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A Conversation On Treating Opioid Addiction While Pregnant

Dr. Jeff Ripperda and Rachel Keener.

Rachel Keener first began using opioids as a teenager. As an adult she was being treated with subutex when she became pregnant.

In March of 2019 StoryCorps visited Carbondale to record interviews with Southern Illinois. Rachel sat down with her doctor, Jeff Ripperda with Shawnee Health Service to talk about her fears and experience giving birth while undergoing medication assisted treatment for opioid use. 

Read the full transcript:

Keener: I was an opiate addicts pretty much since 12 years old, I used vicodin in my whole life. And then I discovered subutex on the street, or suboxone, which you could use a lot less of and make it a lot longer. So I started using subs on the street and they were extremely expensive and just not a good life to be living trying to get them in the streets.

Ripperda: So how does a 12 year old become an opiate addict?

Keener: Well, I was a competitive gymnast and I had an injury pretty young and I had a doctor that gave them to me pretty young. And then I actually had a father who supplied them to me for years afterwards. 

Ripperda: We've talked about this a little bit, but I don't know all the details. I didn't know you were a competitive gymnast either. 

Keener: Yeah. 

Ripperda: So what how long were you taking Suboxone off the street before you started seeing me in the office regularly?

Keener: A year I'd say.

Ripperda: So my memory of this, and correct me if I'm wrong, we started talking about that you had some symptoms of what's called a prolactinoma. Which means your brain was creating too much of a hormone called prolactin, which has two kinds of main effects, right. It makes you not menstruate regularly, so you don't have regular periods. And it can also cause infertility. So we were kind of talking about that and working it up when…

Keener: I got pregnant. 

Ripperda: Yeah

Keener: I went in for my first MRI to see if I had a pituitary tumor, and I was negative and then I was pregnant. When I was taking a pregnancy test for that, and I was pregnant,

Ripperda: I was very surprised to hear that actually,

Keener: Me too! I had been trying for years. It was really shocking.

Ripperda: Had you actually been trying or just not doing anything to avoid?

Keener: No, I had been trying. I was ready for a baby.

Ripperda: Yeah. And all right. So tell me about it. Did you think about the the, because you run this subutex for me at that point that I was prescribing to you. Did you have any thoughts about that when you first got pregnant or any concerns at all? 

Keener: Yes, actually, of course, that was …. I felt guilty at first, because I hadn't thought much about it until I was actually pregnant. And then once you're actually pregnant, and it's there, and it's gonna happen, you can't just stop taking your medication. So I felt I was nervous about it. I did a lot of research on how it would affect ..

Rippperda: So a lot of women who are on subutex in particular, their immediate fear is what are we going to do to control my pain after labor? I'm on this subutex maybe not a great pain tolerance anyway, did you experience any of that? Do remember that day or was it all a haze?

Keener: No, I remember it. No, I wasn't too worried about it. I kind of just viewed it as that would be my consequence for using drugs in my past. Yeah, I just figured if if I was miserable, I would tough through it and deal with it and that's my consequence. But I didn't have an IV. I was perfectly fine afterwards. I didn't have any problems with pain management.

Ripperda: That's both admirable and horrific. That's fair. And Cecilia. Cecilia, your daughter didn't withdraw at all correct?

Keener: No, not at all.

Ripperda: Remember having to stay in the hospital the extra day to make sure that didn't happen?

Keener: Yeah, I was there for three days actually.

Ripperda: Yeah, you know, that's so most women deliver, they go home even as soon as 24 hours after they deliver. So really, the only thing that changed for you is, had you not been on the subutex, you might have going home like a day and a half or two days sooner. But that's it. Alright, so [you] had your daughter and how is she?

Keener: She's great. She's wonderful. so wonderful. I'm doing it again.

Ripperda: Alright, so she's how old? 

Keener: She's 18 months.

Ripperda: 18 months and describe your current physical state.

Keener: Very pregnant. Very pregnant, ready to deliver any day. I'm doing good though.

This story is produced by Steph Whiteside with interviews recorded by StoryCorps a national nonprofit whose mission is to preserve and share humanity stories in order to build connections between people and create a more just and compassionate world.

Visit storycorps.org for more information

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