Pregnancy and Addiction: Substance Misuse, Detox, and Treatment Options
Problems with substance use are heavily stigmatized, with studies showing that stigma contributes to difficulties for those with problematic substance use to reach out for support and enter treatment. When an individual is pregnant, the stigma appears in additional forms aside from the erroneous language and terminology associated with addiction. Pregnant individuals and parents with substance use disorders face stigma in additional forms, such as the delivery and belief of misinformation, punishment of substance use, and belittling of a parent’s relationship with their child.1
But there are pregnant individuals who struggle with substance misuse. Research suggests that about 5% of individuals use one or more addictive substances during their pregnancy.2 Additionally, in a 2022 Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) researchers found that 14% (or 1 in 7) of pregnant individuals surveyed reported current alcohol use.3 Similarly, a 2020 Morbidity and Mortality Weekly Report found that 40% of pregnant individuals who reported current alcohol use also reported the concurrent use of at least one other substance.4
Unfortunately, stigma becomes a barrier that can prevent an individual from seeking treatment for substance misuse while pregnant, including fear of judgment and concern over child custody.5
However, there are health risks associated with substance use during pregnancy for both the pregnant person and the unborn child, which is why it’s so important to seek treatment when it’s needed. Read on to understand the dangers and risks associated with various substance misuse, detox during pregnancy, and how to get the help you or a loved one need.
The Dangers and Risks of Substance Use During Pregnancy
Using alcohol, tobacco, illicit substances, or misusing prescription drugs while pregnant can have severe health consequences for a pregnant person and the fetus. That’s because these substances pass easily to the fetus through the placenta.2
The extent and severity of the potential risk of substance use faced by the pregnant person and the baby depends on the substance, the amount, and the duration and frequency of use while pregnant.2 But the effects experienced by both the pregnant individual and the baby can be painful and potentially life threatening.
Effects of Drinking Alcohol During Pregnancy
Using alcohol during pregnancy increases the risk of miscarriage; stillbirth; and a range of chronic behavioral, physical, and cognitive disabilities in the developing child known as Fetal Alcohol Spectrum Disorders (FASD).6
Some symptoms and effects of these disorders can include:6
- Facial differences, such as a smooth ridge between the nose and upper lip, known as the philtrum.
- Smaller head size at birth.
- Smaller than average height and body weight.
- Poor coordination.
- Hyperactive behavior.
- Difficulty with attention, focus, and memory.
- Difficulty in school, including diagnosis of a learning disability.
- Speech and language delays.
- Diagnosis of an intellectual disability.
- Difficulty with reasoning and judgment skills.
- Vision or hearing problems.
- Problems with the heart, kidney, or brain.
Because of these and other health risks associated with alcohol use, the CDC says that there is no safe amount of alcohol use during pregnancy.6
The Effects of Opioid Misuse During Pregnancy
According to 2019 self-reported data, approximately 7% of pregnant individuals reported prescription opioid use, and of those, 1 in 5 reported misuse.7 The use of opioids—including prescription painkillers, heroin, and methadone—during pregnancy carries risks for both the parent and fetus, including:7
- Maternal death.
- Poor fetal growth and development.
- Premature birth.
- Birth defects.
- Neonatal abstinence syndrome (NAS), which causes withdrawal symptoms in infants.
The Effects of Stimulant Misuse During Pregnancy
Stimulants, which include illicit drugs like cocaine, methamphetamines, and ecstasy, as well as often misused prescription drugs used to treat attention deficit hyperactivity disorder (ADHD) (e.g., Adderall, Ritalin) are the second most widely used and misused drugs during pregnancy in the United States.9 Misuse of these substances can carry significant risks, including:2
- Premature membrane rupture in the pregnant person.
- Placental abruption, which is the separation of the placental lining from the uterus.
- Potential cardiovascular issues, such as dangerously high blood pressure (also known as hypertensive crisis).
- Preterm labor and birth.
- Spontaneous miscarriage.
The Effects of Misusing Sedatives During Pregnancy
The use of sedatives—including benzodiazepines such as Xanax, Ativan, and Valium—during pregnancy has become more common over the last few decades.10 In fact, research indicates that the number of pregnant persons filling at least one benzodiazepine prescription during pregnancy is somewhere between 27% and 93%.10 When used during pregnancy, benzodiazepines and benzodiazepine-related drugs pass easily through the placenta. Benzodiazepine use during pregnancy is associated with an increased risk of certain health conditions, including:10,11
- Preterm birth.
- Floppy infant syndrome—characterized by low muscle tone, hypothermia, lethargy, poor respiratory effort, and feeding difficulties—especially when benzodiazepines are used in the third trimester.
- Withdrawal symptoms in the infant.
Effects of Marijuana Use During Pregnancy
Research indicates that marijuana use during pregnancy more than doubled in the 8-year period between 2010 and 2017.2 Using marijuana during pregnancy can impact the baby’s growth, especially when marijuana is used frequently in the first and second trimesters.2 While some may use marijuana to self-treat nausea and vomiting in pregnancy, the drug has been associated with long-term neurodevelopmental problems in children who were exposed to marijuana in utero.12 Other risks associated with marijuana use during pregnancy include:2,12
- Low birth weight.
- Altered responses to visual stimuli, increased trembling, and a high-pitched cry, which may indicate delays in neurological development.
Effects of Nicotine Use During Pregnancy
Studies show that about 10% of all pregnant people in the United States smoked cigarettes in the past month.2 Besides smoking cigarettes, pregnant individuals use other tobacco products, smoke e-cigarettes, and vape. Regardless of the source, nicotine, the addictive substance in tobacco, easily passes the placenta, causing concentrations of the drug in the fetus’s blood to increase as much as 15% higher than in the mother. Smoking and vaping can also cause carbon monoxide and nicotine from tobacco products to interfere with the fetus’s oxygen supply.2
Smoking, vaping, and using tobacco products increases the risks of conditions, including:2,13
- Birth defects of the mouth and lip.
- Premature birth.
- Low birth weight.
- Brain damage.
- Lung damage.
- Sudden infant death syndrome (SIDS)
Stopping Substance Use During Pregnancy
If you develop a dependency to drugs or alcohol while pregnant, suddenly stopping or drastically reducing the amount of a substance you take may cause withdrawal symptoms to surface and may be dangerous for you and the unborn child. Prior to quitting or cutting back, it may be helpful to seek advice from your doctor or a healthcare professional who specializes in addiction as well as an OBGYN or other maternal fetal medicine specialist.
Detox During Pregnancy
In some instances, undergoing withdrawal through detox while pregnant can pose risks but may be medically prudent. Pharmacological treatment during pregnancy typically occurs with withdrawal syndromes associated with benzodiazepine, alcohol, and opioid dependence.14 While not without some risk, medication-assisted detox during pregnancy ensures both pregnant individual and child are under the controlled care of a qualified health professional, who can improve the outcomes for both the pregnant individual’s and the baby’s health and comfort, too.14
Treatment for Substance Use Disorders During Pregnancy
If you are struggling with substance misuse while pregnant, getting appropriate treatment as early as possible can help minimize health risks for you and your baby. Pregnancy-specific addiction treatment programs may provide prenatal care, childcare, parenting classes, pregnancy education and counseling, life skills workshops, and job training and placement.15
Treatment can happen in a variety of settings, including inpatient or residential treatment centers and outpatient programs. Studies suggest that intensive outpatient services, which provide a high level of care but allow the participants to live at home or in a sober living facility, can be very effective for pregnant individuals.2
Additionally, federal law requires that pregnant women receive priority admission to government-funded treatment programs, allowing them to bypass waitlists and get immediate admission when a bed in a residential program becomes available.2
If you are seeking substance use treatment while pregnant, options are available to you. Call American Addiction Centers (AAC) to find the help, support, and path to recovery you need. Talk to one of our compassionate admissions navigators, who can help you navigate the treatment admissions process, verify your insurance, and assist you in finding the best treatment program for you. Call our free, confidential helpline today at