Adena program combats drug addiction in babies

CHILLICOTHE —  A program that began in 2013 at Adena Medical Center has been focused on treating pregnant women who are struggling with addiction, and a year later, it is still seeing an increase in the number of babies born who test positive for drugs.

Centering Pregnancy, funded by Medicaid Ohio grants, aims to supervise safe, medically assisted detox of women experiencing addiction during their pregnancy while safely delivering and managing withdraw symptoms in infants.

The program is geared toward helping women with opioid dependencies. According to a report on neonatal abstinence syndrome, published in 2013, opioids have surpassed cocaine as the second most common drug abused.

Donna Collier-Stepp, Centering Pregnancy coordinator and a social worker in the Adena Women and Children’s Center, said she has noticed an increase in women who are addicted to heroin entering the program.

According to Collier-Stepp, many women begin using drugs around age 14, and by the time many of the women come to the hospital's program, some have already been using for ten years. She said it's important to remember that the situation is not one the women chose to be in.

"I've learned that there is not stereotypical addict. I've never met anyone with a story that wouldn't break your heart. Heroin is unbelievable. It just doesn't stop getting more and more people," Collier-Stepp said.

The 2010 National Survey on Drug Use and Health revealed girls ages 12 to 17 had surpassed males in use of cigarettes, cocaine, crack, inhalants and prescription drugs. With a growing number of women becoming addicted, those who become pregnant are passing the addiction on to their unborn children.

The rate of babies born with neonatal abstinence syndrome grew nearly nine times from 2004 to 2013, according to a report. Between 2009 and 2013, more than 2 percent of babies born in Ross County were born with a drug dependency.

Throughout 2014, Adena delivered 1,035 babies. Of those born in that year, 100 tested positive for drugs, and 26 of them had to be treated with pharmacological intervention after birth.

However, even with the assistance of the Centering Pregnancy program, the number of babies testing positive at Adena has only increased. Between January and June, the hospital treated 22 babies, more than double the number treated in the same period last year.

Dr. Ronald Lopez, OB-GYN at Adena Medical Center, is one of the doctors who provides prenatal care and checkups to the women involved in the program. Once a month, he has an appointment with each participant to monitors their progress and health.

As treatment, the FDA-approved drugs Subutex and Suboxone are prescribed. Both help to eliminate dependencies on opiates and can help users stop taking drugs without having to suffer from withdrawal.

Subutex is given to women during pregnancy because it contains only one active chemical, buprenorphine, while Suboxone contains two, buprenorphine and naloxone. Suboxone is prescribed after the women give birth to continue to help them through recovery. Eventually, the mothers are weaned off the prescription entirely, and are ideally able to stay clean.

"We are proud we have this opportunity to help women and their children, and we want to reach out more," Lopez said. "We are dedicated to helping these women.

"Statistics show they will be productive citizens, and that's what we want," he said.

Collier-Stepp said some women, however, have heard about Suboxone and are attempting to buy it off the street and detox themselves. The problem with that, she said, is that the drug is not always accessible. When they can't buy it, they are going on and off it, or substituting a similar drug, and Collier-Stepp said it is doing them more of a disservice. A steady, low dose of the drug is what keeps the women feeling OK.

But getting access to the medications through Centering Pregnancy and similar programs is not always easy. Lopez said no one is turned away from his practice, but there is a waiting list to get into the program, and it is possible for women to be removed once they are in by testing positive for drugs too many times.

Through Jan. 4, 2014, the program released seven women for positive drug screens, one for seeking drugs and one for lack of desire for detox. However, there also have been 17 infants born from 16 mothers without significant abstinence syndrome scores and who did not require morphine treatments that year.

Morphine is a common treatment for babies who are experiencing withdrawal symptoms. Babies withdraw when they are no longer receiving a drug through their mother and exhibit symptoms such as seizures, not eating well, excessive crying and irritability.

"It's really terrible, going into (neonatal intensive care units) anywhere in the U.S. or here. These poor babies are on morphine drips, they are jittery and not eating. ... It's terrible," Lopez said.

"It's so devastating to see a child withdraw," Collier-Stepp said.

However, through the Centering Pregnancy program, babies' stays in the hospital are shorter than those who are recovering with a morphine drip.

"Babies that come through our program are staying in the hospital three to five days versus 30 days," Lopez said.

But more than just medical treatment, Collier-Stepp said the program also helps women develop self-care routines and life skills as well as build healthy relationships.

Women also participate in weekly group sessions. Part of those sessions is keeping notebooks and lists of things to do instead of using drugs. That way, when the women are tempted to use, they have tools readily available to help them see other choices. Collier-Stepp said the women feel it is a safe place to come and help each other whenever possible.

"They develop great friendships. They exchange phone numbers, bring each other baby clothes, car seats. If they have extra of anything, they bring it for another woman in group," Collier-Stepp said.

Collier-Stepp said the women who complete the program often tell her she has changed their lives, but Collier-Stepp tells them they are not entirely right.

"I didn't change your life, you changed your life," Collier-Stepp said.