Editor’s note: This is the first in a series on what substance abuse addiction and treatment looks like in our area. On Monday Jan. 9, community forums about opioid addiction in greater Franklin County will take place at Spruce Mountain Middle School from 2:30 – 4:30 p.m. and at Mt. Abram High School from 6 to 8 p.m.
By Jay Naliboff, MD
We have all heard about the epidemic of opioid use and abuse in Maine and the terrible toll it has taken on Maine families. Most of us know someone who is using opioids and many have family members whose lives have been cut short by drug overdose. Opioid abuse is not a disease of the inner city, far from our consciousness, but rather a disease affecting rural areas such as Franklin County disproportionately.
Less has been written and said about babies born to mothers who are using opioids either by prescription or obtained illegally. These babies are said to have Narcotic Abstinence Syndrome or NAS. In NAS a baby goes through narcotic withdrawal after birth because they are no longer exposed to the opioids in the mother’s blood. These babies my become irritable, cry frequently, and have diarrhea. Fortunately symptoms can be controlled by supplying morphine in slowly decreasing doses to wean the baby off opioids. NAS occurs even when mothers are in programs prescribing methadone or buprenorphine to treat addiction.
Much worse for the unborn baby is when a pregnant woman decides to go through withdrawal by herself. The severe symptoms of going “cold turkey” may result in the fetus dying. It is much safer for the mother and baby to be in a treatment program and have NAS managed in the hospital after birth.
Many small hospitals are uncomfortable taking care of these mothers and babies and send women away from their family and friends to deliver. We are very fortunate at Franklin Memorial Hospital to have highly trained and compassionate obstetricians, pediatricians, and nurses who feel that it is better to care for these mothers and babies close to home. We are also fortunate to have local physicians such as Dr. Bein, Dingley and Adler who are willing to prescribe buprenorphine (Subutex) to pregnant women. Because NAS babies often stay for days in the hospital, families are allowed to stay as well. This gives the nursing staff time to teach parenting skills and observe the interactions between mothers and babies.
The opioid crisis will not go away soon. We can’t let babies be innocent victims and we must make use of pregnancy, a time when women are motivated to improve their health for the sake of their baby, to provide treatment for mothers and babies. The conversation about opioid addiction must move away from the stigma of shame about a pregnancy with drug addiction to one of hope for recovery and encouraging mothers to enter into treatment during their pregnancy.
On Jan. 9, community forums about opioid addiction in Greater Franklin County are happening at Spruce Mountain Middle School from 2:30 – 4:30 p.m. and at Mt. Abram High School from 6 to 8 p.m. This is an opportunity for community members to learn more about the complexities of addiction and treatment, and share their own experiences and ideas to develop a plan of action that will help support individuals who are in treatment and strengthen existing prevention efforts.
For more information about the Jan. 9 Community Forum or to RSVP, please contact Program Director Lorri Brown at 779-2409 or ljbrown@fchn.org.
Thank you, Dr. Naliboff, for educating us! This is a problem that was not on my radar,and it evidently is a big one. I appreciate the compassion with which you write and am very grateful that we have the kind of professionals in this community who are willing and capable of helping these mothers & babies closer to home.
I acknowledge the devastating problem opioid addition extracts. I want to speak for those of us this short term pain meds. Personally my back goes out every year to twork years. When that happens, I need pain meds. With the current policies I can not get any. Well honestly, I can get about 5 at a time. This is barbaric treatment. I am not, have never been addicted to pain meds. Bottom line, be reasonable, qualify your patients and for good medicine provide pain meds to know those who need it short term
Very interesting article by Dr.Nalinboff who I have alot of respect for. However the other problem is when the pregnant mother lies to the doctors about the drugs/opiods they take. I have seen this in families and that is not helping the mother or child to lie.It is not easy to deal with these people but it is time to get the help and be truthful about it