SIDNEY — For pregnant women addicted to opioids, there is a place to turn for help in the Miami Valley region. It’s called Promise to Hope.
The Miami Valley Hospital (MVH) program Promise to Hope in Dayton helps connect opioid-addicted mothers to treatment for moms and their babies during pregnancy and for up to a year after the birth.
Promise to Hope specifically focuses on helping pregnant women who are addicted to opioids, as the program is funded by grants and donations to address expectant mothers with an opioid addiction.
“We meet them with a treatment plan that they are agreeable with,” said Promise to Hope Nurse Manager Trish McVey.
Medication-assisted treatment is provided for the mothers as well as withdrawal treatment for newborns exposed to opioids during the fetal period. The program also partners with Alcohol and Other Drug (AOD) organizations to assist in making necessary changes to recover from drug (and alcohol) addiction.
Although most are captured at the Berry Women’s Center at MVH, McVey said opioid-addicted, expecting mothers can simply call Promise to Hope to set up a “game plan.”
She said health providers prefer for addicted, expecting mothers to participate in a residential treatment center program, such as the 28-day program at NOVA Behavioral Health in Dayton. However, if mothers are reluctant, or unable, to commit to an in-treatment program, they can participate in an intense, outpatient program.
Once admitted, expecting moms are sent to the high-risk pregnancy floor at MVH and then are seen by an ultra-sound specialist, a social worker, as well as the program’s medical director. Medication is then recommended for helping the mother cope with the strong opioid craving.
The prescribed abuse-deterrent medication passes from mother to the fetus, in which case, some newborns are not born addicted and do not go through the withdrawal symptoms called neonatal abstinence syndrome (NAS). However, babies are monitored for five days after birth at MVH’s Neonatal Intensive Care Unit (NICU) for symptoms such as fussiness, crying, inability to sleep, fever, jitteriness, rigidness, diarrhea, vomiting, sneezing and a lot of sucking.
Inconsolable babies are treated with an oral dose of morphine for about two weeks, McVey said. The amount administered is determined by a scoring system based on the intensity of a baby’s symptoms.
“When the baby is born, (if the mom has been in treatment) we encourage breastfeeding. Also, skin to skin, low-lighting and gentle rocking. We encourage moms to be (at the NICU) as much as possible,” McVey said. “The staff is great with teaching to moms how to keep the baby comfortable and swaddle.”
Wilson Health Medical Group (WHMG) Pediatrician Dr. Sarah Marshall said although “it is a natural inclination of our culture to want to punish a mother for poor decision making and to separate a newborn from the person whose choices put him at risk in the first place,” it is her opinion “that unless the mother is a danger to the child, separating mom and baby does a disservice to them both.”
“The first hours and days are a time when the baby may struggle and the studies are clear that the comfort of the mother reduces the severity of the symptoms and the need for the baby to be exposed to other medications,” Marshall said in an emailed response to questions from the Sidney Daily News.
Babies born at WHMG with mild withdrawal symptoms are managed in Wilson Health’s “normal newborn nursery with extra TLC, feeding support, and very close monitoring,” Marshall said. But babies who are “more severely affected … often need a great deal of support and are transferred to a larger medical center with a newborn intensive care unit like Dayton Children’s Hospital” where they can receive more advanced care.
McVey said custody is based on a case-by-case basis, when asked if mothers who used during pregnancy automatically lose custody after birth. She said children services are notified at birth, but they look at a variety of factors when determining custody. Children service workers look at how long a mom has been in custody, if she has a safe and sober home to take the baby, if she has a good support system and if she is able to care for herself and her baby. In some cases, the mother retains legal custody, while a family member may hold physical custody of the baby while the mother continues treatment.
“The success of babies born addicted requires a team dedicated to them and their families,” Marshall said. “We have a long way to go in terms of understanding, preventing and treating opioid addiction. Pediatricians at Wilson Health will continue to be on the cutting edge of care for the tiniest patients affected, and for their families. We will continue to care for them in our nursery to ease their difficult transition into the world and in our outpatient office to support them as they grow.”
When asked if McVey had any advice for pregnant women addicted to opioids, she stressed the need for finding a physician in Shelby County. Unfortunately, Promise to Hope lacks a partner in Shelby County. She said counseling is available here, but there are no prescribing physicians in Shelby County that will write a prescription for medication.
Promise to Hope can be reached at the Berry Women’s Center at MVH, 1 Wyoming St., Dayton, or at 937-208-4093. Someone will return the call within 24 hours, if no answer.
Reach the writer at 937-538-4823.