Thursday, June 20, 2013
By John Richardson firstname.lastname@example.org
BANGOR — Mariah arrived last summer, on schedule and weighing in at 7 pounds, 2 ounces.
This baby girl was treated for opiate withdrawal at Eastern Maine Medical Center in Bangor last summer. Her mother was taking buprenorphine, also known as Suboxone, through an addiction treatment program during her pregnancy.
Gregory Rec/Staff Photographer
To her much-relieved mother, she looked and behaved like a normal newborn: very cute and very sleepy.
By Mariah’s third day, however, it was clear she had not escaped her mother’s addiction to pills.
Whenever the baby was awake, she cried. What little she ate, she spit up. And her entire body was stiff, as if all of her muscles were cramping.
Her mother knew what Mariah was feeling. She had experienced the pain of opiate withdrawal once herself.
“I feel bad that she’s in this situation,” said her mother, a thin, soft-spoken 20-year-old from the Rockland area.
Mariah’s mother, like others who were interviewed for this story, agreed to talk about her addiction and her daughter’s withdrawal, but did not want her name published.
As addiction to prescription painkillers spreads in Maine, it touches even some of the most innocent and fragile.
More than 570 babies were born last year to mothers who used prescription painkillers or other drugs while pregnant, according to hospital reports to the state. The number more than tripled in six years, and it doesn’t include the mothers who didn’t tell their doctors about their drug habits.
Most of the drug-exposed newborns experience opiate withdrawal and require weeks of hospital treatment, often with small daily doses of morphine or methadone, a drug to treat adult opiate addicts. It costs about $25,000, on average, to treat each baby in withdrawal.
The most fortunate babies have mothers who got into addiction programs during pregnancy and took controlled doses of a treatment drug. The long-term effects on the children are still unknown, but most of the babies go home after two to four weeks of detox with no immediate complications.
On the other hand, an unknown number of pregnant addicts do not get treatment. They take street drugs throughout their pregnancies, or they try to quit cold turkey in the belief it will help their babies. In both cases, doctors say, the women are much more likely to miscarry or give birth prematurely to babies with higher rates of birth defects.
“When someone is using street narcotics, it’s a seesaw of high, low, high, low. For a baby, that’s very dangerous,” said Dr. Brenda Medlin, a pediatrician who cares for drug-affected babies at Maine Medical Center in Portland.
Quitting suddenly during pregnancy threatens the unborn baby because the mother’s body rebels, causing the uterus to twitch and contract, said Dr. Mark Brown, a neonatologist at Eastern Maine Medical Center in Bangor. “We don’t want (expecting) mothers in withdrawal.”
CRYING OUT FOR ANOTHER DOSE
Treatment during pregnancy with controlled doses of methadone or Suboxone dramatically improves a baby’s chances of avoiding complications, doctors say. It doesn’t mean a baby will be spared all the effects of its exposure to the drugs.
The newborns are watched closely. About 55 percent of the opiate-exposed babies begin showing symptoms a day or two after birth, as their bodies cry out for another dose.
“It’s very difficult to see a baby go through withdrawal,” Brown said. “They’re not cuddly; they’re not lovable. They can’t engage their surroundings. They can’t even eat.”
Doctors and nurses assess the severity of each baby’s symptoms, including fever, diarrhea and vomiting. A baby in withdrawal will often have all of its muscles contracted.
“They are very stiff. If you try to lift them up, instead of their head hanging back a little, they are like a board,” Medlin said.
Once doctors are certain that a baby is experiencing withdrawal, not gas or some other discomfort, they begin medications. They use medicine droppers to put small doses in the babies’ mouths and typically taper the doses off over about two weeks.
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