Pregnant and addicted to co-codamol. Have cut down significantly but am worried I've already harmed baby

[CaptainUnderpants96]

Hi,

I'm incredibly anxious, worried and ashamed, and was hoping for some advice or reassurance. This was an incredibly difficult post to write so please try and be gentle.

I've been taking over the counter low dose co-codamol (8/500) for around four years to treat chronic migraines/severe headaches. About a year ago I realised I was becoming an addict as I would take upwards of 10 tablets a day even if I didn't really have a headache. I must admit I craved the chilled out feeling they gave me. I decided to cut down and gradually over a few months I weaned myself down to 4 or 5 tablets a day. This was actually relatively easy and I didn't really experience withdrawal (aside from getting headaches, otherwise I felt fine).

In June I discovered I was pregnant. I did some research on the effects of codeine during pregnancy and found very conflicting advice. Some sources said it was okay and I saw many posts from women who took it in pregnancy and delivered healthy babies, others said it could cause birth defects such as heart problems and spina bifida! I was absolutely horrified and ashamed and still am

I decided then that I would stop taking co-codamol, but also worried about potential effects of going cold turkey/withdrawal on my pregnancy, so have cut down on the co-codamol even further but not yet stopped completely. I'm now 17 weeks pregnant and take 2, sometimes 3 8/500 tablets a day. However, on days where I've gotten horrific headaches and nothing else has worked, I've given in and taken up to 5. Again, I've not experienced any serious withdrawal symptoms and am planning to cut down even further. My ultimate goal is of course to be completely off them well before baby is born.

I've already noticed that the withdrawal headaches I used to get have vastly improved. When I first started cutting down, I would get a headache if I went more than 6 hours without taking a tablet, but now I can easily go 18 hours without taking any and feel absolutely fine.

I am proud of the progress I've made but I'm utterly terrified of the potential harm I've already done to my baby. All scans and tests done so far have shown a completely healthy perfect baby and I've started to feel movements in the past week or so, but obviously some problems aren't picked up until the 20 week scan. I've got my 20 week scan next month and I'm absolutely terrified they'll tell me my baby has a heart defect/spina bifida/some other horrible illness and it'll have been completely my fault I've even sat and cried about it.

I've not told my midwife or any healthcare professional about my codeine use as I'm so ashamed and worried they'll look down on me/won't think I'll be a good parent.

Has anyone else taken co-codamol in pregnancy and their babies been fine? I've read quite a few posts from women who were actually prescribed co-codamol when they were pregnant and took higher doses than I am, which makes me think it can't be THAT harmful, but then I read another post or article about neonatal withdrawal and the shame and guilt comes flooding back. I guess I'm just looking for reassurance.

I feel like such a shitty mother and my baby hasn't even been born yet.

tell your gp and mw.
tell them how far you have come reducing. that's a good achivement.

afaik codeine is more of a problem close to birth and after (if breastfeeding) as it can cause breathing problems in baby.

I was prescribed it before and during pregnancy. It's recommended you don't take it during the third trimester in case of respiratory problems at birth but was then given codiene in labour

Stop worrying and speak to your midwife for reassurance, however if you're not taking it for pain you should stop. Be aware your body may 'make up pain' that travels around the body but it isn't real.

Thanks @red, I know I need to but I'm SO scared. I'm scared they'll label me an addict and therefore unfit to care for baby. I don't drink or smoke or do illegal drugs, it's just these bloody painkillers.

My family know I used to take a lot of codeine but have assumed I stopped as soon as I found out I was pregnant.

@gamerchick, see, that's what confuses and frustrates me! I read stories like yours but then read other stuff that says you absolutely shouldn't take it! I know I should stop regardless though as like you say it isn't good to take painkillers if you're not actually in pain!

Im just ending a really bad spout of toothache where paracetamol alone wasnt helping with pain releif. (Also on antibiotics off dentist)
I rang my GP on day 3 of excruitiating non stop pain in hysterics, wasnt eating, wasnt sleeping, throwing up worse than morning sickness.
He prescribed me co codamol.(im 20+4) Said the pros far out way the cons, he also said that if i wasnt in my 2nd trimester he wouldnt of given them to me, so maybe if you speak to your midwife shell be able to help you in time for your third trimester.
Its good youve cut down already, but itll be good to not be on them by your last trimester.

Sorry for the long windedness but hope i helped a little...

Look, the amount your taking now if you're being honest won't do any harm if you just stop. It'll be bumpy for around 3 days.

If you aren't being honest then you need to speak to a medical person to get weaned off them. The sooner you do it the better. You're not the first person to need help. Just ask you won't get judged for asking for help.

Hi there well done for cutting down so much you've done really well. I work in a pharmacy and can confirm doctors do prescribe it in high doses for pregnant women . Only when the benefit out ways the risk.. what about making a sort of chart for yourself in ur phone to u can visually see yourself cutting down and making progress as the weeks go by. Say cut down a few tablets or a tablet a day per week. And treat yourself too! Aim to be almost cocodomol free or aim to be cocodomol free by 37 weeks as this is when it can cause breathing difficulties in the baby, it does this by blocking certain receptors in the body that aid breathing , how much of the codeine reaches the baby and does this no one knows. Keep up the good work xoxoxox

Thanks @captain, I've also read that codeine REALLY isn't recommended in the third trimester. I plan to be well free of codeine by the time I'm that far along. I've only taken 1.5 tablets today and that was at 6am, and so far feel fine aside from a niggling headache starting to build. But I'm determined to ignore it!

You need to tell them. You may need medication when you give birth and you could overdose on pain relief if they don't know what you're already taking. There could be an emergency situation where meds are given when you're unable to consent (anaesthetic etc) so they need to know in advance.

Please tell your midwife or gp. Be honest and tell them you have been coming off them but you need help cutting down the rest. Codeine is stupidly addictive, but as addictive as it is for you, it is for your baby too, and you need help to do this properly. Plus, the constipation it causes is going to cause you issues as you get further into your pregnancy.
You've come so far, now is the time to put your child first and go seek professional help. Do not be ashamed, they will help you, not judge you.

Please stop being so hard on yourself.
Your situation is not idea but you know this and have worked hard- and very well by the sounds of it- to reduce your intake for your baby. It show how loving a mother you all ready are.
You really should get further help from your midwife or doctor. They will have so much resources to support you. And if you are honest about the changes you have made they will see how responsible you are being about your intake.
You are making changes for the better and that is great OP.

Definitely tell your midwife as she’s qualified to advise and support you. As it’s an opiate and you’ve been using it throughout your pregnancy I guess (don’t know, just guessing!) it could be possible for your baby to experience withdrawal after birth. It would be good for the people looking after you to know about that in case there’s anything they need to do, or you need to be aware of.

Good luck with your 20 week scan - scans and tests are just stressful anyway because it’s natural to care deeply about your baby. Focus on stopping the codeine and informing your midwife/GP. You’ll feel way more ashamed if you keep burying your head in the sand and then find they could have helped.

Thank you everyone. To be honest I came on here expecting to be judged but have been pleasantly overwhelmed by the support.

I am determined to be completely co-codomol free by my third trimester. It's just the prospect of going from taking 2/3 tablets day to none is fairly daunting but then again if you'd asked me a few months ago wether I'd have been able to go from 10+ a day to 2/3 a day I'd have laughed and said no way!

Tell your midwife. Stop feeling ashamed. It’ll be hard to do, but it’s the right thing to do for you and baby. Well done on cutting down so much. You’re being very brave posting.

Have you thought about cutting the tablet in 4 or 8? So you cut 1/8 a day.

Xx

I agree that it's best they know just in case there are any issues when you deliver. I think the more information they have, the better. You've done really well to cut back and you'll probably be surprised how non judgemental they will be.

Please tell your GP and MW. Get RL support. That’s what you need. Not judging. Good luck OP.

Well done for cutting down.

I would say that you should mention it to your midwife because, in the event that the baby does have some breathing problems, it may be important that they know that this could be related to the co codamol.

I was strongly encouraged to take co codamol in labour, and my baby did have some breathing difficulties when she was born (minor, luckily). This is the first I have heard that the two could be related .

Well done on cutting down as much as you have so far OP. It must have taken some will power and that in itself will show your GP/midwife that you are trying. And they won’t think you’re going to be a bad parent!
I am sure they’ve come across many expectant mothers before who are struggling with medication addiction.
I echo what others say though, please speak to your GP/midwife. I am sure they will be able to help you with stopping taking it completely and be able to provide you with extra reassurance about baby. X

Oh Lordy, it must be so difficult and so scary too. Is there a opiate or addiction helpline you can call?

Or a midwife or social worker on here who can share what the procedures might be for helping you and the baby be safe now and through the birth?

I think it would help if you know what will happen. Knowledge is a good thing when making decisions.

And you need to decide what to do now, because I don’t think the head in the sand and keeping silent approach will work for much longer, will it?

Much much kudos for coming off it as much as you have though

Thanks again everyone. I'm now more determined than ever to come off these bloody pills. I just hope it's not too late for baby.

In fact the part I'm finding scariest is not actually coming off the tablets, but telling my midwife! I'm scared I'll be labelled a druggie and social services will be contacted. I'm probably massively overreacting but that's me to a T.

You have to put yourself through the suffering and stop taking them. To be honest they probably would get other people involved if you tell them your an addict etc, but you could be harming your baby so you need to stop. Do lots of research on how to withdraw from them safely and completely, even if it means seeing someone private without having to give real details etc, someone who is qualified but will not report you for being a substance abuser.

Sorry to hear about this and I sympathise as Solpadeine was the only thing that worked for my migraines before pregnancy (at least 1-2x a week). I was really worried about what might happen during pregnancy since I knew I had to take them if the pain came back. Luckily, my migraines were hormonal so they haven't been a huge problem however I still struggled with a lot of tension & rebound headaches.

The situation is not ideal, but there are definitely women all over the world who smoke or use illegal drugs throughout their pregnancies and still manage to have babies. I think the main risk is that your baby may end up with withdrawal symptoms, similar to mums who use benzos or opioids.

I think in your case it would help to reduce the dosage as far as you can. Even it's just 1/2 a tablet less per day, it will still be better for you and your baby. If you take the water soluble tablets, there are small things you can do to trick yourself such as dissolving 1 tablet (instead of 2) in less water so it tastes more concentrated. Sipping it very slowly can also mean that your headache starts to recede and you realise that you didn't actually need to full dose and can throw the rest away. As you noticed yourself, the rebound headaches improve dramatically if you manage to pull through for a few days.

If you're talking Solpadeine then a significant part of the rebound effect may actually be caffeine. Try weaning yourself off codeine by using Panadol Extra (paracetamol and caffeine), and then going from Panadol to full-fat Coke. Once you get over the first 1-2 weeks, the rebound headaches get so much better and I can manage to control most of them now by using Coke and water.

The final thing you should consider are potential liver issues caused by paracetamol. I had awful tension headaches in early 2nd trimester so I ended up taking 2-4 tablets of Panadol to replace Solpadeine almost every day. Even though it was (just) within recommended dosage, a routine blood test showed my liver enzymes were so elevated which puzzled the doctor to the point they ordered extra tests for hepatitis and other infections. I was too ashamed to admit that I took so much paracetamol, so I made a huge effort to cut down and managed to eliminate it to 1-2 tablets a month. Lo and behold the next blood test showed all liver values back to normal.

I have a long history of depression and anxiety and have taken a plethora of medication over the years and was also addicted to valium at one point. Although I have taken nothing whilst pregnant, I was scared to tell the midwife about my past but she was amazingly supportive and arranged for me to have the best mental health treatment I've ever had. Obviously your situation is slightly different but they want what's best for the baby (and you) and may offer you some support rather than you having to deal with it alone.

@Pomfluff, yup. It's Solpadeine that I take. Ah, I'd never considered that part of my addiction might be caffeine but that makes sense. I have noticed that drinking Coke did improve my rebound headaches. That may explain why, aside from rebound headaches, I haven't experienced any of the horrible withdrawal symptoms I was expecting. Maybe it's more a caffeine addiction than anything else.

Thank you for the helpful and concise advice, and I'm glad to hear you've been through something similar and managed to overcome it. I'm hoping that stopping the tablets now will prevent baby becoming addicted/withdrawing at birth but they may already be addicted which makes me feel like the worst person in the world

@CaptainUnderpants96 So glad it helped, and wish you lots of success with the tapering! Also, wanted to add that I'm quite sure it won't cause birth defects especially if you had a healthy 12 week scan. Each pregnancy has a 3-5% default risk of a birth defect (most of them mild) and I think it's terrible when women beat themselves up over whether they could have caused it themselves. You are already doing everything you can to improve the situation for yourself and your baby :).

In my case I have rare antibodies that posed a risk of causing a serious heart defect. It was nothing I could control but I felt terrible knowing that it would still somehow be indirectly my fault. My doctor said something very good which was "I believe it will be fine but anything can happen, and that's just destiny". It put my mind at ease that things can go wrong in pregnancy, and that is just how nature works. People are also not perfect and you will probably do things which are not "ideal" during pregnancy. But as long as you're aware of it, and try your best to fix that, there's really no point beating yourself up about it.