November 16, 2013

Maine's high opiate addiction rate endangers newborns

Some in the state's medical community worry about the impact of the state's recent two-year cap on methadone and buprenorphine for Medicaid patients.

By Alanna Durkin
The Associated Press

AUGUSTA — The rising number of drug-dependent babies born in Maine is a cause of concern in the medical and law enforcement communities.

Gov. Paul LePage shed light on the issue in his weekly radio address earlier this week, when he said the number of Maine babies who are affected by or dependent on drugs is expected to climb to more than 800 by the end of the year. That would be the largest number recorded in the state and about five times what it was nearly 10 years ago.

The problem is a symptom of Maine’s high opiate-addiction rate: Babies are being born already dependent on drugs, often because their mothers used them during pregnancy.

“I am deeply concerned about the suffering and long-term consequences these newborns are subjected to,” LePage said.

Dr. Mark Publicker, who specializes in addiction medicine at the Mercy Hospital Recovery Center in Westbrook, said he treats significantly more women for opiate addiction than men – particularly women who have been physically or sexually abused.

“The bottom line is we have an epidemic,” he said of Maine’s skyrocketing addiction problem for opiates like heroin and prescription medication. “As the epidemic increases, it’s logical that you’re going to have more pregnant women who are opiate-addicted.”

More than 160 Maine newborns were affected by drugs in 2005, when the state began collecting the data, according to the Maine Department of Health and Human Services. That grew to 779 cases last year, and Le Page said about 770 have been born in Maine so far this year.

“It’s a result that is obviously very troubling, when you have innocent children that are being born that have this impact on their life,” said Roy McKinney, director of Maine’s Drug Enforcement Agency.

Dr. Mark Brown of Eastern Maine Medical Center in Bangor said potentially drug-dependent babies must be observed for five days to see if they experience withdrawal symptoms. Babies who need treatment could be hospitalized for up to a month.

“There’s a significant health-care burden here,” he said. “That’s in addition to concerns about outcomes, concerns about all of the downstream effects.”

Some doctors say the state must distinguish between babies born to mothers on illicit opioids, such as heroin, and those on drugs like methadone and buprenorphine, which are used to treat addicts.

While those drugs can also cause babies to experience withdrawal, they are essential in preventing pregnant women from going through withdrawal, which can cause pre-term labor and have serious effects on the baby’s health, Publicker said.

The state recently put a two-year cap on methadone and buprenorphine treatment for Medicaid patients, unless they get prior approval for an extension. The move has been criticized by some in the medical community, who say arbitrarily limiting access to treatment can cause addicts to relapse and makes it more difficult for pregnant women who are addicts to get the care they need.

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