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Drug-addicted babies staggering issue

Summit
Apr. 12, 2013 @ 08:40 AM

HUNTINGTON -- Seventy-five of every thousand babies born at Cabell Huntington Hospital have been exposed to drugs or alcohol, a staggering figure that trumps the national average of five per 1,000, according to maternal-fetal medicine experts.

That statistic and many others -- as well as examples of programs working to change the culture of drug addiction and dependency in West Virginia -- were the subjects of the Seventh Annual Drug Prevention Summit Thursday at the Big Sandy Superstore Conference Center.

This year's summit, the work of the Cabell County Substance Abuse Prevention Partnership, focused on drug-exposed pregnancies and fetal alcohol exposure.

"'Just say no' doesn't work after the addiction is already established any more than I can say 'no' to food," said Dr. David Chaffin, Thursday's keynote speaker and director of maternal fetal medicine at Marshall's School of Medicine. "This is a monstrous tidal wave we're dealing with. What else would you call it? I want to show you what's happening and, if nothing else, set a fire in you about the rising incidence of neonatal abstinence syndrome."

Neonatal abstinence syndrome, a group of problems that occur in a newborn exposed to drugs or alcohol in the mother's womb, was a focal point of Thursday's summit. The instances of NAS, Chaffin said, have increased tenfold in the United States since 2009. As the leader of the Maternal Addiction and Recovery Center at the Marshall University Medical Center, it's a population Chaffin sees on a daily basis. The MARC program offers drug-addicted pregnant women the opportunity to receive combined prenatal care and addiction treatment using Subutex, a medication that works to reduce the symptoms of opiate dependence.

"What we've seen, in the 52 women who have delivered, is pre-term labor is gone. They are delivering appropriately grown babies and 25 percent of the babies did not require treatment," Chaffin said. "The more disturbing news is that the median hospital stay for those who do require treatment is 22 days."

That environment is where Dr. Sean Loudin, a board-certified pediatrician and member of the division of neonatal-perinatal medicine at Marshall University, sees both the babies and the mothers. Loudin also was a speaker at Thursday's summit.

"I try to utilize that time in the hospital to help them anticipate complications and things they'll experience when they go home," Loudin said. "These babies are abnormal. They're going to have good days and bad days."

Loudin said he also works to educate mothers about the dangers of drug abuse during pregnancy.

"Telling them to just stop taking drugs isn't going to work, but hopefully I can make the connection with them that taking drugs and being pregnant is going to lead to this outcome. My hope is that it will reduce some of the instances, but is it going to go away? No."

Loudin also presented on the topic of fetal alcohol syndrome and fetal alcohol spectrum disorder, calling alcohol exposure to a fetus one of continuous exposure.

"It's a recycling mechanism. The baby is continuously exposed to alcohol from just one encounter. They metabolize it, but it goes into the amniotic fluid, the baby swallows it, urinates and then swallows it again," Loudin said. "It's a continual recycling of alcohol.

"Babies do have a withdrawal from alcohol, so if we're treating them for drugs, we have to keep alcohol in the back of our minds because we know the prevalence of it."

The summit concluded with a presentation by Dr. Lenard Kaye, director of the University of Maine Center on Aging. Kaye brought to the forum an idea implemented in Maine for a prescription drug mail-back program.

"I think, ultimately, if we're going to make a difference, we need to deal with matters of prevention and breaking the chains between folks and their access to drugs," Kaye said. "Education combined with programs to reduce access is crucial."

In Maine, with features similar to many in West Virginia -- an older, sparsely-populated, rural state -- Kaye said the Safe Medicine Disposal for ME Program has allowed all segments of the community to become involved in getting unused, expired and unwanted prescriptions off the street. The program utilizes a variety of community partnerships, including pharmacy students, law enforcement and drug stores to circulate envelopes in which residents can mail their medications for safe disposal.

"We found that 15 percent of the medications mailed back were controlled drugs," Kaye said. "We were able to get hundreds of thousands of dollars in controlled substances out of medicine cabinets and off the streets.

"A community committed to making this happen can make it happen," Kaye said.

All three presenters took Thursday's summit as an opportunity to stress help needed at the state level for programs and initiatives.

"Widespread prescription drug takeback legislation would be helpful," Kaye said. "I know you have representatives at the state level who are committed to this issue."

Chaffin said the issue is a "pay now or pay later" concern for lawmakers.

"To the politicians, I would say, 'pay now or pay later,'" he offered. "You have this huge flood affecting pregnancies, affecting kids, kids coming into the school system, associated illnesses later on in life. This issue is here and it's not going to go away."

Follow H-D reporter Beth Hendricks on Facebook or Twitter @BethHendricksHD.

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