd in womb or out of womb? And also I hear 3rd trimester is safest time for baby to wd,is this true?
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Answered by Dr. Dr. Matt Wachsman (2 hours later)
Brief Answer:
Tricky... nothing is perfect

Detailed Answer:
First, withdrawal is DANGEROUS. It can precipitate delivery. worse in first or second trimester. So tapering or cold turkey is OUT.

The two alternatives are methadone or subatek. Methadone is the recommended one despite having a much higher likelihood of newborn withdrawal. I thought that was crazy till I became an addiction doctor. The methadone program watches people DAILY. the majority of those on heroin really need close attention. Subatek is potentially an option and has worked BUT only when the person was already really stable in drug treatment otherwise no.

The downside is the baby will have withdrawal with methadone and in either case the urine screen will be positive. BUT everyone is going to be much happier with someone in recovery than someone who is trying to lie about it.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Ways To Wean Off Heroin

Brief Answer: Tricky... nothing is perfect Detailed Answer: First, withdrawal is DANGEROUS. It can precipitate delivery. worse in first or second trimester. So tapering or cold turkey is OUT. The two alternatives are methadone or subatek. Methadone is the recommended one despite having a much higher likelihood of newborn withdrawal. I thought that was crazy till I became an addiction doctor. The methadone program watches people DAILY. the majority of those on heroin really need close attention. Subatek is potentially an option and has worked BUT only when the person was already really stable in drug treatment otherwise no. The downside is the baby will have withdrawal with methadone and in either case the urine screen will be positive. BUT everyone is going to be much happier with someone in recovery than someone who is trying to lie about it.