Youngest vic­tims of the opi­oid cri­sis need help

Hos­pi­tals battle to save ba­bies born with a drug habit

Times-Record - - NEWS - By CHRISTINA ACOSTA ca­costa@ches­ Pe­di­atrics. Health Af­fairs,

BAL­TI­MORE — Mary­land is one of the top five states with the high­est rates of opi­oidrelated over­dose deaths, and some of the vic­tims are still in the womb.

One in­fant is born ev­ery 15 min­utes with with­drawal symp­toms after be­ing ex­posed to opi­oids be­fore birth in the United States, ac­cord­ing to a study pub­lished in

In Bal­ti­more, doc­tors at Mt. Wash­ing­ton Pe­di­atric Hos­pi­tal said ba­bies born with neona­tal ab­sti­nence syn­drome, ac­count for 25 per­cent of the hos­pi­tal’s ad­mis­sions.

Neona­tal ab­sti­nence syn­drome is a set of con­di­tions caused by with­drawal from ex­po­sure to drugs. It is linked to use of opi­oids, in­clud­ing heroin, and Vi­codin.

“The in­fant goes through a very se­vere with­drawals for the first cou­ple of weeks in life,” said Chief Med­i­cal Of­fi­cer at Del­phi Be­hav­ioral Health Group Dr. Neeraj Gan­do­tra. “These chil­dren re­quire a week or two in the Neona­tal In­ten­sive Care Unit to be watched over to not go through ex­treme dis­com­fort. They are at in­crease the risk of phys­i­cal ab­nor­mal­i­ties, seizure dis­or­ders and higher risks of men­tal re­tar­da­tion and some cog­ni­tive im­pact.”

Ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, rates of opi­oid use dis­or­der at de­liv­ery hos­pi­tal­iza­tion more than quadru­pled from 1999 to 2014. Gan­do­tra said the moth­ers who are ad­dicted to opi­oids come from a low so­cioe­co­nomic sta­tus, and are the ones who need the most health care, food as­sis­tance and a sta­ble place to live.

“A ma­jor­ity of them did not have good model­ing from good par­ents. They didn’t have the model­ing of frus­tra­tion tol­er­ance, mal­adap­tive model­ing; and then the other ele­phant in the room, where are they in the pic­ture, not prac­tic­ing safe sex,” Gan­do­tra said. “The in­no­va­tive thing re­ally is to pro­vide re­sources in­clud­ing com­pre­hen­sive care, psy­chi­atric ser­vices with the substance abuse ser­vices, cen­ter of ad­dic­tion and preg­nancy and de­creas­ing urine tox­i­col­ogy.”

Ac­cord­ing to

ad­dic­tion treat­ment ad­vo­cates say two pro­vi­sions would sub­stan­tially im­prove ac­cess to treat­ment — one that would al­low Med­i­caid pay for res­i­den­tial treat­ment in large fa­cil­i­ties and an­other that would al­low Medi­care to pay for methadone treat­ment.

“Health providers are sup­posed to re­port preg­nant women with ad­dic­tion prob­lems to the De­part­ment of So­cial Ser­vices for a fol­lowup,” said Tal­bot County Health De­part­ment Of­fi­cer Fre­dia Wadley. “How­ever, if a physi­cian does a risk as­sess­ment and there are no sus­pi­cions of ma­ter­nal drug use, then a re­fer­ral will not be made. Physi­cians may ask the health de­part­ment to do a home visit on mother and new­born with Med­i­caid (Med­i­cal As­sis­tance) if they feel the in­fant is at risk for prob­lems but this can be a risk due to any­thing and not just ma­ter­nal use of drugs.”

To ex­pe­dite as­sis­tance for fam­i­lies, the Tal­bot County De­part­ment of So­cial Ser­vices and Tal­bot County Health De­part­ment are part­ner­ing to im­ple­ment START — So­bri­ety Treat­ment and Re­cov­ery Team. This ev­i­dence­based pro­gram will pair a so­cial worker and a fam­ily men­tor to pro­vide in­ten­sive sup­port to fam­i­lies af­fected by substance abuse who are in­volved in the child wel­fare sys­tem. The goals of the pro­gram are sup­port­ing par­ents in achiev­ing re­cov­ery and keep­ing chil­dren safe in drug free homes.

“It is my un­der­stand­ing that we should be hear­ing soon, per­haps this month, about those de­tails and will then be able to work to­gether to re­cruit and hire the Fam­ily Men­tor,” said Tal­bot County De­part­ment of So­cial Ser­vices Di­rec­tor Linda C. Webb, LCSW. “Once that per­son has been hired, train­ing will be pro­vided and the ser­vice will be im­ple­mented with fam­i­lies im­pacted by substance abuse who are en­gaged with the De­part­ment of So­cial Ser­vices.”

START hopes to be run­ning in a few months.

Preg­nant women with an ad­dic­tion can seek help in get­ting into ap­pro­pri­ate treat­ment at the Tal­bot County Health De­part­ment. Many ad­dic­tion providers also will as­sist a preg­nant woman in find­ing the care she needs.


One in­fant is born ev­ery 15 min­utes with with­drawal symp­toms after be­ing ex­posed to opi­oids be­fore birth in the United States, ac­cord­ing to a study pub­lished in

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