Close to Home: A message of hope for opiate addicted pregnant women

There is no doubt that opiate abuse in pregnancy is a growing problem in Sonoma County. As outlined in a recent article (“Spike in number of drug-addicted babies,” Feb. 28), we have seen an increase in the number of infants born dependent on opiates. While we all feel saddened by the tragedy of this problem, I want our community to know that there are many hopeful narratives out there.

Multiple local agencies are working to reduce prescription opiate misuse and abuse, which largely drives this current crisis. Together, we can reduce fear and stigma around addiction, another important step to addressing this problem. Most importantly, I want anyone struggling with opiate addiction to know that there is help available.

The solution to reducing drug-exposed pregnancies isn't as simple as improved screening. While it is a standard of care to ask all pregnant women about substance use, many women don't answer these screening questions truthfully, often due to fear, denial and shame. They are afraid they will be judged and denied access to good prenatal care. They are even more afraid of legal repercussions or that Child Protective Services will strip them of their right to parent before they even have a chance. Many hope that they can get control of their addiction before anyone finds out.

At Santa Rosa Community Health Centers, we care for many patients who struggle with addiction; some are women who become pregnant. Our primary goal is to treat them with compassion and respect. It is helpful to view addiction as a chronic disease, similar to diabetes, rather than a moral problem.

For many struggling with addiction, especially women, childhood trauma, domestic violence and mental health issues co-exist with substance use. It is hard to treat the addiction without simultaneously acknowledging why the use initially began. When we begin to understand these stories our compassion grows, and we can see the person before us, not just an addict.

For women who are pregnant and addicted, I founded the New Beginnings Clinic at the Vista Family Health Center. Our team of nurses, psychologists and doctors aims to get substance-abusing moms into treatment while they are still pregnant.

We help women overcome the many perceived and real barriers to treatment, including their own denial. We help them find stable housing, assist with transportation, treat underlying mental health problems and connect them with community resources. We coordinate with local treatment providers to increase their likelihood of being drug-free when their babies are born.

If a woman is brave enough to disclose her use while pregnant, we have an opportunity to optimize obstetric outcomes and help mom begin her journey to recovery before she shows up to the hospital in labor. Ideally, mom and baby don't have to be separated at birth, and we can continue to support mom in maintaining her sobriety postpartum.

As physicians, we do our best to meaningfully address the fear, stigma and misinformation that makes our patients hesitant to trust us. We need you to join us in this compassionate effort to improve lives. Whether you are struggling with substance use or supporting someone who does, know that addiction, like diabetes or asthma, isn't something you can just get under control. It requires the support of professionals and loved ones.

To tackle opiate abuse during pregnancy in our community, we need to remove our value judgments and encourage those who are suffering to seek help. Pregnancy can be a unique opportunity for women to turn their lives around, and we have helped many women in our community do just that.

Erin Lund is a family physician working at the Vista Family Health Center and a faculty member at the Santa Rosa family medicine residency program. She lives with her family in Santa Rosa.