NYT: MPH’s Patrick and the Children of the Opioid Epidemic
In the midst of a national crisis, mothers addicted to drugs struggle to get off them — for their babies’ sake, and their own. The standard of care for a pregnant women addicted to opioids is medication-assisted treatment: a long-acting opioid substitute — traditionally methadone — that binds to the body’s opioid receptors to prevent withdrawal symptoms, usually without causing the euphoric sensations that commandeer the brain’s dopamine system into a relentless quest for more.
But because methadone and buprenorphine are still opioids, a fetus adapted to them is still at risk for withdrawal after birth. Most experts feel that this risk is justified. “As a society, if we’re thinking about the trade-off, it is much better to get Mom into treatment, for her health and her infant’s health, and then have some risk of neonatal abstinence syndrome,” Dr. Stephen Patrick, a neonatologist at Vanderbilt University Medical Center, told me. Compared with other babies in the neonatal intensive-care unit, “for the most part, infants with neonatal abstinence syndrome are just not that sick.”