Methadone Use During Pregnancy | Concerns & Safety

Methadone is an opioid agonist that is used to treat opioid use disorder and opioid dependence. It can also ease withdrawal symptoms and drug cravings. It’s often compared to buprenorphine and naloxone which work in similar ways.

While methadone is an opioid medication, it’s sometimes prescribed to opioid/opiate-dependent women who are pregnant because it’s a much better alternative than having them use an illicit drug like heroin.

But while methadone may be considered safer for pregnant women to use than illicit opioids, it can still pass through the placenta to the fetus, increasing the possible risks for the mother and baby.

Is Methadone Use Safe During Pregnancy?

Taking methadone while pregnant is generally considered safe as long as it’s under the supervision of a healthcare professional.

According to the American College of Obstetricians and Gynecologists (ACOG) and the Substance Abuse and Mental Health Services Administration (SAMHSA), there have been very few incidences of serious issues when pregnant women have taken methadone.

Methadone Maintenance Treatment

As long as the mother practices good prenatal care and takes methadone as directed, the mother and baby should be healthy.

This is especially the case if they take it as part of methadone maintenance treatment for opioid addiction as any issues the methadone may create are less severe than drug abuse would create.

Methadone Abuse

If methadone is abused, it can lead to the baby becoming dependent on the drug and lead to severe withdrawal symptoms once they’re born.

Methadone abuse may also lead to poor growth of the baby, low birth weight, stillbirth, and preterm delivery. The baby can also be born addicted to the drug.

Concerns Of Using Methadone During Pregnancy

As with any medication, you and your doctor need to weigh the risks versus the need to take the medication. Usually, the benefits of not relapsing with an illicit drug are much higher than the risks that may come with prescribed methadone use while pregnant.

Beyond weighing the benefits and the risks, you’ll also want to watch the dosage of methadone you take. It’s important to monitor the dose of methadone during the final three months of pregnancy. This is the time when metabolism increases and the baby reaches the final stages of development.

The dose of methadone may need to be increased so the mother doesn’t go into withdrawal. Withdrawal symptoms could negatively affect both mother and baby.

Methadone Side Effects

Just like most other medications, methadone has some side effects. These side effects include:

• dry mouth
• headache
• weight gain
• sore tongue
• stomach pain
• difficulty urinating
• changes in vision
• problems swallowing
• mood disturbances
• nausea
• dizziness
• trouble falling or staying asleep

If any of these side effects occur, it’s important to contact your doctor. While the medication may be important, you don’t want any of these side effects to affect your overall health or baby.

Effects Of Methadone Use On Babies

Neonatal abstinence syndrome (NAS) is one of the most common issues affecting a newborn baby when the mother takes methadone while pregnant. It usually occurs if methadone is used during the final trimester, but can happen if drug use is continued throughout pregnancy.

Neonatal withdrawal symptoms or withdrawal syndrome may occur when newborns no longer receive the medication in utero.

For a medication like methadone, opioid withdrawal symptoms can include:

• difficulty breathing
• extreme drowsiness
• poor feeding
• irritability
• sweating
• tremors
• high-pitched cry
• vomiting
• diarrhea
• fever

These symptoms can begin a few days after the baby is born and last for two weeks or more. If necessary, the baby may need to be treated for withdrawal when staying in the hospital or need follow-up appointments with the doctor.

But while these symptoms can seem dangerous, they are much less risky than if the baby was exposed to heroin or other opioid medications during pregnancy. Most times, a quiet and comfortable space is all the baby needs.

Methadone & Breastfeeding

Taking methadone in the postpartum period or after the birth of the baby is considered safe.

Breastfeeding while on methadone doesn’t cause much harm to the baby, but a very small amount of the drug gets into the breast milk.

How much depends on if you’re taking a high dose or not, but as long as your healthcare provider is aware and doesn’t advise against it, serious issues are unlikely.

If you or a loved one live with opioid addiction or another substance use disorder, substance abuse treatment programs are available. To learn about our outpatient treatment options, please contact us today.