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FARMINGTON Program helps pregnant women with drug addiction

FARMINGTON Program helps pregnant women with drug addiction.

IF ONLY THEY COULD WRITE THESE WONDERFUL ARTICLES ABOUT SUBOXONE, WITHOUT FEELING THE NEED TO BELITTLE METHADONE!


BY BETTY JESPERSEN
Staff Writer
Kennebec Journal & Morning Sentinel 01/17/2010


Staff photo by David Leaming
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Staff photo by David Leaming
CARE FOR TWO: Nurse-midwife Daisy Goodman sits in an examination room at Franklin Women’s Care, a program of the Franklin Community Health Network in Farmington. Goodman earned a doctorate of nursing practice degree with a thesis on treatment of pregnant women in rural areas who have chemical addiction issues.


FARMINGTON — Nurse-midwife Daisy Goodman remembers caring for a pregnant woman looking for help in kicking an addiction to prescription painkillers.She was among a rising number of women, including pregnant ones, who were seeking treatment for drug addiction, according to a study of a 10-year period by the state.

“She wanted to stop because she knew it was bad for the baby,” said Goodman, who now works at Franklin Women’s Care, a program of the Franklin Community Health Network in Farmington.

“She described herself as a good mother but had a pill habit she couldn’t stop,” she said.

The woman, who had children at home, wanted to try methadone, a narcotic used in the treatment of addiction. It meant she had to travel hours every day to get her dose at the nearest clinic. She knew that otherwise, she would go through painful withdrawal at home, Goodman said.

“I had deep respect for her commitment,” she said. “She did very well during her pregnancy, went to the clinic consistently, delivered a healthy baby at term and breastfed successfully. But her baby did experience withdrawal.”

Out of that experience and others, Goodman developed a plan to help pregnant women in rural areas who are addicted to drugs.

The plan was the doctoral project for her Doctor of Nursing Practice Degree she received from Massachusetts General Hospital’s Institute for Health Professions last month.

The guidelines encourage doctors in rural communities to build collaborations with addiction specialists and physicians who can prescribe buprenorphine — a drug with fewer side effects than methadone.

Preliminary study findings indicate that buprenorphine is at least as safe as methadone treatment during pregnancy, according to National Institute of Drug Abuse, which is evaluating the drug as a treatment for pregnant women dependent on narcotic pain relievers.

Goodman said when prescribed by a physician in a medical office, addiction treatment with buprenorphine can become part of the patient’s general medical care. Then, if specialized care, such as substance abuse or psychological counseling, is needed, those referrals can be made directly, and privately, by the physician.

The study reports that the use of methadone during pregnancy is controversial and that it does not protect newborns from going through withdrawal, a condition that requires medical intervention and extended hospitalization.

In Maine, there has been a significant increase in the number of women entering treatment for drug addiction, according to a study by the Maine Office of Substance Abuse.

Between 1997 and 2007, the number of Maine women in treatment for drug abuse increased by 72 percent, from 3,828 to 6,589. The statistics ranged from a decrease of 18 percent in Lincoln County to an increase of 287 percent in Franklin County.

Hancock, Washington and Oxford counties had increases of more than 200 percent. Kennebec County increased by 63 percent and Somerset by 85 percent.

The report also found the number of pregnant women seeking addiction treatment increased by 79 percent.

Goodman said the high numbers are just the tip of the iceberg.

“The larger, submerged part of the iceberg is all the women who have opiate dependency but are not yet in treatment. Also, physicians who prescribe buprenorphine are not required to report those cases to the Office of Substance Abuse,” she said.

“I would like to see obstetrical providers become more involved in recognizing and treating opiate addiction,” she said.

Research shows the health of mothers and infants improves when addiction treatment programs and prenatal programs are brought together, Goodman said.

“The goal is to deliver care within the community as much as possible, not just during the pregnancy but post-partum and through the stress of motherhood when there is an increased chance of a relapse,” she said.

Kelley Bouchard, a certified registered nurse and perinatal outreach educator at Maine Medical Center in Portland, has developed a program on the care of babies whose mothers are in treatment for addiction.

“We are seeing more and more pregnant women with addictions around the state. The real challenge for health care providers is to get comprehensive care for these women,” Bouchard said.

“Buprenorphine is a way for a woman to get treatment closer to her community but the issue is that the support system is not in place,” she said.

“Daisy’s guidelines for treatment are the first that I am aware of in the country and they offer a consistent approach to the care of these women,” she said.

The public is quick to stigmatize women who become pregnant while addicted, both Goodman and Bouchard say.

“Some of their stories are horrific,” Bouchard said. “They are dealing with trauma from domestic violence and 90 percent of that is sexual abuse.”

“The public doesn’t think about that,” she said.

Nurse practitioner Noreen Comeau and Dr. Steve Bien, who work at Wilson Stream Family Practice in Farmington, offer addiction treatment and see pregnant women in collaboration with Franklin Health Women’s Care. Bien is one of three physicians in Franklin County who can prescribe buprenorphine.

Comeau said as part of the treatment, patients attend counseling and support groups to deal with the issues that led them to addiction in the first place.

“I would like to see more primary care offices offering their own patients addiction treatment. It is a medical problem just as high cholesterol or diabetes or heart disease is,” she said.

“Stop ostracizing people because they have an addiction problem. It is a disease, so let’s help these people fix their problem instead of blaming them,” she said.

Betty Jespersen — 778-6991

bjespersen@centralmaine.com

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  1. February 28, 2010 at 7:24 am

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