News Column

La Familia Tackles Infant Drug Addiction

July 4, 2013

Phaedra Haywood

The number of New Mexico babies being born addicted to opiate drugs taken by their mothers -- usually heroin or prescription painkillers -- has increased over the past decade and doesn't appear to have peaked, state and local health officials say.

Data from the state Department of Health shows the number of babies treated for drug withdrawal after birth has increased by a factor of about three in the past decade, jumping from just under two babies (1.7) per 1,000 births in 2000 to more than six (6.2) babies per 1,000 births in 2011, the most recent year for which comparable data is available.

Santa Fe County's Health and Human Services Division director, Rachel O'Connor, said numbers specific to Santa Fe are not currently available, but her department has heard "from all sectors," including hospitals, schools and the county jail, that they are seeing more pregnant, drug-addicted women.

For example, the Santa Fe County jail encountered 15 pregnant drug-addicted mothers in July 2012, according to data provided by O'Connor. In the previous year, the largest number of drug-addicted pregnant women the jail incarcerated in any one month was six, in December 2011.

County Public Safety Director Pablo Sedillo said all 18- to 25 year-old female inmates who admit to using opiates are tested for pregnancy.

If an inmate is pregnant and addicted to opiates, Sedillo said, she is transported to University Hospital in Albuquerque, where she is stabilized and, in most cases, started on a chemical replacement therapy before returning to Santa Fe County to serve the remainder of a sentence or await trial.

Lisa Leiding, nurse administrator at the jail, said pregnant women with opiate addictions are usually prescribed a less harmful drug to replace the opiate while they are pregnant -- usually methadone or buprenorphine (Subutex) -- because allowing unborn babies to experience withdrawal can result in their death.

When the babies are born addicted, they are typically detoxed in a hospital setting -- meaning they are given smaller and smaller doses of a substance until they are weaned off it completely while being carefully monitored and being made as comfortable as possible by medical professionals.

Babies born addicted to replacement drugs generally suffer shorter and milder withdrawal periods -- a week or two as compared to a month or more -- than those who are born addicted to heroin or prescription drugs, Leiding said.

When the inmates are released from jail, Leiding said, they are given referrals to providers who can help them continue their treatment. However, there are few providers who can prescripe Subutex. To offer the treatment, providers must get special training and obtain additional certification from the federal Drug Enforcement Administration.

La Familia Medical Director Dr. Wendy Johnson said it's hard to get health professionals to become qualified to offer Subutex because it's "difficult and time-consuming work" that is often not well-compensated.

The shortage of qualified providers makes it difficult for drug-addicted mothers-to-be to get help, Johnson said, and it's expensive for taxpayers.

The public often foots the bill for the weeks or months a baby stays in the hospital while being medically withdrawn from the addictive substance, she said.

Sedillo said the county spent about $53,00o in fiscal year 2012 on medical, transportation and security costs for sending pregnant women to Albuquerque to be stabilized, partially because the women who are treated at the hospital must be guarded during their stay. Three days of security detail for a pregnant woman being treated at University Hospital costs about $2,500, Sedillo said.

Given these challenges, O'Connor said, she felt it was important for Santa Fe County to start to address the issue.

Last month, the county awarded a $25,000 contract to La Familia to start developing a foundation for pregnant Santa Fe women to have greater access to drug addiction treatment.

Johnson said some of the money will be spent training and licensing eight to 10 of La Familia's physicians to prescribe buprenorphine. La Familia also will provide training opportunities free of charge to other interested physicians and hire a case manager who has experience with addiction and maternal health issues to help pregnant addicts access support services such as mental health care.

Finally, Johnson said, La Familia wants to meet with jail officials to discuss how to address the issue there.

"It's a very small amount of money," Johnson said Monday. "We are focused on using it to build our capacity. We're committed to providing some sort of service there, but it's premature to say what the program is going to look like."

Johnson and O'Connor both said they expect Santa Fe County to provide more funding to bolster drug addiction treatment for pregnant mothers.

Johnson noted that even though the grant was awarded last month, the training won't take place until August, and the providers won't have credentials to start providing the treatment for another few months after that, meaning it could take four to six months for pregnant addicts to see more access to treatment.

"We want it to be holistic for the pregnant women and make sure we have a program that can support them through pregnancy and after," Johnson said. "We have to figure out how to do that, and we want to do it right."

Contact Phaedra Haywood at 986-3068 or phaywood@sfnewmexican.com.

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(c)2013 The Santa Fe New Mexican (Santa Fe, N.M.)

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Source: Copyright Santa Fe New Mexican, The (NM) 2013


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