Sylvia - On Getting Help for Opioid Addiction During Pregnancy

My Recovery from Opioid Addiction During PregnancyPREFACE: 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 of overdose.

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.

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