Substance abuse during pregnancy continues to rise

By Heather Meade hmeade@civitasmedia.com

May 15, 2014

DARKE COUNTY - The prevalence of substance abuse during pregnancy is shocking, said Dr. Peter Lachiewicz, Western Ohio OB/GYN. Between 30 and 40 percent of pregnant Western Ohio OB/GYN patients are suspected of using drugs, tobacco and/or alcohol.

Tennessee is awaiting their governor’s signature on a bill (HB 1295) which recently passed through both sides of Tennessee’s Congress that will criminalize pregnant women for “assaultive offenses” if a child is born “addicted to or harmed by” the mother’s illegal drug use.

“A year ago, the Tennessee Senate, House and governor defeated the bill. So, it’s surprising that now this legislation was passed, despite 100 percent non-approval by physicians and the medical community,” Dr. Lachiewicz reflected. “I talked to a colleague of mine in Tennessee, these women will not seek prenatal care, and then just show up at the end. Or they’re going to tell a lot of lies. Or, like we see here [in Darke County], most drug testing we do through a urine - just like employers do random toxicology screens - just like here, they ‘can’t’ give a urine specimen.”

Dr. Lachiewicz estimated that 30-40 percent of the 250-350 births his practice performs each year are to patients who used some sort of drug during their pregnancy; and some women, he said, don’t even attempt to quit. Those who do wish to quit, do not have access to local resources, because there aren’t any, Lachiewicz noted.

“If you look at what’s out there – you don’t want to say everybody’s doing it, but if you have 30-40 percent of our pregnant moms using, that’s kind of concerning,” Dr. Lachiewicz commented. “The community leaders in Greenville and Darke County talk about ‘What are we going to do? How do we help these women? etc.’ The resources are just not there. So these women, even if they want to stop – and we just had one who made the decision to go to Columbus on her own – these women really tend to fall through the cracks. And others have no desire to stop.”

A program at The Ohio State University, the Substance Abuse, Treatment, Education and Prevention Clinic, focuses on providing these resources, Lachiewicz said, but it’s a big commitment to drive to Columbus once a week, and many women will not have the means or the desire to commit to getting treatment.

“As obstetricians, it makes our job much more difficult,” Dr. Lachiewicz stated of drug use during pregnancy. “The patients are more difficult, others don’t seek care, or they receive sporadic care. We worry about pre-term births, and naturally, addiction of the fetus.”

Dr. Lachiewicz said he is surprised to see that a community like Greenville has such a drug problem, but it’s something that’s going on everywhere, he noted.

“Am I surprised that a small community like Greenville has drug problems? I am very surprised,” Lachiewicz stated. “However, it shows that a community like this is not immune to what we would normally think of as big city problems. This only goes on in Dayton, Columbus, Cleveland – bull, this goes on here.”

Obstetricians are testing using urine toxicology analysis, Lachiewicz said, but what they can do with that information is limited in Ohio.

“We can’t have them arrested,” Lachiewicz said. “If it’s necessary, we can get Children Protective Services involved, but most likely we’re going to call in a social worker and try to get that mom the help she needs, get her to the resources she needs in order to do what’s healthiest for her and her unborn child.”

For those who use drugs during pregnancy, the risk of premature birth and birth defects are greater, Dr. Lachiewicz explained. Babies born prematurely are at risk for a host of other health problems and developmental delays, and babies who are born addicted to narcotics will experience withdrawal, which in severe cases can lead to death, Lachiewicz stated.

Lachiewicz suggested that intervention start within the family, but he was quick to note that the family structure in these situations is often one of the roots of the problem, making it difficult even for family to step in. The best thing pregnant women can do if they find themselves in a situation of addiction is to seek help; The Substance Abuse, Treatment, Education and Prevention Clinic in Columbus might be a helpful place to start, Lachiewicz said. To reach them, call 614-293-2222 to make an appointment or a referral. Visit medicalcenter.osu.edu/obgyn/care-and-research/services/maternal-fetal-medicine/programs-clinics/pages/substance-abuse-and-prevention-clinic.aspx to learn more.