Drug use and mental illness
If you take drugs regularly it can be really tough to stop, but now that you are planning a pregnancy you have a big chance to stop safely. Recreational drugs can harm your unborn baby and there is lots of support to help you stop taking them.
You are the most important person for the wellbeing of your child. If you are dependent on drugs or cannot control your drug intake, it will affect your ability to look after a child so it is important that you get help with this before becoming pregnant if possible. If you are already pregnant, be honest with health professionals; they can help you.
Telling health professionals about drug use can be really difficult. Fear of their reaction, worry about the involvement of social services, anxiety and guilt about the impact of drugs on the baby can make it easier to avoid thinking about it at all. But professionals are there to help and support you, not judge, and their support will help you quit.
Drug use and mental illness
Many people with a mental illness also use recreational drugs. Taking drugs can make your mental illness symptoms worse and can affect how well your medication works.
Getting help as early as possible gives you a better chance of giving up drugs and getting successful treatment for your mental illness.
You can speak to any health professional you see, for example your GP, mental health team or child and adolescent mental health services (CAMHS).
Many women with mental illness who use drugs also experience domestic abuse. If someone at home shows controlling or abusive behaviour towards you, speak to a health professional or a domestic abuse advocate or advisor.
You can read more about relationship problems and domestic abuse here.
Should I stop taking drugs before I get pregnant?
Yes. If you take any recreational drugs the best thing you can do for yourself and your baby is stop.
Using drugs, such as cannabis, synthetic cannabis (known as spice), cocaine and other drugs such as ecstasy, ketamine and amphetamines can cause fertility problems. This means that if you or your partner take these drugs, you may find it harder to get pregnant.
But some women may get pregnant very quickly, so it’s best to keep using contraception until you have stopped using drugs. Your doctor can give you advice about this if you need it.
It’s important to get advice and support before you start trying to give up drugs such as heroin or benzodiazepines. Your GP can refer you to a specialist service or you can find details of other organisations that can help you at the bottom of this page.
What support can I get?
There is lots of support available to help you. Talk to your GP or psychiatrist about what drugs you’re taking, how often and how you feel about this.
If you’re pregnant, you should be offered a referral to a specialist midwife or doctor who can give you advice and offer you regular appointments. If you don’t want to do this, they will still help you to cut down on drugs. They will also be able to tell you about local services that can help.
They will talk with you about your antenatal care, any extra appointments or scans that may be needed, as well as any extra support you and your baby may need after the birth. Health professionals will work together with you to make sure your baby is safe and well when they’re born. You will be invited to any meetings that are held to talk about your baby’s wellbeing.
You can talk about your feelings and worries and your healthcare team will work with you to help you have as healthy a pregnancy as possible.
They can give you information on good oral hygiene, eating healthily and giving up alcohol and smoking. All of these things are important for reducing the likelihood of pregnancy problems. You can also ask for text message reminders and other practical help with getting to your appointments, such as transport.
If you’re pregnant and are taking opioids, your doctor may refer you to a team who specialise in mental health and substance misuse during pregnancy. They can help you to safely stop using drugs and will continue to support you afterwards.
After the birth
After you've had your baby, your healthcare team will offer you talking therapies and support. If you stopped using drugs during pregnancy but start again after your baby is born, there is a chance you could take too much by accident. Your healthcare team can talk about this with you and help you avoid this happening.
If you need practical help with housing or education for other children, you can ask your healthcare team to refer you to your local early help services.
If you or your healthcare team feel you need more support with looking after your baby, you or they can ask for a referral to social services. Health professionals would always speak to you about this first, unless they’re worried about your baby’s safety. This doesn’t mean that your baby will be taken away from you. The social worker’s role involves making sure you have the support you need to help you look after your baby.
You can read more about the role of social services here.
How do drugs affect a baby?
Taking recreational drugs during pregnancy increases the chance of your baby’s growth being affected and of premature birth. Your healthcare team will help you to give up, either by prescribing other drugs, such as methadone, or by helping you stop completely.
Will I be able to breastfeed?
Some drugs cross into the breastmilk. If you use cocaine, crack cocaine, amphetamines or a high dose of benzodiazepines talk to your doctor about the risks of breastfeeding. If you’re using other drugs, you may be able to breastfeed. Your perinatal mental health team can give you advice on breastfeeding if you’re using drugs or alcohol.
Drugs, men and fertility
Drug-taking causes fertility problems in men. Cannabis, for example, can cause:
- low testosterone
- problems with the quality of sperm
- less enjoyment of sex
- difficulty having erections and sex
- being less able to produce sperm.
By giving up drugs, your partner will be helping you to give up too.
More information and support
Adfam works to improve life for families affected by drugs or alcohol.
The Breastfeeding Network provides a Drugs in Breastmilk Information Service by email and facebook page.
- Hunt GE et al. (2019) Psychosocial interventions for people with both severe mental illness and substance misuse. Cochrane Database of Systematic Reviews. Issue 12. Art. No.: CD001088. DOI: 10.1002/14651858.CD001088.pub4.
- National Institute for Health and Care Excellence (2019) Coexisting severe mental illness and substance misuse Quality standard [QS188]. www.nice.org.uk/guidance/qs18
- National Institute for Health and Care Excellence (2014, updated 2020) Antenatal and postnatal mental health: clinical management and service guidance. Clinical guideline [CG192].
- Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group (2017) Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf
- National Institute for Health and Care Excellence (2010) Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. Clinical guideline [CG110]
- Mactier H et al. (2019) NHS Greater Glasgow & Clyde paediatric guidelines:Neonatal abstinence syndrome (NAS) www.clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-guidelines/neonatology/neonatal-abstinence-syndrome-nas/
- Clinical Guidelines on Drug Misuse and Dependence Update 2017 Independent Expert Working Group (2017) Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf