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Avoiding NAS multiple answers?

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  • Avoiding NAS multiple answers?

    Dr Hale can you maybe better answer this question.
    After reading through many of the posts on this forum there seems to be a few different answers for the same question.

    In one post regarding if 6 weeks tramadol free before birth was enough time to avoid withdraw in a newborn the answer was possibly bit we don’t know for sure.
    In another regarding hydrocodone you recommend only 2 weeks to avoid withdrawal.
    to my understanding hydrocodone is stronger than tramadol so wouldn’t it require more time?
    can you please explain in utero detox before delivery vs after birth & clear up this question as to how long a mother would need to be off a medication (maybe with the example of half life’s of the medication) as a way to judge?

  • #2

    There is no way to answer the question concerning withdrawal, and avoiding it. Every drug and every situation is different.
    In general, the withdrawal from opioids is going to be significant, depending on dose and duration of exposure. Withdrawal from Tramadol is generally less frequent and certainly less severe.

    With most opioids, such as hydrocodone, etc, withdrawal may take some weeks to get completely off of it. This of course depends on how high the dose it.

    In utero withdrawal is risky, and much OB literature suggest it is NOT worth the risk to the fetus to withdraw before delivery. This is a subject for your OB to decide.

    Tom Hale Ph.D.


    • #3
      What about in the case that someone was able to do a slow taper and be completely off the medication.

      in a previous post it was suggested to be off hydrocodone with 2 full weeks to be safe
      with tramadol being not as strong would 4 weeks without the medication be long enough ?


      • #4

        A slow taper of one month should be sufficient to prevent withdrawal from Tramadol.

        Tom Hale Ph.D.


        • #5
          Just to clarify they would have slowly tapered and been completely off with another 4 weeks still before delivery.

          That would give 4 full weeks medication free before the delivery.
          That should be plenty of time?


          • #6

            yes, I agree to 4 full weeks Medication-Free should be plenty of time.

            Tom Hale Ph.D.