Pubdate: Thu, 21 Aug 2014
Source: Pittsburgh Post-Gazette (PA)
Copyright: 2014 PG Publishing Co., Inc.
Author: Mackenzie Carpenter


At a time when heroin use and prescription drug abuse have reached
epidemic levels, local health care providers are stepping up to the
plate to help one targeted group: pregnant women.

On Wednesday, Magee-Womens Hospital of UPMC, along with several local
insurers, announced the launch of what it called the "first-of its
kind" outpatient recovery center in the country for pregnant women
addicted to opiates - heroin and Vicodin, Oxycontin, hydrocodone and
other highly addictive painkillers. And West Penn medical officials
said a similar program is in the works.

This program breaks new ground in two important ways, said Dennis
English, a physician and vice president of Medical Affairs at Magee.
First, it uses buprenorphine, a relatively new drug used to treat
opioid addiction that has fewer side effects than methadone and is
easier on babies, who must be weaned from the drug after birth.

Second, it can be prescribed in weekly outpatient visits, instead of
requiring daily visits to the methadone clinic, thus reducing health
care costs, not to mention easing the burden on poor women without
ready access to transportation.

In the past, Dr. English said, pregnant women taking heroin had to be
hospitalized for three days to begin treatment with methadone, and
once the baby was born the infant had to be weaned off the methadone
in a traumatic process taking between 12 and 20 days.

Under buprenorphine, the weaning process is much shorter, perhaps five
to six days. Mothers, under the new Magee program, will be able to
meet with midwives and social workers for routine prenatal care and
behavioral counseling during and after their pregnancy.

The center will provide "consistent, collaborative care throughout the
patient's pregnancy," said Dr. English, noting that the program was
initiated by the state Department of Public Welfare and involves four
local Medicaid insurers: UPMC for You; Community Care Behavioral
Health Organization; Gateway Health and United Healthcare for Families
and Communities.

Actually, the state approached all the health care providers and
insurers in Pittsburgh two years ago proposing a citywide initiative,
and West Penn Hospital joined Magee in writing a grant to the federal
government - which fell through, "so we decided to pursue a program on
our own because we had the only active methadone program of any
hospital in the area," Dr. English added.

West Penn is moving ahead with its own methadone program, not just to
treat heroin but because of a skyrocketing use of pain pills, said
Mark Caine, director of labor and delivery at West Penn. "That has
become a big problem," he said, although just how big isn't clear. The
last survey of inpatients addicted to heroin - which didn't
necessarily break out pregnant women - was done by Allegheny County in
2011, he said.

Several of the insurers affiliated with West Penn pay for
buprenorphine treatment, which is administered by private physicians,
but talks are ongoing about consolidating the program in one place, he

Treating pregnant patients with buprenorphine is a relatively new
practice, but emerging research has found that treating mothers with
the drug means that babies recover more quickly after birth. "We hope
this approach will make it easier for our pregnant patients to recover
from their dependencies and start their parenting journey confidently
and in good health," said Michael Madden, chief medical officer of
Gateway Health, in a statement issued by Magee.

Word is out on the street, and "we've notified emergency rooms and OB
providers about the availability of the program," said Dr. English,
"to talk about the criteria, which is for those on opiates only and
patients willing to come to Magee and go through drug addiction
counseling and behavioral health."  
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