Hospitals programs address opioid use disorder during pregnancy

Renee Maloney, RN, was working at the Pregnancy Care Center at Catholic Medical Center in Manchester, NH, when she noticed a disturbing trend about seven years ago.

Renee Maloney, RN

The trend was a steady increase in the number of newborns experiencing symptoms such as diarrhea, shaking, breathing problems and excessive fussiness.

The infants were suffering from neonatal abstinence syndrome, or withdrawal from drugs they had been exposed to in the womb from opioid use disorder.

The trend was fueled by a surge in the number of moms who had gotten hooked on opioids, and Maloney felt compelled to find a way to help these women with their addictions earlier in pregnancy.

She and Nicole Pendenza, BSN, RNC-NIC, director of maternal, child and women’s health at the hospital, proposed a plan for a program to provide addiction treatment and recovery services to pregnant women in the area. Hospital leaders were supportive, and the facility opened Roots for Recovery in 2017.

Women in the program have access to prenatal care, individual counseling with a social worker, recovery support groups and a provider who can prescribe medication like buprenorphine, a medication-assisted treatment to help patients reduce or quit using heroin or other opiates.

The program is helping many pregnant women overcome addictions that started after physicians prescribed opioids to treat pain.

“I’ve been surprised to see women from all walks of life,” Maloney said. “The addiction may have started after medication was prescribed for pain following a tooth extraction or athletic injury, and they became physically dependent.”

In some cases, women start buying heroin off the street after prescriptions run out.

Catholic Medical Center is among a growing number of hospitals launching programs specifically geared to help pregnant women who are struggling with opioid use disorder. The number of these women more than quadrupled from 1999 to 2014, according to the Centers for Disease Control and Prevention.

Researchers found the national prevalence of opioid use disorder increased from 1.5 per 1,000 hospital deliveries in 1999 to 6.5 in 2014. The annual rate increases were highest in Maine, New Mexico, Vermont and West Virginia.

Innovative approaches to treating withdrawal from opioid use disorder

pregnancy opioid addictionAt Catholic Medical Center, new patients initially meet with Maloney and a social worker, who gather information about the patient’s history and collect a urine sample to screen for drugs.

Then patients meet with a nurse practitioner, who can prescribe medication-assisted treatment. The staff completed a four-month training to learn about motivational interviewing, trauma-informed care and how to provide care to newborns with neonatal abstinence syndrome.

One common misconception the providers address with patients is the belief that women should stop using illegal opioids during pregnancy, according to Maloney.

“Stopping abruptly could cause withdrawal and potentially put the pregnancy at risk,” she said. “Instead, we encourage women to come in and get the support they need to start taking prescribed medication that can help …read more

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