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I just found out that I’m pregnant. Now I fear that I may have caused some damage to my baby. Before I found out that I was pregnant, I had a few drinking binges when I got really drunk. Earlier, perhaps a year ago, I have also smoked marijuana a few times. Can it still cause harm to my future baby? I’ve heard that cannabis remains in the system for a very long time.

The Answer
Thank you for your question. It sounds good that you have such a responsible attitude towards pregnancy and having a baby. Pregnancy and becoming a mother brings a lot of new responsibilities for a woman. Motherhood is a developmental process that begins as soon as you find out that you are pregnant. At its best it includes joy and happiness as well as worries and sorrows. That you are concerned about what consequences your own behaviour has for the child is a good and life-sustaining quality. It is good that you think about the effects of alcohol use already at this stage.

I’m glad I can ease your mind somewhat: occasional alcohol use before the mother knows she’s pregnant will probably not cause problems. Even in normal pregnancies - without any particular predisposing factors - there is a 2-3% chance that the foetus will develop some abnormalities. Occasional alcohol use before the mother even knows she is pregnant does not noticeably increase this risk. The earlier cannabis use that took place before the pregnancy will not have any effect. You need not worry about these things anymore, so just concentrate on the pregnancy. Contact the maternity clinic where you will also get information about nutrition during pregnancy.

However, it is important to be aware of the risks that the foetus may be exposed to if the mother continues to use alcohol or drugs. The foetus begins to differentiate and develop as soon as the mother misses her period, so the mother should stop drinking as soon as she suspects that she may be pregnant.

As no safe limit for alcohol use during pregnancy is known, you should avoid alcohol throughout the entire pregnancy. Generally speaking, it is a good idea to avoid drinking already when pregnancy is being planned, as the mother often does not know she’s pregnant during the first few weeks. Even moderate use of alcohol can also affect your fertility and make it more difficult for you to get pregnant.

Alcohol easily penetrates the placenta and is carried into the foetus. The foetus cannot process alcohol as quickly as an adult, so the alcohol content in the foetus may be even higher than that in the mother. Large-scale, repeated alcohol use in the early stages of pregnancy increases the risks of deformations and miscarriage. Repeated drinking or heavy, occasional drinking during the pregnancy may cause foetal alcohol syndrome (FAS), which causes the baby to have abnormal physical features, short body-length, a small head and possibly developmental disorders of the central nervous system. Depending on the severity of the disorder, the problems may manifest themselves in childhood as learning disabilities, behavioural problems or mental retardation.

Earlier marijuana use has no effect on a pregnancy that begins later. Using marijuana or smoking cannabis during pregnancy, however, will decrease the blood flow in the placenta and may interfere with the foetus’s nutrient supply and thereby slow down growth. Long-term effects (effects that become evident later in life in e.g. behaviour) are possible, if the mother uses these substances during pregnancy.

Becoming a mother makes us think about our attitudes towards many things, including intoxicants. A new, developing life makes us responsible in an entirely new way. I wish you a wonderful and harmonious pregnancy.

I’m a 45-year-old man, married with children. I have a stressing and demanding job that also requires me to travel a lot. At first I had a few beers in order to relax after work, but now the drinking is out of hand. Often both Friday and Saturday are spent drinking. In the evenings in hotels I don’t really have anything else to do and it is so easy to have a few beers or a bottle of red wine at a restaurant. In addition, I’ve started to take anti-anxiety medicines (Oxepam and Diapam) that has earlier been prescribed to me for tension and depression. Before I go to bed I have to take a sleeping pill (Imovane) in order to be able to sleep. My wife is very worried and angry. She threatens to leave and take the children with her if I don’t stop drinking. I do not want to lose my family. I can take care of my job. Do you have any suggestions as to how I could control my drinking?

The Answer
You have taken the brave first step by contacting this service! You have reason to worry about your drinking. I’m worried about the fact that you have had to use medicines for anxiety and sleeping disorders. The medicines you mentioned are benzodiazepines that can have unpredictable and even life-threatening effects when used together with alcohol. It is absolutely forbidden to take them when you have been drinking. You can also become physically addicted to benzodiazepines. Psychological addiction is based on the belief that you cannot live with the symptom without the medication. Gradually, however, the medicines begin to cause the very same symptoms they were meant to cure, so these medicines are to be used only temporarily.

I got the impression that you have got stuck in a vicious circle. Anxiety and sleeping disorders are often the result of drinking, so in a way your drinking causes your need for these tranquillisers and sleeping pills. I recommend that you abstain from alcohol entirely for a month. During this time all withdrawal symptoms will disappear and based on the symptoms that possibly remain your need for medication can be reassessed.

There are plenty of suggestions that you asked for but there is no patented miracle cure. First you must find out what it is that you want to change and what your hopes are. You said that you do not want to lose your family. It would be a good idea to discuss matters with your wife: how she feels about your drinking and how she would like things to change in order to be able to continue sharing her life with you. And what about you: are you ready to give up drinking completely or is your goal a so-called moderate use of alcohol? Why do you need alcohol? Could you e.g. relax and release work-related tension in some other way or change the situation at work so that the pressure would not be unbearable? What harms has your alcohol use caused you and your loved ones? What does alcohol give you; what would be missing from your life if you did not drink? In which situations are you able to you control your alcohol use and when does it get out of hand?

If you aim at moderate use, it is important to keep track of the amount of alcohol consumed e.g. by writing down daily all alcohol units you have had. When you aim to use alcohol moderately, set clear, measurable goals or a limit you must not exceed. A good standard of comparison is the limit for large-scale use, which for men is 24 units per week and 7 units per day. If you exceed these limits regularly, the likelihood of alcohol-related harms increases considerably. If your drinking diary shows that you can’t keep within the set limits, you should rethink and redefine your goal.

Planning ahead is essential when you work towards moderation or sobriety. If you know you will be facing a situation where alcohol will be offered, plan ahead how you can say no or, if you intend to drink, how much and how quickly you will drink. Otherwise it is easy to slip. Also, think about what you could do instead of drinking in situations where you usually drink.

Nowadays there are also medicines for controlling drinking and cravings. For those who want to become completely sober there is Antabus which causes unpleasant reactions with alcohol (palpitations, blushing of the face, nausea etc.). You should absolutely not drink when taking Antabus as the joint effects may be even life-threatening.

Naltrexone is suitable for controlling drinking. It is sold at pharmacies under the brand name ReVia, and it decreases the feelings of pleasure and incipient intoxication when you drink alcohol. ReVia does not have any unpleasant effects when used together with alcohol, but the use of opiates and thioridazine-based medication is forbidden. ReVia is usually a well-tolerated medicine. The most common side effects include nausea and tiredness but they will usually abate within a week. Best treatment results have been achieved by combining the medication with cognitive therapy.

Sometimes problems may have become so serious that you cannot deal with them alone nor with the help of your loved ones. Non-institutional treatments for intoxicant-related problems are in Finland offered mainly by A-Clinics that operate in many municipalities all over the country. A-Clinic services are confidential and free of charge. If you feel shy about contacting an A-Clinic, you can also call (also anonymously) and talk with a professional. The services of A-Clinics are also meant for family members, so your wife can also contact them if she wants. Naturally you can take the matter up with any health care professional who can refer you to the appropriate treatment centre.

You have already taken a big step by writing to AddictionLink so you shouldn’t leave it at this. From what you’ve told it seems that you still have a lot of valuable resources (work, family and most importantly, the willingness to change), so I believe you can get through this situation. Do not hesitate to contact e.g. your local A-Clinic and take concrete actions. The earlier you tackle drinking problems, the easier they are to be solved!

More information on mixed use of alcohol and pharmaceuticals:

On benzodiazepines:

On alcohol addiction and its treatment:

On sleeping pills and tranquillisers: