Pregnant and taking Vicodin

[killezoey]

Hi

I posted this in the substance abuse forum as I was unaware of this group (thanks, Alera!) Here's what I wrote:

****************************************

I have a Vicodin prescription for 5/500, 40 pills every 30 days to manage my Crohn's disease pain. I've had this revolving prescription for about a year. I am 27 weeks pregnant and have been taking 1 to 1.5 pills a day all but 1 week of my pregnancy. My OB does know that I was taking them in the beginning and hasn't asked me anything in follow up. At that time I had brought up the pills which I had been off for a week (from 6-7 weeks, after discovering I was pregnant), just wanting to know if at 6 weeks pregnant I had done any damage. To my surprise he shook his head and murmured something like "maybe if you were taking them every day and toward the end..." but otherwise was quite dismissive of any risk. Soon after I saw a perinatologist who also dismissed Vicodin as fine pregnancy "unless you go overboard". With this in mind, I started taking them again.

Even at this low dose they sure have made my pregnancy more bearable physically. But here's the thing. I think they have also been helping me mentally and I think I've slipped into taking them just as maintenance, whether or not I physically feel I need to. But then I also do have pain (arthritic mostly, due to the Crohn's)... and Tylenol doses adequate to really get me functioning would be at levels harmful to my liver and possibly baby, so what am I to do?

So here I am at 27 weeks, currently taking 1 5/500 pill in 2 divided doses. Even with some physical dependency I don't think that this would be considered too risky to continue during pregnancy provided that they were made aware in the hospital so that they could be prepared if any withdrawals set in in the baby. But here's the thing - I have to go see my prescribing general practice doc to get another sequence of refills, and this doc is not aware that I'm pregnant. So I'm going to assume that they would refer me to my OB instead. So if I just keep this to myself I am going to be out of pills in about 2 weeks at my current rate, more if I taper after this final round of pills, as I had planned to do all along.

But I've done some research recently and discovered to my surprise that it's not necessarily the amount you take but the frequency that makes stopping difficult. Like, if it never totally clears your system, dependency sets in. And based on what I know of the half life, I haven't been clear of Vicodin now for like 19 weeks. So I'd assume even at this low dose I will experience some withdrawal after going to zero. I am quite sure I can tolerate the withdrawal (hell, I quit Zoloft - what a riot that was!) but should I be worried that even that low a taper could affect my unborn child?

So that's the quandary. Do I just go ahead and taper down as I had planned? I could do 1/2 pill per day for a week, then 1/4, then nothing. Or should I consider even this low taper to be too risky and discuss with my OB? For some reason, even though this man will be opening me up for a c-section in a few months, I'm ashamed to tell him that I may be physically dependent (and possibly mentally as well).

I am posting this because I noticed that there are a few other women here who have been in the same boat, but I'm not sure anyone here has been on this low of a dose and in this position.

Thanks in advance for any support you can give!

[kaniyah100]

this is my own personal opinion, but i also took vicodin during my pregnancy and never told anyone either but towards the end of my pregnancy the doctor found out because of a test that they ran and it showed up in my system and because i kept it from them it looked really bad and i was getting the prescription from another doctor that i didn't tell i was pregnant. might i add though i had an addiction to pain medication so i was purposely hiding it and at the end i got the baby taken away from me. I've been clean for almost 14 months now and got my children back thankfully. So i would tell you that being open to your doctor would be the best thing and they will take in consideration your disease and believe me they will work with you and work it out. the sooner the better though

[killezoey]

Thanks a lot, Kaniyah. I appreciate your perspective on this. I never honestly considered the idea of having my baby taken away, given that this is a prescribed med! Was your baby born addicted? How many were you taking a day at the end? Why did they test you?

The other day I tried to bring this up with my OB over the phone, but I confess that I caved and ended up not telling him, just asking him general questions instead about pain control during pregnancy. His tone was very different this time from the early pregnancy brush off. He sternly said that it is only ok short term, that there is risk of withdrawal, that the long term effects aren't known...if he had put it that way early on I wouldn't have started back up at 7 or 8 weeks, I think. I admit that this put my tail between my legs for not disclosing to him that I had been taking all along, and caused me to continue to hide it rather than confess. His "bedside" manner is very hasty and brash at times. So now I have THIS conversation behind me, which he will recall and note that I wasn't honest even when bringing up the very subject. So now I'm even more scared to discuss. Oh, what to do!

I'm on day 2 of only taking 1/2 of a 5/500. I feel ok, but I know I'm doing the wrong thing by tapering off the 1.5 I had been taking, without consulting a Dr. I think I will continue on the 1/2 pill a day to stave off complete withdrawals, and try to find a new OB in the interim. I need to start fresh with someone, hopefully someone I feel I can talk to. This will be challenging as OB's are in high demand here, and if it doesn't pan out I will try my best to talk to the OB I'm stuck with.

Thanks again, and please let me know more about your story if you can. I am glad you have your kids back and congrats on being clean!

[Alera]

I have a family member with a chronic pain condition. She is on morphine. Eventually she wants a baby and was very concerned. The problem is, for her, stopping the pain meds is not an option.

Her doctor told her that as long as the pediatrician and ob/gyn know the situation, they can wean the baby off once it is born without any damage or withdrawls.