When an expectant mother arrives at MedStar St. Mary’s Hospital, she will undergo a variety of tests prior to delivering, including a screening for drugs and alcohol. If a mother’s results are positive, her newborn child will also be tested.
“We are seeing episodes of babies testing positive for opioids much more frequently than several years ago,” said Jeanne Hill, MSN, RNC, director of MedStar St. Mary’s Hospital’s Women’s Health & Family Birthing Center. Babies born to drug-addicted mothers are the youngest victims of what continues to be a nationwide crisis and they are not difficult to identify, said Jeanne. “They have a high-pitched cry, they can’t calm themselves down, they have tremors, they often have diarrhea and tensed muscles,” she said. “It is just heartbreaking.”
MedStar St. Mary’s Hospital is among 30 birthing centers in Maryland joining forces with the Maryland Patient Safety Care Center to standardize care for babies suffering neonatal abstinence syndrome. As part of the hospital’s efforts, mothers are presented with information about how and where to get help with substance abuse. Although Jeanne feels their work is making a difference, there is still plenty to be done.
Fighting the Addiction
“We need every single person in the community to recognize addiction is an illness, it is a brain disease and it requires an evidenced-based approach to treatment,” said Meenakshi G. Brewster, MD, MPH, St. Mary’s County Health Officer. The Health Department, MedStar St. Mary’s Hospital and Sheriff’s Department are among the many community organizations coming together to offer a comprehensive response to this epidemic. “It is a challenge like we have never seen before in the treatment community,” said Kathleen O’Brien, PhD, chief executive officer of Walden, which provides crisis, behavioral health, trauma, and recovery services to Southern Maryland. “Certainly, here, historically most of our treatment was related to alcohol and a mixture of some other drugs, but prior to about six years ago, we weren’t seeing opioids or heroin as a presenting problem. Now, that is about 70 percent of the primary substance abuse cases coming through our doors.”
Harry Gill, MD, PhD, medical director of Behavioral Health for MedStar St. Mary’s Hospital and president of Axis Healthcare Group, says he believes the opioid epidemic has gotten worse due to the prevalence of more lethal synthetic opioids. “Most patients have co-occurring disorders − they have a psychiatric disorder and addiction,” said Dr. Gill. “Going through substance abuse treatment provides temporary relief, but if the psychiatric condition is not treated, relapse is highly likely.”
Dr. Gill said many people who turn to opioids also have anxiety, depression, and post-traumatic stress disorders, all of which are treatable. In his work with the hospital, Dr. Gill is called in for psychiatric consultations with patients suspected of intentionally overdosing on opioids. These patients are typically discharged to outpatient substance abuse programs such as those provided by Walden, but often need treatment for co-occurring disorders. Support from their family and their community also plays a large role in the recovery process. “Family support is critical because it is such an isolating illness, such an isolating disorder that re-engaging with the world and, in particular, the people who love you unconditionally is a critical component of recovery,” said Dr. Gill.
Changing the Conversation
Winning the battle against opioid addiction means making sure those fighting their addictions know that assistance is available and they can receive help to access it. In addition, the community as a whole needs to accept that addiction is a disease, not a choice or a moral weakness, said Dr. O’Brien, and that treatment works and recovery is possible. “This disease doesn’t affect others, it affects all of us, and we all could possibly be afflicted by this disease,” said Dr. O’Brien. “In all my years in doing this, people think it’s the other who gets impacted, but we are all vulnerable.”