Drug abuse is not a victimless crime. You could be the brother of someone who overdosed and required a hospital stay. You could be the pharmacist afraid to go back to work after a robber held you at gunpoint for prescription medication. Or, as a Tuesday article that’s part of the BDN’s new MaineFocus initiative made clear, you could be an infant born craving drugs because of the pills your mother took during pregnancy.
The personal and economic costs associated with drug and alcohol abuse are staggering. In 2010, the total estimated cost of substance abuse in Maine — including corrections, law enforcement, long-term health effects and premature death — was more than $1.4 billion, translating to $1,057 for every Maine resident. It represented a 56 percent increase from just five years prior, according to the Maine Office of Substance Abuse and Mental Health Services.
Maine’s youngest are not spared. The state has seen an alarming spike in the number of drug-affected babies: In 2012, 779 babies were born drug-affected, which is five times the number in 2005. Some have been exposed in utero because of the mother’s abuse of illicit substances during pregnancy, while others have been exposed because the mother is receiving treatment for her addiction with drugs such as methadone.
Not one but many approaches to do with treatment, prevention and law enforcement are needed to address the state’s drug epidemic. Similarly, a variety of approaches is needed to reduce the number of babies born experiencing withdrawal from narcotics, help those who are born drug-affected return quickly to their homes, and prepare them for a healthy life.
The problem is complicated by the fact that not much research exists on the long-term effects of withdrawal symptoms in infancy. In addition, doctors must not only treat the infant but help the mother, or family, through recovery.
Being a new mom or dad is stressful and exhausting anyway. But it can be especially difficult when parents are struggling with their own addiction and the drug dependence of their child. Treatment for drug-affected babies, therefore, should not simply center on getting them through withdrawal but on addressing the factors that led to or exacerbated the mother’s addiction, which could include poverty, poor parenting skills, no health care, violence in the home, or drug abuse within the family.
One agency in Maine, a nonprofit in Scarborough called Crossroads, is following this inclusive treatment approach. It runs a residential substance abuse treatment program that lets pregnant and postpartum mothers live with their children. Studies have shown that women are more likely to complete these programs when they are allowed to keep their children close, and in 2012 the federal government validated Crossroads’ efforts with a $1.5 million, three-year grant. Treatment there is family-focused, with an emphasis on parenting and education.
What are often called “wraparound services” — such as child care, prenatal care, mental health services and workshops on parenting and women-centered issues — have proven to result in decreased substance use, improved health at birth, and decreased rates of depression. It will be important for Crossroads to share widely the results of its work — for possible replication and improvements to the model.
Mothers also are more likely to see greater rates of success overcoming addiction if they have access to outpatient treatment programs that include pregnancy- and parenting-related services, according to studies reviewed by the Substance Abuse and Mental Health Services Administration. It makes sense that their babies also are more likely to thrive in an outpatient program instead of a hospital room.
Unfortunately, Maine does not have an outpatient program for drug-affected babies. That’s a reality Dr. Mark Brown, a physician at Eastern Maine Medical Center in Bangor, is hoping to change. After studying infants’ health, he said he believes babies can be better cared for at home, with regular trips to an outpatient program, instead of remaining in a hospital sometimes for weeks.
An outpatient program would pair well with efforts already underway in the region, such as the Penquis Regional Linking Project, which works in Penobscot and Piscataquis counties to increase the well-being of children and their families who have been affected by substance abuse. An outpatient program also would be significantly cheaper than inpatient treatment.
Helping adults get the most effective care possible will be key to reducing the number of drug-affected babies. The state, however, estimates only about 20 percent of adults — 14,996 out of 71,660 — who needed treatment for alcohol or drug addiction in 2010 actually received it.
Treating addiction makes not just human but economic sense. The costs associated with addiction treatment and intervention in 2010 in Maine were $47 million, while associated crime costs were more than seven times greater at $343 million.
Programs must be in place to treat drug-affected babies in the location that’s right for them — often in their home, surrounded by their family. Getting more adults into and through treatment, however, also will help create an environment in which Maine’s littlest residents aren’t born craving drugs in the first place.