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Pregnant & Court-Ordered to Take Vivitrol: Is My Baby Safe?

It’s a question many women might be asking themselves, as more and more females of childbearing age are ordered by drug courts to take Vivitrol – the injectable form of naltrexone.

An opioid-antagonist, Vivitrol blocks the brain receptors that bind to opioids, making it impossible to get high off of drugs like heroin, OxyContin, and Vicodin. In its injectable form, Vivitrol lasts for about a month.

Quite a few judges, most recently one in Ohio, have offered Vivitrol to drug offenders as a way to avoid jail. When the choice is between taking a medication and going to jail, most choose the medication.

Vivitrol and Pregnancy

One glaring issue, however, is that little is known about the effects of Vivitrol on pregnant women or fetuses. In a recent article published by Drug and Alcohol Dependence Weekly, Dr. Mishka Terplan, professor at the University of Maryland School of Medicine said, “There are a few case studies — perhaps a total of 14 women — who were on naltrexone throughout their pregnancy without any negative outcomes. But this is not the same thing as safety.”

Believe it or not, Vivitrol’s own website states, “It is not known if Vivitrol will harm your unborn baby.”

What is known is that Vivitrol crosses the blood-placenta barrier, so women taking the medication will pass the drug along to the baby.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently issued a report in which it called for further research into the issue of pregnant women taking Vivitrol. This is a surprising recommendation, since Vivitrol is a Schedule C drug, meaning that it has not been declared safe for use during pregnancy.

Answering the Unanswered Questions

Even women who aren’t court ordered wonder about the effects of Vivitrol. Jamie, 26, was instructed by to take Vivitrol by local authorities while attending an inpatient rehab. Now Jamie has questions.

“No one at my rehab ever told me that this drug might be dangerous if I get pregnant,” she says. “I wouldn’t want to be faced with a decision if I did discover I was pregnant and didn’t know if the Vivitrol that’s already in my system had harmed my baby.”

It has long been a principle of medical ethics that experimenting on vulnerable populations, such as prisoners and the mentally ill, is unethical and generally illegal. More and more, questions are popping up surrounding this very issue and Vivitrol. Are they using those who are court-ordered or addicted to determine the safety of Vivitrol in pregnancy? If so, it’s a risky and unethical proposition.

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