JOHNSON CITY (July 30, 2019) – ETSU Health OB/GYN in Johnson City is working to prevent the number of babies who are born addicted to drugs through expansion of its Neonatal Abstinence Prevention work.
“This program is available to pregnant women who are struggling with opioid addiction and want a step-down plan to slowly reduce their dependency on drugs,” said Dr. Marty Olsen, ETSU Health physician and professor at Quillen College of Medicine. “Our goal is to prevent neonatal abstinence syndrome (NAS) and to ultimately deliver healthy babies.”
Neonatal abstinence syndrome (NAS) occurs when infants go through withdrawal from an addictive drug they were exposed to in the womb. NAS can lead to short- or long-term health challenges such as low birth weight, seizures, vomiting and tremors. Babies with NAS are transferred to costly newborn intensive care units. In the worst cases, it can also lead to infant mortality.
Over the past decade, Tennessee has seen a 10-fold increase in the number of babies born with NAS, according to the Tennessee Department of Health.
In Johnson City, Olsen estimates that 9%, or one in every 11 pregnant patients, are on buprenorphine, which is the generic ingredient found in Subutex and Suboxone, medications used to treat dependence and addiction to opioids. Buprenorphine helps patients fight the symptoms of drug withdrawal in medication assisted therapy programs, but it is also the number one cause of NAS in Tennessee.
In 2016, ETSU Health began piloting a program to help pregnant women safely lower their dosage of the medication Subutex, which was developed for the treatment of opiate addiction. The goal of the program is to work with pregnant mothers to help them taper their doses down to two milligrams or even lower for many patients. Since May 2016, more than 150 patients have participated in the program. All participants have been able to decrease their dose of buprenorphine, and approximately 25 patients have been able to completely come off buprenorphine during pregnancy. The program partners with Frontier Health to provide mental health counseling to patients, as well.
Olsen added that two milligrams is about one-eighth of the average dose most commonly prescribed to patients in the region. Research is in progress to compare the effects of this lower dose with standard higher doses. Preliminary data indicates that patients who come off buprenorphine completely have a very high chance of delivering healthy babies without NAS. Coming off buprenorphine completely does put a patient at risk of relapse, so the patient must be aware that overdose can occur when patients relapse, Olsen said.
“As obstetricians, we take care of pregnant patients with diabetes; we take care of pregnant patients with hypertension,” Olsen said. “And since we have more patients presenting with opioid addiction than either of these diagnoses, as obstetricians we need to treat this diagnosis as well. I’m proud of the leadership ETSU Department of OB/GYN has shown in this area.”
The ETSU Health program has recently expanded in 2019 to accept new patients with the addition of another physician, Dr. Jessica Murphy.
Murphy joined ETSU Health and Quillen in late 2018 after previously working in Culpeper County, Virginia, which has one of the highest rates of opioid-related deaths in Virginia. She shares Olsen’s passion for helping patients who are dealing with addiction.
“It is important for providers to treat the whole patient,” Murphy said. “Addiction is a medical diagnosis, and when pregnant women come to us, we don’t want to say to them, ‘We’ll treat your pregnancy and someone else has to deal with your addiction.’ What we are providing is an important part of health care, and we’re seeing a difference that it makes in patients’ lives.
“So many pregnant women who have substance use disorder feel like their lives are chaotic and there is a feeling of lack of control,” Murphy added. “This program is a way to reintroduce a measure of control in their lives – and ultimately the hope is that they will deliver healthy babies.”
To learn more about ETSU Health OB/GYN’s buprenorphine program, call 423-439-7272.