Pregnancy & Postpartum Opioid Treatment at Cooley Dickinson | Connecting Point | Apr. 24, 2018


OPIOID CRISIS AFFECTING THE
REGION TOUCHES PEOPLE FROM ALL WALKS OF LIFE INCLUDING ONE
GROUP WHO ARE OFTEN OVERLOOKED IN THE BATTLE AGAINST IT. PREGNANT WOMEN. BUT A LOCAL EFFORT IS TRYING TO
ADDRESS THAT. A NEW PROGRAM AT THE HOSPITAL IN
NORTHAMPTON IS DESIGNED TO HELP PREGNANT AND POSTPARTUM WOMEN
WHO ARE RECOVERING FROM OPIOID USE. CAROLEE MCGRATH SAT DOWN WITH
NURSE MIDWIFE AMY WALK WHER WHOS HEADING UP THE PROGRAM TO LEARN
MORE.>>IT’S A PROGRAM OFFERING GROUP
PRENATAL CARE AND POSTPARTUM SUPPORT GROUP FOR MOMS IN
RECOVERY FROM OPIOID USE. AND SO WHAT WILL HAPPEN IS THAT
WHEN PATIENTS COME INTO OUR CARE, OBSTETRIC CARE, THEY’LL BE
OFFERED TO START IN THE NEW BEGINNINGS PROGRAM AROUND 20
WEEKS OR BEYOND. AND THEY’LL COME EVERY — ABOUT
EVERY OTHER WEEK FOR GROUP VISITS DURING THE PREGNANCY
WHICH WILL INCLUDE A TWO-HOUR SESSION AND IN THAT SESSION, WE
DO THE REGULAR PRENATAL CARE. SO CHECKING, YOU KNOW, BLOOD
PRESSURE AND WEIGHT AND CHECKING ON THE BABY. AND ANYTHING ELSE THAT NEEDS TO
BE COVERED AT THAT TIME. BUT THEN THERE’S ALSO AN HOUR
AND A HALF OF TIME TO COVER EDUCATION AND ALSO HAVE GUEST
SPEAKERS COME IN LIKE PEDIATRICIANS, SOCIAL WORKERS,
LACTATION CONSULTANTS.>>ARE THESE MOMS ALREADY IN
RECOVERY? COULD SOMEBODY JOIN YOU WHO, YOU
KNOW, IS STILL USING AND SAYS LISTEN, I’M FIVE MONTHS PREGNANT
AND I NEED HELP. LIKE WHAT DO YOU DO IN THAT
SITUATION?>>ABSOLUTELY. SO EITHER OF THOSE SITUATIONS,
THOSE PATIENTS SHOULD BE ELIGIBLE TO COME IN. A LOT OF OUR MOMS ARE ALREADY IN
RECOVERY AND MAY BE ON MEDICATION ASSISTED TREATMENT
LIKE METHADONE ALREADY. AND COMING INTO OUR CARE. BUT SOME OF OUR MOMS ARE COMING
IN, FINDING OUT THAT THEY’RE PREGNANT AND HAVE ACTIVE ILLICIT
USE. THIS IS A PROGRAM TO OFFER
SUPPORT SO THAT PATIENTS CAN, YOU KNOW, BECOME SOBER AND
MAINTAIN SOBRIETY. IF SOMEONE COMES TO ME WITH
ACTIVE USE, THEN WE HAVE A PROCESS OF REFERRAL TO GETTING
THEM INTO SUBSTANCE USE TREATMENT WHICH IS ANOTHER GOAL
OF THIS PROGRAM IS TO GET MORE MOMS WHO HAVE ACTIVE USE INTO
SUBSTANCE USE TREATMENT.>>OK. LET’S TALK A LITTLE BIT ABOUT
THE AMOUNT THAT THE NUMBERS HAVE SHIFTED SINCE 2004. I WAS READING A STATE REPORT
THAT SAID THE NUMBER OF BABIES EXPOSED TO OPIATES JUMPED 500%
SINCE 2004 TO 2013. WHICH IS STAGGERING.>>IT IS. IT’S A HUGE INCREASE. AND WHAT’S NOT REPRESENTED IN
THOSE NUMBERS IS THAT THERE ARE OTHER PATIENTS WHO ARE NOT USING
DURING THE PREGNANCY AND MAY BE NOT ON MEDICATION ASSISTED
TREATMENT SO THE BABY DOESN’T HAVE ANY OPIOID EXPOSURE BUT
THEY MAY HAVE A HISTORY AND ARE AT RISK FOR RELAPSE POSTPARTUM
SO THERE’S A WHOLE ANOTHER SECTION OF THE POPULATION THAT’S
NOT REPRESENTED WITH THE BABIES THAT ARE EXPOSED.>>YOUR PROGRAM DOES COVER
POSTPARTUM. I WOULD THINK THAT, YOU KNOW, AS
A MOTHER, YOU KNOW, AFTER THE BABY IS BORN WHEN YOU’RE
EXHAUSTED AND WHEN YOU’RE STRESSED OUT AND WHEN THE BABY
IS NOT SLEEPING OR DOESN’T CRY, I THINK THAT’S WHERE SO MANY
MOMS NO MATTER WHO YOU ARE ARE VULNERABLE. HOW DO YOU HELP WORK WITH THEM?>>SO WE HAVE A WEEKLY
POSTPARTUM SUPPORT GROUP THAT WILL BE OPEN TO ANY MOM WHO
WANTS TO COME AND THIS IS SPECIFIC TO MOMS IN RECOVERY. AND SO WE’LL BE OFFERING SUPPORT
IN THAT WAY LIKE KIND OF A PEER SUPPORT MODEL. BUT ALSO, WITH SOME TEACHING
ABOUT FOCUS ON HOW TO RECOGNIZE SYMPTOMS OF DEPRESSION, HOW TO
TEACH COPING SKILLS FOR STRESS MANAGEMENT ESPECIALLY IN THAT
STRESSFUL TIME WHERE PARENTING IS SO TOUGH IN THOSE EARLY WEEKS
AND THAT EARLY YEAR.>>RIGHT. I WOULD SAY DEFINITELY IN THAT
FIRST YEAR. TALK TO US A LITTLE BIT ABOUT
WHAT HAPPENS TO THE BABY WHEN THEY ARE EXPOSED PRENATALLY AND
SPECIFICALLY THE NEONATAL ABSTINENCE SYNDROME.>>SO NEONATAL ABSTINENCE
SYNDROME IS A CONDITION OF WITHDRAW. SO WHEN BABIES ARE EXPOSED TO
SUBSTANCES DURING THE PREGNANCY AND THEN AFTER THEY’RE BORN,
THEY WILL WEAN OFF OF THAT AND SOMETIMES IF THEY’RE EXPOSED TO
OPIOIDS, THEY WILL HAVE NEONATAL ABSTINENCE SYNDROME. WITH THAT, YOU CAN HAVE
IRRITABLE BABIES AND FUSSY. THEY MIGHT BE UNCOMFORTABLE AND
HAVE TROUBLE WITH EATING OR SLEEPING, MAYBE DIFFICULT TO
CONSOLE BECAUSE OF THOSE THINGS. SOMETIMES THEY CAN HAVE
GASTROINTESTINAL SIDE EFFECTS LIKE LOOSE STOOLS OR DIFFICULTY
GAINING WEIGHT. IT IS A TREATABLE CONDITION. AND IT DOES RESOLVE SO THE WAY
THAT WE TREAT IT IS THE FIRST THING WE DO IS WE TEACH MOMS HOW
TO TAKE CARE OF THEIR BABIES. AND, YOU KNOW, REALLY EVIDENCE
HAS SHOWN THE BEST THING IS TO KEEP MOMS AND BABIES IN THE
PROCESS, WE CALL IT ROOMING IN AND WE DO THAT AT COOLEY
DICKINSON WHERE MOMS AND BABIES STAY TOGETHER. THE BABY DOESN’T GO TO THE
NURSERY UNLESS THERE’S SOME OTHER MEDICAL REASON AND WE
TEACH MOMS HOW TO DO SKIN TO SKIN WITH THEIR BABIES AND HOW
TO SWADDLE THEIR BABIES AND SOOTHE THEM. THOSE ARE THE THINGS THAT WE DO
FIRST LINE. BREAST-FEEDING IS ALSO
RECOMMENDED UNLESS THERE’S ANOTHER REASON WHY WE WOULD NOT
RECOMMEND IT LIKE ACTIVE USE.>>WHAT ABOUT METHADONE? HOW DOES THAT WORK WITH THEM?>>SO WE RECOMMEND THAT — SO
WHEN MOMS ARE ON METHADONE WHICH IS WHAT WE RECOMMEND FOR
TREATING OPIOID USE DISORDER, IF WE EXPECT THAT BABIES MAY HAVE
SOME SYMPTOMS OF WITHDRAWAL AND WE RECOMMEND BREAST-FEEDING FOR
SOOTHING THE BABY AND ALSO THERE’S THE BENEFIT OF THE BABY
MAY GET SOME OF THE METHADONE THROUGH THE BREAST MILK AND THAT
CAN SOOTHE THEIR WITHDRAWAL SYMPTOMS AS WELL.>>DOESN’T CAUSE ANY LONG TERM
EFFECTS?>>NOT THAT WE HAVE SEEN. WE REALLY, THE USING THE
METHADONE TO PREVENT RELAPSE AND WITHDRAW IN PREGNANCY IS THE
RECOMMENDED THING BECAUSE THE BIGGEST RISK WOULD BE ILLICIT
USE, CONTINUED ILLICIT USE.>>SO I HAVE TO IMAGINE THAT A
MOM WHO COMES IN CRISIS WHO IS REALLY CONCERNED MIGHT SAY, OH,
MY GOSH. I DON’T KNOW HOW THIS BABY WILL
SURVIVE. HOW DO YOU, I GUESS, GIVE A
MESSAGE TO PARENTS OR TO MOMS AND ALSO TO GRANDPARENTS WHO ARE
CONCERNED ABOUT THAT UNBORN BABY.>>YEAH. I THINK THAT’S ONE OF THE
HARDEST THINGS BECAUSE MOMS HAVE A LOT OF GUILT. AND EVEN MOMS THAT ARE STABLE IN
RECOVERY THAT ARE ON TREATMENT HAVE A LOT OF GUILT ABOUT THE
SYMPTOMS THAT THE BABY IS GOING THROUGH. WHAT WE TRY TO SEND IT
EMPOWERING MESSAGES TO MOMS ABOUT, YOU KNOW, YOU’RE NOT
ALONE IN THIS. YOU’RE DOING THE RIGHT THING. IT BEING IN RECOVERY IN
TREATMENT FOR YOUR BABY AND THIS IS WHAT WE RECOMMEND AND, YOU
KNOW, WE WANT TO PARTNER WITH YOU TO TEACH YOU HOW TO TAKE
CARE OF YOUR BABY AND HELP YOU BE SOBER AND SUCCESSFUL.>>TELL US ABOUT THE PROGRAM HAS
BEEN GOING SO FAR. YOU HAVE PATIENTS ALREADY.>>YEAH, WE HAVE SOME PATIENTS
THAT HAVE BEEN INVOLVED AND IT’S BEEN REALLY GOOD. YOU KNOW, THE THING THAT IS
GREAT ABOUT GROUP IS THE PEER SUPPORT, TOO, YOU KNOW, IT’S NOT
JUST ABOUT ME TEACHING. IT’S ABOUT US ALL LEARNING FROM
EACH OTHER AND CONNECTING AND I’VE ALREADY SEEN SOME
CONNECTIONS HAPPENING WHICH IS REALLY INSPIRING AND EXCITING.>>THAT’S FANTASTIC. AMY WALKER, THANK YOU FOR
JOINING US AND TELLING US ABOUT THIS PROGRAM THAT I THINK IS
GOING TO BE SO HELPFUL TO SO MANY PARENTS OUT THERE. THANK YOU.

Leave a Reply

Your email address will not be published. Required fields are marked *