What happens when heroin addicts fall pregnant.

Content warning: This post contains details of addiction and drug use some readers may find triggering.

Imagine you’ve just learned you’re pregnant. How do you feel? Elated? Anxious? Overjoyed? Likely a combination of conflicting emotions that hardly make sense and seem bent on the sole purpose of driving you mad. Whatever your feelings and decisions later, those few moments when you first learn of your pregnancy are absolutely overwhelming.

Now imagine you’re also addicted to heroin.

That was the reality I found myself living in the summer of 2013, when I looked through blurred vision at a little plus symbol that indicated I was pregnant. The next year would prove more difficult than anything I had ever experienced, riddled with PTSD flashbacks, depression, and complete disregard by almost every medical professional I encountered.

Most people think that an opiate addicted woman who becomes pregnant should immediately stop using all drugs. I thought that, but when I admitted my addiction to a doctor, he demanded that I continue using if I wanted a healthy pregnancy.

You read that correctly. When I became pregnant while addicted to heroin, my doctor told me to keep using until I could get a prescription for methadone, a non-euphoric, long-lasting opiate that would prevent me from experiencing withdrawals. Withdrawals, the doctor explained, are associated with growth abnormalities, miscarriages, and even late-term fetal death. They are to be avoided at any cost.

Even if that means using heroin during pregnancy.

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The average methadone clinic in the United States has a wait time of a month or more. When I called my local clinic, the woman on the other line droned, “An intake counsellor will call to set an appointment after the weekend.” When I asked, she said it would be at least a couple weeks before I was actually seen.

“I’m pregnant,” I spat. I could feel my rage building. “I don’t want to keep doing drugs.”

She told me she couldn’t help. I had to dial the state Methadone Authority just to get an appointment that would allow me to quit heroin within the week. I’d make several calls like this throughout my time on methadone. Years later, after I detoxed, I learned from a patient that I was infamous at that clinic. Even new staff who hadn’t treated me knew of the young woman who stood up for her rights. It’s not something that happens at these types of facilities often.

"Imagine you've just learned you're pregnant. How do you feel? Elated? Anxious? Overjoyed? Now imagine you're also addicted to heroin." (Image: Supplied)

I will never forget the doctor who prescribed my methadone. He was an older man, retired from his main practice, who shared the same surname as a popular accessories brand. His hair was dyed an awkward goldenish hue--very much like the current US president--and every time I saw him, he was wearing some new item from his namesake brand.

At the end of our first appointment, he handed over my prescription, laughed, and asked, "So did you run out of money?"

"No," I answered, confused.

"Did you dealer run out of heroin?"

"No..."

"So then what was the big hurry?" It was a statement that embodied the general attitude directed toward me during my time as a methadone patient. My health and safety, and that of my child's, was practically a joke.

I'll give staff credit for one thing though: they always made sure I took my dose, each and every day. Missing my methadone dose was the big fear while I was pregnant. My obstetrician, my prescriber, all my nurses and therapists; everyone warned me about the dangers of missing a dose. Because methadone has a long half-life, my baby could have potentially survived missing one. Two in a row would almost certainly cause complications or a miscarriage.

Methadone patients have to drink their little cup of medicine every day at the clinic while a nurse watches. Once our monthly urinalysis results come back drug free several times, we are eligible to earn "take-home" doses. Because my clinic was closed on Sundays, all patients received one weekend take-home from the start.

I didn't live in town, so I had to bus to my clinic every morning. It wasn't a problem on weekdays, but on Saturdays, the nearest running bus was two miles from my basement apartment. Every morning, I made that trek so I could down my Saturday dose at the clinic, and pick up my Sunday take-home. I biked it, until my belly pressed into my handlebars. When I couldn't bike anymore I walked, even when I was flanked by feet of snow, or pelted by sheets of rain.

One day, it started raining and didn't stop. The Boulder creek gushed out of its gully into the streets, knocking cars into sidewalks. Even the drains in my suburb overflowed. The country watched President Obama declare a small town in Colorado under a state of National Emergency, and that Saturday, my methadone clinic was closed. I was five months pregnant.

Patients were rerouted to the sister clinic in Denver, but I had no way to get there. When my treatment counsellor called with the news, I panicked. Two doses were on the line. I begged her to find a way for me to get my medicine. There was a hospital not far from my home, but state methadone regulations prevented them from dispensing methadone.

My counsellor contacted the Federal Emergency Management Agency (FEMA). While they prepared to airlift me by helicopter to the Denver clinic, I once again dialled the Methadone Authority. It took forty-five minutes of begging, and pretty severe bending of state methadone regulations, but I managed to get the green-light to dose through a local hospital instead. No FEMA helicopter needed. Perhaps if it was as difficult to get prescription opiates in the first place, there wouldn't be such a need for methadone.

LISTEN: Cameron Daddo on his addiction: "I understood that I needed assistance." (post continues after audio...)

The nurse at the hospital eyed my big belly while I downed my Saturday dose. When she handed me the paper bag that held my Sunday take-home, her eyes were cold. She didn't say anything, but she didn't have to. I knew exactly what she thought of me.

I would experience the same attitude after giving birth. Methadone passes through placenta, so my daughter had to be weaned with morphine after she was born. When my husband and I visited her in the Neonatal Intensive Care Unit, staff spoke only to him. Once, a nurse denied me access to my baby. Another called Child Protective Services to report that I had relapsed, even though I was simply a tired new mother.

I took my daughter home, healthy, after a month and a half of medically supervised withdrawals. The same is not true for all Medication Assisted Therapy patients. Some states prosecute pregnant women for entering treatment because of the drugs in their system at the start, or simply because the prescription drugs caused the infant to be opiate dependent at birth, even though they were taken correctly.

I understand the mindset behind the stringent methadone regulations. They are meant to prevent illegal selling or abuse of the drug, and to ensure the safety of children born to addicted mothers. The problem is that these regulations often contradict the opinion of doctors, and place so many barriers to treatment that some addicts who become pregnant decide it's easier to just keep using.

I am a loud-mouthed, educated woman who knows how to advocate for myself. Even so, I felt invisible most of the time. Other women, often less educated or otherwise more vulnerable, fall to the wayside and end up paying the ultimate price: losing their babies to miscarriage, premature delivery, or Child Services.

The regulations need to change, but that won't happen until our cultural consciousness shifts. Instead of shaming and arresting addicted mothers, let's try supporting them, and see what happens. I have a feeling we'll all be better for it.

If you or someone you know is struggling with substance abuse, please seek help from a medical professional or contact the Alcohol and Drug Foundation. If you're in immediate danger, call 000.

Elizabeth Brico is a freelance writer who lives in the United States with her family. She authors the blog Betty's Battleground, centred around living and parenting with PTSD, and recently joined HealthyPlace as a contributing blogger. Her writing on mental health, women's issues, and parenting can be read across the web. Recent credits include Vice, Vox, and Mom.me. When she isn't actively momming or working, she can probably be found reading, writing, or watching speculative fiction.

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