West Virginia Perinatal Partnership

Committee on Drug Use During Pregnancy

Chair:
Stefan Maxwell, MD, CAMC Women and Children's Hospital, Charleston

Members:
--Mary Aldredge-Crouch, MSW, LICSW, Bureau for Behavior Health and Health Facilities, Charleston
--Charlita Atha, RN, IBCLC, Right from the Start Program, Bridgeport
--Luis Bracero, MD, CAMC Women and Children’s Hospital, Charleston
--Christopher Byers, MA NCC CCFC, Wheeling Treatment Center, Wheeling
--David Chaffin, MD, Marshall University, Joan C. Edwards School of Medicine, Huntington
--Elizabeth Cohen, MSW, WVU Ob-Gyn, Morgantown
--Teresa Frazer, MD, FAAP, Bluefield Regional Medical Center, Bluefield
--Susan Hammond, M.A.LPC, NCC, LSW, Parkersburg Treatment Center, Parkersburg
--Michelle Kosa, MSW, Family Care, Scott Depot
--Shelda Martin, MD, PEIA, Charleston
--Jim Matney, MS, Bureau for Behavior Health and Health Facilities, Charleston
--Dee Meadows, RN, Right from the Start Program, Baboursville
--Stephanie Nicodemus, CNM, MSN, Shenandoah Women’s Health, Martinsburg
--Fran O’Brien, RN, Greenbrier Valley Medical Center, Lewisburg
--Trish Sheridan, RN, CAMC-Women and Children’s Hospital, Charleston
--Denise Smith, Director, Division of Women’s and Perinatal Services, Office of Maternal, Child, and Family Health, Charleston
--Gerry Thompson, RNC, Cabell Huntington Hospital, Huntington
--Amy Tolliver, MS, WV State Medical Association, Charleston
--Nancy Tolliver, RN, MSIR, Director, WV Perinatal Partnership, Charleston
--Anne Williams, RN, BS, MS-HCA, Director, Office of Maternal, Child and Family Health, Charleston
--Penny Womeldorff, MSW, WV Healthy Start/HAPI Project, Morgantown
--Sandy Young, DNP, Thomas Memorial Hospital, South Charleston

Staff:
--Janine Breyel, Morgantown

Volunteer to serve on this Committee

Committee on Drug Use During Pregnancy Sub Committee on Medical Guidelines Report and Recommendations

Substance abuse during pregnancy has been identified as an issue critical to the health of mothers and babies. But the issue of how to identify substance abusing pregnant women accurately and quickly and refer them to treatment early is a dilemma for many providers of maternity care.

READ MORE

NAS Tool Kit Now Available Online

Click here to access the toolkit

Maternal Drug Use

The use of illicit and legal drugs and alcohol among pregnant women has been reported as a major factor in West Virginia's poor newborn outcomes.  The increase in the number of chemically-dependent babies presents a cost to society.  The Perinatal Partnership has identified the problem in detail and made policy recommendations for the treatment of both pregnant women and newborns.  This information is contained in the Reports on the Blueprint to Improve Perinatal Health, and the partners are working now to implement the recommendations.

Drug-Free Moms and Babies ("DFMB") Project - Grants Available

The West Virginia Perinatal Partnership is pleased to announce the availability of funding for projects to provide comprehensive services for pregnant women with substance abuse problems. The newDrug Free Moms and Babies Project will provide funds for up to four pilot sites around the state. Download any or all of the following:

• Full announcement of the DFMB Project (PDF format)
• DFMB Request for Proposal (MS Word 2007 format)
• List of hospitals that participated in 2009 umbilical cord study (MS Word 2007 format)
• Helpful contacts for questions and help with the application (MS Word 2007 format)
• Collection of "best practices" documents (zipped file)
• SBIRT information (zipped file)
• Options for Treating Opioid Additction (MS Word 2007 format)

First Drug-Free Moms and Babies Grant Awarded to Shenandoah Valley Medical Systems

Staff from WV Perinatal Partnership’s Drug Free Moms and Babies project made a site visit to Shenandoah Valley Medical Systems on February 24, 2012. Left to right: Laura Clayton, Board President, SVMS, Janine Breyel, Project Director, Drug-Free Moms and Babies, WVPP, Nancy Tolliver, Director, WVPP, and David Fant, CEO, SVMS.)

The WV Perinatal Partnership awarded its first Drug-free Moms and Babies grant Shenandoah Valley Medical Systems (SVMS) in February 2012. SVMS provides comprehensive primary health care, including maternity, pediatric and behavioral health services in a single site located in Martinsburg. The new program will utilize existing in-house staff, including nurse midwives, obstetrician/gynecologists, psychiatrists, psychotherapists, and certified addictions counselors. Grant funding will be used to hire an additional part time psychotherapist/substance abuse provider (SAP) and a Recovery Coach to work with pregnant and post-partum women. Grant funds also will help pay for drug testing, including cord tissue, incentives, and other program expenses. For more information about the Drug Free Moms and Babies funding opportunity, please contact Janine Breyel at (304)216-3437 or jbreyel@hsc.wvu.edu.

The State Journal covers Pregnancy, Drug and Alcohol Use, and Tobacco

Read these interesting articles from The State Journal:
Born addicted
Tobacco, Alcohol Still Prevalent
W.Va. Perinatal Partnership Plans Programs

New Model Policy Developed: Substance Screening and Testing of the Pregnant Patient at the Outpatient Visit

As part of its work, the West Virginia Perinatal Partnership developed a model policy for substance screening and testing of the pregnant patient. Screening and testing for substance abuse in pregnancy increases the identification of substance users and allows for early intervention and treatment. Health care providers tend to show unintentional bias when determining who to screen or test. Therefore all pregnant women should be screened each trimester as part of the normal routine. It is also recommended that all postpartum women be screened, if possible.

Model Policy: Substance Screening and Testing of the Pregnant Patient at the Outpatient Visit (Antepartum and Postpartum)

Model Informed Consent: Screening & Testing for Controlled or Addictive Substances in Pregnancy

Presentation Available: Answering the Questions of Perinatal Illicit Substance Exposure

Sandra Young, DNP, RN-BC, Director of Pediatrics/Oncology /Medical-Surgical, Thomas Memorial Hospital, Charleston, WV is available to present the program, Answering the Questions of Perinatal Illicit Substance Exposure.  The program is sponsored by the West Virginia Perinatal Partnership and CAMC Health Education and Research Institute. Download brochure for more details.

 Other resources:

NAS Tool Kit Available Online: Click here to access the toolkit

Read the most recent Committee on Drug Use During Pregnancy Sub Committee on Medical Guidelines Report and Recommendations (11/10).

One in five West Virginia born infants were found to have been subjected to drugs or alcohol while in utero.  View the report of the study and the associated PowerPoint Presentation (12/09)

The Substance Abuse Services Directory published by the West Virginia Department of Behavioral Health and Health Facilities can help you locate treatment services in your area. It includes programs targeted to women. The directory can be found at:
WV Substance Abuse Services Directory as of 4-18-12. (Download PDF)

Maternal Smoking

The problem of maternal smoking offers a challenge to all involved in perinatal health care.  The prospect of a good birth outcome for a pregnant smoker is much dimmer compared to that of a pregnant non-smoker.  On June 19, 2007 the West Virginia Perinatal Partnership sponsored a newly completed presentation on the maternal smoking in West Virginia. You may hear and view the presentation and the discussion here. The following supporting material was made available at the presentation:

Maternal Smoking in West Virginia, 1996-2005: A Hypothetical Assessment of Its Impact on Infant Health by Daniel M. Christy, MPA (Power Point Presentation)

Health Statistics Center Statistical Brief No. 4 Update: Smoking: Effects on Mothers and Babies in West Virginia (MS Word Document)

Table: West Virginia Births 2004-06; Maternal Smoking vs. Non-smoking and Average Birth Weight (Excel Spreadsheet)

West Virginia Division of Tobacco Prevention's (DTP) 2007 Annual Progress Report (External Link)

Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure

The New England Journal of Medicine reported in the December 9, 2010 issue results of a study related to treatment of addicted pregnant women with buprenorphine vs methadone exposure and resulting NAS.  Read more here.

Results: Treatment was discontinued by 16 of the 89 women in the methadone group (18%) and 28 of the 86 women in the buprenorphine group (33%). A comparison of the 131 neonates whose mothers were followed to the end of pregnancy according to treatment group (with 58 exposed to buprenorphine and 73 exposed to methadone) showed that the former group required significantly less morphine (mean dose, 1.1 mg vs. 10.4 mg; P<0.0091), had a significantly shorter hospital stay (10.0 days vs. 17.5 days, P<0.0091), and had a significantly shorter duration of treatment for the neonatal abstinence syndrome (4.1 days vs. 9.9 days, P<0.003125) (P values calculated in ac- cordance with prespecified thresholds for significance). There were no significant differences between groups in other primary or secondary outcomes or in the rates of maternal or neonatal adverse events.