The following story is based on an interview with a woman we’ll call
“Sylvia” (not her real name). Sylvia gave birth on March 8,
2018 to a full-term baby girl at Catawba Valley Medical Center who weighed
8lbs, 4oz. “Baby Girl” spent six days in the neonatal intensive
care unit (NICU) under observation for neonatal abstinence syndrome (NAS)
before going home with Sylvia who receives services from a new program —
Catawba Medication Assisted Treatment (MAT). Catawba MAT integrates behavioral
health and substance abuse treatment into prenatal care for pregnant women
age 18 or older with opioid dependence.
Q: Sylvia, congratulations on your beautiful daughter. Can you please tell
our readers about yourself and your journey?
A: I grew up in Northwest Hickory and graduated twenty-second in my class
with a 4.2 grade point average. I went off to college, but, at 19, a knee
injury sent me in another direction. After taking the pain meds doctors
prescribed, I started buying painkillers illegally and crushing them to
inject them intravenously. Then I graduated to cocaine, methamphetamines
and, eventually, heroin. After dropping out of college, I moved back to
Hickory. My parents and siblings all have substance abuse issues, so the
cycle naturally continued.
When I found myself pregnant (the first time), I tried going “cold
turkey”. I didn’t know that stopping opioids suddenly could
cause a miscarriage. I lost the baby and moved to another state where
I got help at methadone clinics. But then I met a guy and started using
again. I ended up homeless, half-way across the country.
Q: How did a professional healthcare provider learn about your opioid use?
A: After my family helped me get back to Hickory, I got pregnant again last
year, and I was still using heroin. That’s when I knew I was going
to face consequences for my actions. I needed help, so I went to CVMC’s
Maternity Services at Catawba County Public Health where I failed a drug
test and begged the midwife to help me get clean. I desperately wanted
to take responsibility and make a positive change
— not just for myself, but also for my unborn baby. The drug problem in
Hickory is rampant. I've lost count of the friends I've lost because
A social worker talked to me about the Catawba MAT program. At first, I
was scared because I have friends who’ve been pregnant while using.
A few have had their children taken away by child protective services.
I was determined to do whatever I could to turn things around and get
clean. I got an appointment to be assessed and was accepted into the MAT program.
Q: Did you feel judged or stigmatized while in the program?
A: No. They wanted to help me, not make me feel ashamed. The MAT team put
together a slow, supervised opioid withdrawal plan where I got doses of
Subutex. They also counseled me on prenatal care, nutrition and I had
talk counseling sessions. During the program, you’re closely watched
to make sure you ingest the Subutex doses in the clinic because some addicts
that go to methadone clinics put doses between their molars and their
cheeks where they hold it until they get back out on the street to sell
it for five or six times more than what they paid for it. I am proud to
say that I had good success with the program, passed all my drug tests
and, I even quit smoking cigarettes!
Q: So, what’s next for you and Baby Girl?
A: I’m breastfeeding and in love with this baby girl. But, my greatest
fear is relapse. I know it’s going to be hard to stay clean. My
sister has been clean for a year and she’s my biggest cheerleader.
The most important thing I want other pregnant girls to know is to be
honest with your providers. There is help out there – but you have
to be honest with them, so they can help you.
Sylvia & Baby Girl Today
Sylvia’s team of providers say that both mom and baby are doing great
at home, adjusting to breastfeeding and making progress. It will be approximately
six months before Sylvia’s current dose of Subutex is adjusted with
the long-term goal of getting her off Subutex completely. She will continue
having routine evaluations and receive “wrap around” services
such as post-partum depression screening and provided resources to address
both the emotional and physical aspects of opioid dependence.
ABOUT CATAWBA MEDICATION ASSISTED TREATMENT (MAT) PROGRAM - Pregnant women are considered a priority for the Catawba MAT
partnership. This program, formed between Catawba Valley Medical Center
Maternity Services, Catawba County Public Health and Gaston Family Health Services (GFHS),
serves pregnant women age 18 or older, who are dependent on opioids, not
currently in treatment and receiving prenatal care at Catawba Valley Medical
Center’s Maternity Services. Patients identified through CVMC Maternity
Services will be referred to the Catawba MAT program to determine eligibility.
Patients who are eligible will be offered treatment in coordination with
CVMC Maternity Care. Other patients will be assisted in finding an appropriate
treatment resource. The program utilizes a team-based approach to care
including a DATA-waivered physician, behavioral health providers and licensed
social workers. This team-based approach extends beyond GFHS as the MAT
team provides regular treatment updates to CVMC providers and a MAT behavioral
health provider works onsite at the CVMC clinic.
Although other buprenorphine and methadone providers and programs exist
in the area, none are specifically tailored to the pregnant population
and none are integrated into prenatal care. NOTE: Subutex, or buprenorphine
hydrochloride, is FDA-approved as a medication treatment for opiate dependence.
It minimizes symptoms of withdrawal from heroin and other opiates.
For more information about Catawba MAT, please schedule an appointment at Catawba Valley Medical Center Maternity Services
by calling 828.466.7196 or come to the clinic located directly behind Catawba Valley Medical Center at 3070 11th Avenue
Drive SE, Hickory, NC 28602. Hours are
Monday – Friday between 8am to 5pm.