Posted: 10/19/2016
Opioid use at crisis levels nationally
Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn exposed to addictive opiate drugs while in the mother’s womb. It can cause premature birth, poor intrauterine growth, seizures and birth defects. With the explosion of opioid drug use across the U.S., it’s becoming an all-too-common occurrence. The Centers for Disease Control and Prevention says opioids (including prescription opioid pain relievers and heroin) killed more than 28,000 in 2014.
Parkland Health & Hospital System launched a program in 2015 to help ensure the birth of healthy babies to mothers who use drugs during pregnancy. Called the Neonatal Abstinence Program, it is funded by the Network Access Improvement Program (NAIP).
The 83rd Texas Legislature approved the creation of NAIP to increase the availability, quality and effectiveness of primary care for Medicaid clients by providing incentive payments administered by managed care organizations to participating health institutions and public hospitals.
The baby son of Dallas mother “Jennifer” (name changed to protect her identity), born at Parkland in August 2016, owes his good health to the program.
At a young age, Jennifer was prescribed hydrocodone for back pain. By age 15 she was addicted to opioids, had her first child and was struggling to finish high school. At 19, she was a single mom with three daughters, working and attending college classes. She stayed “clean” for a while, but within months started using cocaine and meth. The cycle continued. Eventually Jennifer signed over custody of her children to her father.
“I knew I wasn’t stable and it was the right thing to do for my girls’ well-being. I was self-destructive and couldn’t take care of them,” she said. “I wanted what was best for them.”
When she was 25, Jennifer entered a drug treatment program. “I also suffer from depression. I’m bipolar and I was self-medicating. I finally got the help I needed in the rehab program.”
This time, she said, the treatment worked. “It changed my life. I realized there’s a solution to my addiction. I am responsible for my life.”
Jennifer met her fiancé “John” in the rehab program and eventually became pregnant. “I was clean for about eight months before I got pregnant,” she said.
Excited but fearful, she was determined to remain drug-free. She received regular prenatal care. But when she was 26 weeks pregnant, they both relapsed.
“It was a terrible mistake and I was panicked. We were so afraid for our baby,” she said. “I didn’t want to detox on my own because I feared for my baby’s life. I was mentally exhausted and afraid to ask for help because I thought they would take my baby away.”
But concern for their baby’s health overruled their fears. John took her to the Emergency Room at Parkland Memorial Hospital. “I told them I had relapsed on heroin,” she said. To her amazement, the Parkland staff replied, “We can help you. We have a program for that.”
“The doctor told me about the Neonatal Abstinence Program,” Jennifer recalled. “They said they would decide whether to use methadone to taper me or maintain me through the rest of the pregnancy. I felt hopeless when we came in, ashamed and frightened. This program probably saved all of our lives – mine, John’s and our baby’s.”
Brian M. Casey, MD, Chief of Obstetrics at Parkland and Professor of Obstetrics and Gynecology and Chief of the Division of Maternal-Fetal Medicine and Obstetrics at UT Southwestern Medical Center, was Jennifer’s doctor.
“Jennifer was immediately admitted to Parkland from the ED and spent the next three weeks as an inpatient in the antepartum unit. She was tapered off drugs and received daily counseling with a psychologist. When discharged 21 days later, she was provided the community resources she needed to make a safe transition, including referral to a rehab program and a housing plan. Jennifer is exactly the type of patient that the Neonatal Abstinence Program is designed to help,” Dr. Casey said.
“Dr. Casey and the Parkland team didn’t rush me. They made sure I was ready and would be safe and healthy,” Jennifer said.
At 39 weeks and 5 days, Jennifer was induced at Parkland. She gave birth to a healthy 7 lb., 6 oz. boy, with John at her side. Together, they marveled at their precious baby and tears came to their eyes as they tried to describe their gratitude for the assistance Parkland has given them.
“This program was an incredible blessing for us,” John said. “I don’t know what would have happened to us and our baby without it.”
“It took initiative for us to get help,” Jennifer said, “and we were blessed that Parkland has this program that made all the difference. I know now that relapsing into old behaviors doesn’t work. It’s not a solution.”
Jennifer will soon return to work in the real estate business. She hopes to play a bigger role in her daughters’ lives and to become the parent she wants to be.
“I want to continue changing my life for the better. I want to be a strong, healthy, loving and reliable mother for my daughters and my son. I want other people to know, ‘you don’t have to be that person.’ I hope I can help someone else someday. I am so thankful that Parkland was here for us and I thank God they were able to help.”
For more information about Parkland, please visit www.parklandhospital.com.