Most people want to quit the moment they learn they’re pregnant. With opioids, heavy drinking or sedatives, stopping suddenly can put parent and baby at risk.134 For opioids, doctors recommend methadone or buprenorphine instead.2 The best next step is getting prenatal care and addiction care started together, soon.
Is it safe to stop using while pregnant?
It depends on the substance, and a clinician should make the call.
| Substance | Stopping suddenly | The safer route |
|---|---|---|
| Opioids (heroin, fentanyl, pain pills) | Not recommended. It often leads to a return to use (see below).12 | Methadone or buprenorphine, alongside prenatal care.1 |
| Alcohol (heavy, daily drinking) | Can cause seizures and delirium that can kill.3 | A medical assessment before stopping. Addiction medicine guidance says inpatient care should be considered during pregnancy, with an obstetrician involved.3 |
| Benzodiazepines (Xanax, Klonopin, Valium) | Can cause life-threatening withdrawal, including seizures, even when taken as prescribed.4 | A gradual plan made by the prescriber and the prenatal team together.4 |
| Street fentanyl with medetomidine | Can cause severe withdrawal that may need intensive care.5 | A higher level of medical care, which may mean a hospital.5 |
| Stimulants (meth, cocaine) | Ask a clinician what to expect, and watch mood closely. | Close support and a clinician who knows about the pregnancy. |
For more on quitting without medical help, see when withdrawal is dangerous. Whatever the substance, encourage your loved one to be honest with the prenatal provider about what and how much they use. A clinician can only plan around what they know.
Why do doctors recommend medication instead of quitting opioids?
The American College of Obstetricians and Gynecologists (ACOG) recommends methadone or buprenorphine for pregnant people with opioid use disorder, and says it is preferable to medically supervised withdrawal.12 The reasoning is practical. Withdrawal is followed by high rates of return to use, and because tolerance has dropped by then, that return carries a higher risk of accidental overdose. Medication lowers the risk of relapse, and together with prenatal care it reduces pregnancy complications.2 It is a prescribed treatment for a medical condition, and SAMHSA says it does not simply substitute one drug for another.10
Some babies have temporary withdrawal symptoms after birth; not all do.1 Ask the prenatal team early how the hospital cares for newborns exposed to opioids or treatment medication. Knowing the plan ahead of time makes delivery less frightening. If opioids are involved, read more on how methadone and buprenorphine work.
How do we find treatment that takes pregnant patients?
- The prenatal provider. Ask whether they can start treatment or refer you to someone who can. With no prenatal care yet, a primary care doctor or community health center is a reasonable first call.
- FindTreatment.gov. SAMHSA’s locator lists state-licensed substance use and mental health providers.6 Call any program you find and ask whether it treats pregnant patients.
- The SAMHSA National Helpline, 1-800-662-4357. Free, confidential and open 24 hours a day in English and Spanish. If your loved one has no insurance, it can refer you to the state office that handles state-funded treatment. You can also text your ZIP code to 435748.7
- Medicaid. You can apply any time of year, and HealthCare.gov encourages applying even if you doubt your loved one qualifies, especially during pregnancy.8
Some states have policies that give pregnant patients priority admission.1 Walk away from any program that would make your loved one stop methadone or buprenorphine to get in. Our guide to finding and vetting a program covers the rest.
What can families do?
How you raise it matters. Blame makes the next call harder to make, and your calm makes it easier. Practical help often counts for more than advice: a ride to appointments, sitting in on a phone call, a hand with the paperwork.
If opioids are involved, keep naloxone at home. It is sold without a prescription.9 In pregnancy it may stress the fetus, but ACOG says it should still be used to save the parent’s life.1
What to say instead
“How could you do this to the baby?”
“I love you and the baby. Can we call your doctor together today?”
“Just stop. You have to quit now.”
“Quitting suddenly can be risky. Let’s ask a doctor what’s safest.”
“You’ll lose the baby if anyone finds out.”
“Let’s find a doctor you trust and ask what happens next.”
What should we ask her doctors and treatment program?
Bring this list to the prenatal visit or the admissions call.
Questions for the prenatal provider and treatment program
- For the prenatal provider
- For a treatment program
Frequently asked questions
Will a doctor report drug use during pregnancy to CPS?
It depends on state law, and the rules vary. Some states treat opioid use during pregnancy as a form of child abuse or neglect.1 Ask the provider directly what they are required to report, or ask a local legal aid office about your state. Our page on what treatment programs can share with families explains privacy protections for addiction treatment records.
She takes a prescribed benzodiazepine or opioid. Should she stop now that she's pregnant?
Not on her own. The prescriber and prenatal provider should plan any change together. If she is on methadone or buprenorphine and also takes a benzodiazepine, the FDA has cautioned against withholding opioid use disorder medication for that reason, and says careful medication management can reduce the risks.4
What if she refuses treatment?
Encourage prenatal care even if she isn’t ready for addiction treatment, since that keeps a clinician involved. Our guide on what to do when someone refuses help has more steps, and the full range of treatment options shows what she could choose later.
Sources
- American College of Obstetricians and Gynecologists — Opioid Use Disorder and Pregnancy (patient FAQ). acog.org/womens-health/faqs/opioid-use-disorder-and-pregnancy — accessed Oct 2026
- American College of Obstetricians and Gynecologists — Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy (2017). acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/08… — accessed Oct 2026
- American Society of Addiction Medicine — The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management (2020). asam.org/docs/default-source/quality-science/the_asam_clinical_practic… — accessed Oct 2026
- FDA — FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class, Drug Safety Communication (September 23, 2020). fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning… — accessed Oct 2026
- CDC Health Alert Network — Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome, HAN-00527 (April 2, 2026). cdc.gov/han/php/notices/han00527.html — accessed Oct 2026
- SAMHSA — Find Substance Use Disorder Treatment. samhsa.gov/substance-use/treatment/find-treatment — accessed Oct 2026
- SAMHSA — National Helpline. samhsa.gov/find-help/helplines/national-helpline — accessed Oct 2026
- HealthCare.gov — Medicaid & CHIP coverage. healthcare.gov/medicaid-chip/ — accessed Oct 2026
- FDA — FDA Approves First Over-the-Counter Naloxone Nasal Spray (March 2023). fda.gov/news-events/press-announcements/fda-approves-first-over-counte… — accessed Oct 2026
- SAMHSA — Treatment Options for Substance Use Disorder (updated August 2025). samhsa.gov/substance-use/treatment/options — accessed Oct 2026