A Hampton Roads woman was born to a drug addict. She’s urging pregnant women to get treatment.
Born to a heroin addict, she weighed only 3 pounds, 6 ounces when she arrived in a
"Back then, they didn't test mothers for drugs," she said. "If the babies had withdrawals, it was like, 'Whatever ... ' "
But she does know this: Her father remembers her non-stop crying in the months after her birth.
Now she knows that's the classic symptom of babies exposed to drugs in the womb. And it's becoming more common in hospital nurseries as an opioid epidemic unfolds across the country.
During a 12-month period ending in mid-2016, there were 1,334 drug-exposed babies born in
The
She received care from high-risk pregnancy obstetricians at
Her daughter,
"I was introduced to drugs in utero,"
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Worried about the next hit
And stirred up they were.
The
Medication-assisted treatment is widely recognized as the way to treat opioid addiction because it controls the physical need to use opioids, stemming the illegal use of them. When women use illicit opioids, they are at high risk of overdose because they don't always know what is in the drug, and they continually crave more.
Besides the risk of overdosing, addiction also exposes the fetus to ever-increasing amounts of drugs, as the brain is wired to want more and more. That in turn, can lead to fetal distress, premature labor and, in the worst cases, death of the baby.
One of Langille's clients last year described to him the experience of being in jail and having to help another woman, who was 33 weeks pregnant. She was going through heroin withdrawal.
"The problem is twofold. It's brutal on the individual. And on the fetus. But there's a prejudice against people with opioid addiction. There's a thinking that they're not sick, they're criminals. That doesn't help anyone. That doesn't do anything but bring it down on an unborn child."
Avalere, a health analyst, recently looked at which states had the lowest number of providers certified for medication-assisted treatment using buprenorphine, compared to the number of opioid overdose deaths, and found
Dr.
Another is burdensome regulations that are required of doctors giving medication-assisted treatment. A third is the stigma and bias against the treatment, with critics saying it's substituting one drug for another.
"We never say, 'We hope some day diabetics can wean themselves off of insulin,' " Harris pointed out. "We don't say, 'They're substituting one drug for another.' "
Langille asked his patient to share her experience:
"My deepest wish is to encourage other ladies who find themselves pregnant and opioid dependent to know there exist options and help, without judgment, and that they can safely deliver healthy babies."
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"Who wants their baby to go through pain?"
The inspiration for
Her mother was a heroin addict and went back and forth between drug rehab facilities, jails and raising her daughter. The
Her mother was in the hospital at the same time, dying of AIDS, a disease caused by HIV. The virus, which attacks the immune system, is spread through semen, blood or breast milk. Drug users pick it up through used needles.
"People came to visit, like my uncle from
After she got out of the hospital, she went to her father because she had a get-well card she wanted to give her mother.
"There's something I need to talk to you about," he told her. "Your mom died."
Asked how that made her feel, she thinks a moment:
"I cried for a little bit, and that was it."
It was around then that doctors discovered her mother had transmitted HIV to her.
After her mother died, she went to live with her father and stepmother.
"I remember when I was 13, 14, I always thought 'I'm never going to do drugs.' I looked down on my mother."
But she did, starting as a teen.
"When I was 16, I would try anything. Ecstasy, Xanax, weed, cocaine. Anything. I never said no to anything."
She never felt addicted, though, until she tried prescription pain pills in her mid-20s.
"Prescription drugs really got ahold of me. I liked to smoke weed, but I could stop. There was never a drug where I needed to have it. Until pain opioids. Someone asked me one day, 'Do you want to try this?' and I said sure. I was 24, 25. At first, it was nothing, but then I needed two a day."
The number kept increasing.
It was only after she got married that she sought help. Her husband called Right Path, and she had her first appointment in
"If you continue to do drugs," she said, "your baby is going to go through withdrawal. Who wants their baby to go through pain?"
Going to a high-risk pregnancy doctor was a given, not just because she was in drug recovery, but because she had HIV.
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High-risk pregnancies
The doctor who oversees that department, Dr.
He said he has seen the number of pregnant women addicted to drugs rise over the years, though it's difficult to pinpoint a number because many women don't disclose they have a substance-abuse problem.
"Some may know they are addicted, and some may not know," he said. "I'm confident the number we see is much lower than what really exists."
As president of the
The workshop in
Currently, pregnant women who come to the high-risk ob-gyns at EVMS are either being treated at a methodone clinic or use a drug called buprenorphine, which can be prescribed by doctors outside methadone clinics. But the doctors need to go through special training to prescribe the drug because it's a narcotic.
Abuhamad said there is another school of thought that pregnancy should be used as an opportunity to wean women completely off drugs. He said there are studies under way to get more data on the issue.
"They could be very motivated, but it requires resources and support," Abuhamad said. "Once you get an addict to abstain, they need long-term, intensive support."
An important step the state of
But relaxing that regulation for substance abuse treatment, and also improving provider reimbursement, has led to more Medicaid recipients accessing care, according to
The number of Medicaid recipients receiving substance abuse treatment increased by 40 percent when a nine-month period in 2017 was compared to the previous year. For pregnant women recovering from opioid abuse alone, the number rose from 38 to 241. There has also been a 39 percent drop in emergency department visits related to opioid abuse for Medicaid recipients.
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"What can I do ...?"
Langille said he believes it's safer for women to be in medication-assisted treatment. Many women, though, want desperately to go completely off of drugs when pregnant.
"These moms will do anything to carry their babies," he said. "A lot of them want to go off completely because somehow MAT (medication-assisted treatment) is not as pure to them as faith-based or abstinence approaches. Some who try that do not last a year; it's not long before they are back on opioids."
The baby is exposed to drugs in medication-assisted treatment -- but to lesser, safer and more consistent amounts than if the mothers were using street drugs. Once the baby is delivered, babies are gradually weaned off the medications if they are breast-fed, since the drugs cross over into the breast milk.
Here's the difference though: She had HIV transmitted to her before her mother knew she had the virus. Treatment for HIV has advanced to the point where few babies are born with it now, as long as women stay on HIV medications to keep the virus at undetectable levels, and are monitored throughout their pregnancy.
"I think, 'What can I do to keep her from doing the same?' I kind of believe it's an opportunity thing. I want to make sure she's in an environment where she's involved in sports, after-school activities."
She gives her own father credit for taking her in after her mother died. "He could have gotten rid of me, but he didn't. He took care of me."
Three years ago, he showed up on her doorstep, diagnosed with dementia. She and her husband cared for him.
He died a week after
And "that's basically it," she says in an almost dismissive way at the end of her story, adding that she hopes it will encourage pregnant addicts to get help: "It's not fair to the baby not to."
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