What Happens If You Test Positive for Opioids During Pregnancy?

Pregnancy is a time of heightened medical attention, and routine screenings help ensure both mom and baby stay healthy. If you test positive for opioids during pregnancy, you may feel scared or unsure about what happens next. You’re not alone, and there are steps you can take to protect yourself and your baby. This article will explain what a positive opioid test means, potential medical and legal consequences, and how to get help if you need it.

Why Are Pregnant Women Tested for Opioids?

Many doctors include drug screenings as part of prenatal care, especially if there are risk factors such as:

• A history of substance use
• Lack of prenatal care
• Signs of withdrawal symptoms
• A prior child with neonatal opioid withdrawal syndrome (NOWS)

Hospitals may also conduct routine drug tests at labor and delivery, especially if there are concerns about substance use.

What Happens If You Test Positive for Opioids?

If a drug test shows opioids in your system during pregnancy, here’s what to expect:

1. Your Doctor Will Discuss the Results With You

A positive opioid test doesn’t always mean you are misusing substances. Some prescription medications, like oxycodone or hydrocodone (often prescribed for pain), can show up in drug screenings. Be honest with your doctor about any medications you are taking. If opioid use is a concern, your doctor may:
Recommend additional screenings
Refer you to a substance use specialist
Discuss treatment options to protect your baby

2. Your Baby May Be Monitored for Withdrawal

Opioid exposure in the womb can lead to neonatal opioid withdrawal syndrome (NOWS), also called neonatal abstinence syndrome (NAS). Babies born with NOWS may experience:

• Tremors or excessive crying
• Feeding difficulties
• Breathing issues
• Sleep problems

Hospitals closely monitor newborns exposed to opioids and may provide medical treatment if necessary.

3. Child Protective Services (CPS) May Get Involved

In some states, testing positive for opioids during pregnancy requires healthcare providers to report the case to CPS or social services. Whether this results in legal action depends on several factors:

• Whether the opioid use was from a valid prescription
• If there is evidence of substance misuse
• If the baby tests positive at birth
• Whether the mother is in treatment

CPS’s goal is to ensure the safety of the baby. In many cases, seeking treatment during pregnancy can prevent child removal and help you keep custody of your baby.

What Should You Do If You Test Positive?

If you test positive for opioids during pregnancy, don’t panic. Here are some steps you can take: Talk to Your Doctor – Be honest about any medications or substances you’ve used. Your doctor can help create a plan for a safe pregnancy. Consider Treatment Options – If you’re struggling with opioid use, medication-assisted treatment (MAT) with buprenorphine (Subutex) or methadone may be recommended. This is safer for your baby than quitting suddenly. Know Your Rights – Every state has different laws about drug use in pregnancy. Some states focus on treatment and support, while others may have legal consequences. Look up your state’s policies or talk to a lawyer if needed. Seek Support – Organizations like SAMHSA (Substance Abuse and Mental Health Services Administration) can help connect you to resources and treatment programs.

Can I Lose Custody of My Baby?

In many cases, seeking treatment early reduces the risk of losing custody. CPS and hospitals often consider:

• Are you in a treatment program?
• Are you receiving prenatal care?
• Is there a safe and stable home environment?

If you are actively working toward recovery and following medical advice, CPS is more likely to allow you to keep your baby while providing additional support.

Final Thoughts: There Is Help and Hope

Testing positive for opioids during pregnancy can be overwhelming, but it doesn’t mean you’re a bad mother or that you’ll automatically lose your baby. The most important thing is to seek help and work with your healthcare team to ensure the best outcome for you and your child. If you’re struggling, you are not alone—support, treatment, and a healthy future for you and your baby are possible.