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Probability of NAS from suboxone

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  • Probability of NAS from suboxone

    Hello,

    im currently around 16 weeks pregnant. I was on a pain management program for about a year and a half due to a permanently damaged ankle and a severed spinal accessory nerve after lymph node removal. I started on suboxone about a year and a half ago, initially with the intention of getting through the first few weeks of w/d from the prescribed oxycodone & morphine, as I felt the medications were becoming less effective and had the potential to control my life. However, the suboxone significantlly relieved the pain and did not alter my mental state so Ive been on a suboxone maintance program for pain management since that time. When I found out I was pregnant I was taking two 12mg/3mg strips a day which was immediately reduced to two 8mg Buprenorphine tablets without Naloxone per day.
    Firstly, my OB said that it was fine to remain on the suboxone, however my sub dr said subutex is safer. I’m still getting sick almost daily (my last pregnancy the nausea/vomiting didn’t subside until I delivered so this could be a long term issue) and quite often I get sick immediately after placing the subutdx tab and will have to redose. The dr understand when I run out early but my ins refuses to pay early. Under the circumstances, would it be advisable to request going on Zubsolv as they dissolve in a fraction of the time and wouldn’t likely be somewhat easier to dose with?

    Most importantly, I have a few questions regarding what is the liklihood of baby experiencing NAS after birth for suboxone vs subutex? I’ve read and been told very conflicting information from 20% to 100% of babies born to mothers that took suboxone will w/d and even that babies will ONLY w/d if mom abused heroin or pills during pregnancy! If the bay does experience w/d, how quickly would the symptoms appear and how long can I expect them to be in w/d? Is there even the option of weaning baby down at home or would this always be a condition treated in a hospital setting? If baby has not exhibited any signs of w/d by 24 hours (or even 48) what is there any chance of being discharged home with me with instructions to return to the hospital should anything appear or would monitoring be required for a longer period of time? It seems that, while my drs genuinely care and are very compassionate of my situation, there’s so much that is yet unknown. I realize that it’s impossible for anyone to definitively determine or even predict the individual risk of my baby experiencing NAS but I would be so incredibly grateful for ANY statistics, research findings or insight that can be offered. Thank you SO much!
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