Detoxing From Cocaine While Pregnant

Cocaine and Pregnancy

The majority of women who abuse cocaine and other drugs are of childbearing age. In fact, approximately 5% of all pregnant women use some type of addictive substance. More than 750,000 babies are born each year that have been exposed to cocaine in utero.¹ A woman who is abusing a substance like cocaine may become pregnant and not even realize it at first, if it is unplanned. Many are reluctant to seek help for substance abuse during pregnancy because of the fear of losing custody of their baby or because of social stigma, but the health of you and your unborn baby are what’s most important.

There are many risks associated with drug use during pregnancy; because of the potential complications, it is essential that pregnant women who may be using cocaine receive appropriate psychological and medical care, including treatment for addiction. With the proper treatment, these risks can be reduced.¹

Effects of Using Cocaine During Pregnancy

During pregnancy, many normal cardiovascular changes take place. These changes are extensive and begin in the early stage of pregnancy. By the time a woman is 8 weeks pregnant, her cardiac output has already increased by about 20%.² Since cocaine is a stimulant, it exacerbates such changes, which can lead to:¹

• Severe problems with high blood pressure.
• Preterm labor.
• Spontaneous miscarriage.
• Complicated delivery.

There are many other adverse effects of using cocaine during pregnancy. Common risks of using cocaine while pregnant include:^1,3

• Premature rupture of membranes (i.e., early ‘water breaking).
• Separation of the placenta from the uterus before delivery.
• Maternal seizures and migraines.
• Maternal malnutrition.

Cocaine is especially dangerous to the developing fetus because it cannot metabolize cocaine at a fast rate. This means that exposure to cocaine is extended, which makes the effects of the stimulant drug more pronounced, thereby increasing the likelihood that your baby could be born with a congenital malformation or anomaly (i.e., a birth defect).³ Furthermore, newborns who were exposed to cocaine use during pregnancy are often delivered prematurely and may relatively have a small head circumference and low birth weight compared to babies born to mothers who don’t use cocaine.¹

Researchers are now finding that cocaine use during pregnancy can lead to future behavioral issues and deficits in cognitive performance, such as:¹

• Problems with self-regulation.
• Impaired cognitive functioning.
• Information processing issues.
• Attention deficits.
• Memory or language problems.

These issues may affect the person for life and can negatively impact their ability to function at school, work, or home. Quitting cocaine and other drug use can help reduce the risks to both you and your baby. For this reason, it is essential to seek professional detox and substance abuse treatment right away.

There are some risks associated with quitting cocaine cold turkey, especially while you are pregnant. Although you might be tempted to detox on your own, it is essential to seek the assistance of a professional treatment program.

Dangers of Continued use of Cocaine During Pregnancy

Continuing with ongoing treatment for cocaine abuse is vital. Former cocaine users are at risk for relapse even after many years of abstinence.¹⁰ Continuing to use cocaine can lead to a variety of severe consequences for you and your baby. It damages your health, putting you at a higher risk for:¹⁰

• Stroke.
• Bleeding within the brain.
• Inflammation of the heart muscle.
• Aortic ruptures.
• Dangerous weight loss and malnourishment.
• Seizures.
• Parkinson’s disorder.
• Paranoia, panic attacks, and psychosis.
• Sensitization, meaning lower amounts of cocaine are needed to produce toxic effects, such as convulsions.
• Problems with motor control, attention, impulse control, memory, and making decisions.

Continued substance abuse will affect your child too. Children whose parents abuse drugs are at risk for a range of problems including behavioral challenges, medical issues, psychosocial impairments, and substance addictions.⁹

Risks of Detoxing from Cocaine on Your Own

Continuing with ongoing treatment for cocaine abuse is vital. Former cocaine users are at risk for relapse even after many years of abstinence.¹⁰

People with significant levels of physiological cocaine dependence may experience a withdrawal syndrome that can make it difficult to just stop using the drug without detox. Withdrawal occurs after someone who has been using cocaine for an extended period of time suddenly reduces use or stops the drug altogether.⁴ There are several different phases that a person may go through during the cocaine withdrawal process.⁵

The cocaine withdrawal symptoms during Phase I emerge within a few hours to a couple days after sudden cessation of heavy cocaine use.⁵ This is sometimes called the crash period. It consists of:⁵

• Irritability.
• Anxiety.
• Restlessness.
• Dysphoria, or general unease.
• Increased appetite.
• Exhaustion and increased need for sleep.

Phase II of cocaine withdrawal may last anywhere from 1 to 10 weeks following cessation of use.⁵ The following symptoms may appear during this phase:⁵

• Poor concentration.
• Lethargy.
• Mood swings.
• Depression.
• Erratic sleep patterns.
• Strong cravings.

A person who has quit cocaine can experience sadness or dysphoria for up to 28 weeks after last using. This is called the extinction phase of withdrawal.⁵

If you attempt to stop using cocaine on your own, you will likely experience unpleasant cocaine withdrawal symptoms. Although these symptoms are not typically fatal, withdrawal can have a negative impact on your mental and physical health. People who are going through cocaine withdrawal should be carefully monitored for severe depression and suicidality.⁶ Maternal suicidality and any attempts at suicide could clearly be devastating for the unborn baby. Additional, although rare, seizures may occur during cocaine withdrawal.⁶ If a pregnant woman experiences a seizure, this could put significant stress on the fetus, leading to possible complications.

Because cocaine, along with most other drugs, passes from the mother’s bloodstream to the fetus, the baby may experience some withdrawal symptoms at birth, although the issues often appear to be due to the toxicity of cocaine itself as opposed to dependence.⁷ Regardless, the sooner you quit abusing cocaine the lower the risk of giving birth to a baby with a birth defect or other deficit.

Treating Cocaine Withdrawal

The first step of treatment for cocaine addiction is the detoxification process.

Maternal cocaine abuse is associated with numerous fetal complications, such as premature labor, miscarriage, and decreased birth weight.⁸ Getting clean with the help of professional detox can go a long way towards bettering these potential outcomes.

The first step of treatment for cocaine addiction is the detoxification process. Here, you will receive a comprehensive medical assessment when admitted to a detox unit. There are no FDA-approved medications for the management of stimulant withdrawal, but some adjunct medications may be used, such as antidepressants if the depression is severe enough.⁶ The physician should explain the risks and possible side effects of any medications that you are given.⁸

Detox and Rehab

The ideal treatment will consist of inpatient detoxification followed by comprehensive cocaine addiction treatment. Inpatient detox treatment takes place in a hospital or inpatient detox facility where you will be carefully monitored 24/7 by medical staff to ensure you and your unborn baby’s safety. Outpatient detox treatment is typically conducted at a community clinic or through your physician. You would remain at home and visit the clinic or doctor’s office for withdrawal treatment on a regular basis.

After you’ve completed the detox process, follow-up care should link you with a range of services, such as:⁸

• Medical and obstetrical assessments, including sonograms and blood work.
• Mental health and psychosocial assessments and care.
• Financial support services.
• Drug-free safe housing.
• Case management services.
• Pediatric follow-up care.
• Vocational services.

Follow-up care should continue long after the baby is born to ensure that both you and your baby recover fully.⁸ Once you are stabilized, it is important that you transition into a cocaine abuse treatment center so that you can maintain sobriety for both you and your child. Many of these addiction treatment programs specialize in treating the unique needs of pregnant women and mothers and some programs even offer daycare, so it’s important to do your research when looking for a recovery program that is best for you. Without a formal addiction treatment plan, you are at risk of relapsing because you might not have the coping skills necessary to avoid potential triggers.

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