Report: Opioid abuse poses special problems for pregnant women

Recommendations on how doctors should handle the growing population of pregnant women affected by opioid drugs in New York were to be released Tuesday as representatives from more than a dozen states gathered in Washington, D.C., to discuss how to address the problem on a nationwide basis.

Pregnant women impaired by opioid drugs are a hidden but significant segment in the ongoing narcotic epidemic, according to the American Congress of Obstetrics and Gynecologists, District II, which represents specialists who treat women and their developing babies in New York. The Congress, public health experts and members of advocacy groups, formed a task force earlier this year in response to the crisis.

Their report recommends statewide screening of all pregnant women for evidence of opioid drug use, encourages a potent education campaign for doctors, and urges medical professionals and the public to banish the term “addict.” The panel of doctors, public-health officials and drug-abuse experts suggests pregnant women who are dependent on opioids be referred toas people with an “opioid use disorder.”

Dr. David Garry, director of maternal and fetal medicine at Stony Brook University School of Medicine and co-chair of the task force, said pregnant women afflicted with problems brought on by narcotics can no longer be relegated to society’s shadows.

“This is a forgotten population,” Garry said in an interview Monday. “We have had patients coming here withdrawing in labor and delivery.” The time has arrived for outreach and treatment to interrupt patterns of drug use and potential harm to newborns, he said.

Changing how people refer to pregnant women on highly addictive narcotics acknowledges opioids dramatically alter brain chemistry and affect rational thinking, Garry said. People who take narcotics have a physical, psychological and emotional dependence that is difficult to shake, he added.

Not only are pregnant women affected by the drugs, but their babies are born with the same problems, some suffering signs of withdrawal soon after birth, Garry said. He estimates at Stony Brook alone, about 200 children have been born in recent years to drug-addicted mothers, reflecting the upward surge in narcotics use throughout Long Island.

A Newsday analysis in 2015, based on data from 2009 to 2014, showed the birthrate for babies born addicted to opioids, including heroin and prescription painkillers, had more than doubled in Suffolk County compared with the previous six years.

The Suffolk addiction rate outpaced increases in Nassau and other suburban counties in the region, the newspaper’s examination of statistics from the State Department of Health found.

Dr. Leah Kaufman, co-chair of the task force and vice chair of obstetrics and gynecology at SUNY Upstate Medical University in Syracuse, said screening pregnant women for signs of drug use provides an opportunity to intervene with appropriate care for both the mother and child.

“We felt we needed to identify the specific challenges and propose solutions associated with caring for pregnant patients with opioid use disorder and put those recommendations into action,” Kaufman said.

Doctors from 14 divisions of the American Congress of Obstetrics and Gynecology, including New York’s District II, are scheduled to gather in Washington Tuesday to launch the Alliance for Innovation on Maternal Health. The aim is to work on recommendations encapsulating those developed in New York, but go farther by working toward the prevention of drug use during pregnancy.

Garry, who serves as medical director the Maternal Opioid Maintenance Support — MOMS — program at Stony Brook, specializes in treating women who are pregnant and addicted to opioids. The MOMS program focuses on weaning these patients from narcotic substances.

“At least 80 to 90 percent of these patients come to it [drug depedence] from a prescription opioid, and I know this because I take care of these women and I hear their stories,” Garry said.

The new report also encourages doctors to become familiar with the prescription medication buprenorphine (sold as Subutex), which counteracts withdrawal symptoms.