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General overview

Heroin is an ester derivative of morphine and is used on a recreational basis due to its euphoric effects. Frequent use of this drug is associated with tolerance and physical dependence.

Its main route of administration is intravenously by injection and has 2-4 times the potency of morphine. This, together with the physical and sensory effects it has, makes heroin the most addictive illicit drug in the world today. People who have previously used heroin have said that they still would get cravings for the drug up to 12 years since last using it. 

Long-term effects of heroin on the user may include the following issues:

  • Pneumonia, due to damage caused by inhaling heroin vapours.
  • Endocarditis, which is an infection of the heart lining and/or the valves of the heart. This occurs due to heroin passing through the heart when injected intravenously.
  • Thrombophlebitis (inflammation of the veins) or collapsed veins due to intravenous use.
  • Liver damage.
  • Abscess formation in the body.

Effects of heroin in pregnancy 

Heroin, together with drugs such as opioids from which heroin is derived from, can cross the placenta and enter the bloodstream of the unborn baby.

As heroin is very addictive, the fetus can become dependent on this drug. Using heroin can have detrimental effects on a pregnancy and these issues include the following:
  • There's an increased chance of experiencing premature birth.
  • Low fetal birth weight.
  • Increased chances of intracranial haemorrhage (bleeding within the brain).
  • Increased chance of hypoglycaemia (low blood sugar).
  • Infant death.

After delivery of the baby

The baby can be born addicted to heroin and since it is now independent of the mother's nutrient supply, the baby isn't getting exposed to any heroin anymore. This can then cause the baby to experience withdrawal symptoms.

The symptoms could include:

  • Irritability
  • Convulsions
  • Fever
  • Diarrhoea
  • Sleep disturbances

Luckily, these symptoms should resolve within 7-10 days time and only a small percentage would need in-hospital monitoring of their progress.

Another danger of heroin use is the potential exposure to infections such a Hepatitis B and HIV. A mother could unknowingly be infecting her unborn child with these infections due to her high risk activity.

What if you are addicted and become pregnant?

The best idea is to speak to your primary care physician to discuss the situation with them. They would advise you on the best way forward regarding the correct medication to use and which counseling services would be best suited for your needs.

Methadone can be safely used in pregnancy to help mimic the effects of heroin until the baby is safely delivered. There may be some withdrawal symptoms due to the methadone, but not as severe as what would be experienced with heroin.

Going cold turkey would not be a good idea as the expectant mother could experience severe withdrawal symptoms that could result in a miscarriage of the pregnancy. 

Many mothers who have used heroin while pregnant have said that their children didn't experience any issues in their childhood or later on in life. That may very well be true, but it would still be suggested that help be sought to get one off heroin so that the baby has the best possible outcome at the end of the day. 

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