By Frank Lewis
One-hundred-and-fifty babies each year are born drug addicted at Southern Ohio Medical Center. For a number of years, Scioto County was ground zero for the illegal prescription drug problem in the U.S., but what may surprise you is 13 percent of moms and newborns are testing positive on admission for an illegal substance or a prescription drug that is obtained illegally.
Jone Stone, RNC, nurse manager in the Maternity Department at SOMC, said positive action is taken upon discovery of the scenario and the first thing that is done is an assessment of the baby to see if that baby is going to go through withdrawal from the effects of the drug.
“The withdrawal is dependent on what drugs the mom took and how long she took them and how much she took,” Stone said. “That all effects the withdrawal process.”
Stone said if the baby needs additional care, it is kept in the hospital from two to four weeks and the pediatricians utilize morphine to help the baby withdraw.
“It helps ease the symptoms of withdrawal so that they don’t have severe shaking. They don’t have seizures,” Stone said. “It’s enough morphine to take the edge off some of those symptoms but it doesn’t knock them out.”
Stone said the babies are gradually tapered off the morphine and at the end of that taper, which is around 24-48 hours, they can be discharged.
Stone said where the baby is discharged to is something that has to be decided based on several factors.
“It becomes actually a Child Protective Services situation,” Stone said. “So Scioto Conty Child Protective Services assesses that situation, interviews parents and then makes the decision as to whether or not they go home with those parents, the go home to a relative or they go into foster care.”
The drug-addicted baby and drug-addicted mom are a small percent of the whole population that is using some sort of illegal substance. Stone said, while early on, around 2008-2009, when Scioto County was the epicenter of the illegal drug activity in the U.S. what SOMC medical personnel saw in a large amount was oxycontin. Fact is, Scioto County was four times higher than the rest of the nation. She is of the opinion the rest of the U.S. has caught up with Scioto County when it comes to illegal substance abuse.
“That’s when we had all the pill mills in the county,” Stone said. “Today the oxycontin has dropped because the pill mills have gone away, thanks to the Ohio Attorney General’s Office and local law enforcement officials and our (Southern Ohio) Drug Task Force. But now, what’s filling that vacuum is heroin. So, just because the pill mills went away didn’t mean the addiction went away.”
Stone said drugs are detected through analysis of the baby’s umbilical cord.
The positive part of all this is the help that is being given to addicted mothers.
“We have a great relationship with The Counseling Center in Portsmouth and more specifically the Stepping Stones House,” Stone said. “Some of our moms fortunately are already in Stepping Stones before they ever come to us and that is wonderful because they are already in a program. They have all that supportive counseling, plus they’re starting to taper off.”
Here is one more statistics: 26 babies were born of Stepping Stone moms last year that were drug-free. One of the weapons in the war on drug addiction is subutex, but Dr. Darren Adams, DO, obstetrician/gynecologist says it is only part of a complete program.
“I only deal with subutex for pregnant women,” Adams said. “Mine is a different scenario than other treatment programs. I only prescribe subutex for in-patient residential individuals so that they can guarantee that they are getting the counseling component as well as the medication to withdraw off their opiate addiction. Without the two it makes it very difficult. I think you have to have the whole package to make it work.”
Adams said outpatient treatment only works for people who are motivated by going to counseling and stick to the program. Adams said the biggest problem for the pregnant women is not the subutex or the counseling. Their biggest problem comes after they leave the program and relapse. He said there are rapid subutex weaning programs, but he has to take it a little longer because his patients are pregnant. Adams said there is no good research to know what the effects are from rapid withdrawal because the program is relatively new.
“Some people are under the mistaken thought that when they come here that they’re going to come here for 90 days then leave,” Adams said. “The ones that are most successful are the ones that come down, they stay through delivery, stay six weeks postpartum for that after-care. That gives us the opportunity to help get them to where they can make changes.”
The good news through it all is that there has been no infant mortality at SOMC as a result of babies born addicted.
“We have had no fetal deaths as a result of the withdrawal,” Adams said.
“We haven’t had any bad outcomes,” Stone agreed.
Add to the mix, a nursery with experience in handling the problem and additional non-medication tools such as positional aids, iPod’s with soothing music, swaddling and swings, and well-trained volunteers to, when needed, rock the babies, and there is light at the end of the tunnel.
“People from all over the state come here and look at our program because we’re out there on the front edge,” Adams said.
Reach Frank Lewis at 740-353-3101, ext. 1928, or on Twitter @franklewis.