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 added.
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.”
Mackenzie Carpenter, firstname.lastname@example.org, 412-263-1949 or on Twitter @MackenziePG.