The birth of a child can be a powerful motivator to kick unhealthy habits. Even before giving birth, pregnant women know that any substances they put into their body will be shared with their developing baby.
It’s an especially critical time for parents struggling to overcome a drug addiction who, feeling the immense responsibility of raising a child, may be inspired to finally get the help they need to fight their addiction and learn how to make better choices.
Montana should do its utmost to support these parents in their efforts. At the very least, we should not leave them to fight their addictions alone.
Yet it’s clear that amid Montana’s unfolding opioid crisis, most pregnant women who use drugs are not getting the support they need to build a better future – and all of Montana is paying the price. The steps that must to taken to brighten this bleak future need more attention and more public backing.
A series of recent stories, “Addicted and expecting,” the result of a partnership between the Missoulian and the University of Montana School of Journalism, brought much-needed attention to the issue and highlighted some of the life-changing work being done.
The path Montana is on now is not sustainable. Consider that:
- The rate of infants experiencing opioid withdrawal after birth grew by a factor of four over the seven-year period between 2008 and 2015, and neonatal abstinence syndrome is now diagnosed in nearly 9 out of every 1,000 births in Montana.
- The costs for these births tend to be higher due to complications, and of babies born with this syndrome, Montana Medicaid covers the bills for more than half of them.
- The situation is even worse on Montana’s reservations. According to the most recent assessment, 44 percent of pregnant women tested positive for opioid use in the Blackfeet Indian Reservation’s Browning. Nearly half the infants born in Lake County, which includes the Flathead Indian Reservation, were deemed at risk for neonatal abstinence syndrome.
Unfortunately, many drug-addicted women who become pregnant avoid doctors and hospitals as much as possible, fearing that they might be forced to either give up their drugs or give up their kids. Years of throwing drug users in jail has led to overcrowding in Montana’s prisons, an overburdened foster care system and has done nothing to fix the problem.
So, how do we fix the problem? With full support from their communities, Montana’s obstetricians and hospitals that provide maternal care can lead the way by encouraging a less judgmental attitude toward addicts.
One hospital in northwestern Montana is demonstrating how it works. Kalispell Regional launched a new program in 2014 to rethink the way it treats pregnant drug addicts. It has integrated maternal care with addiction treatment and social services, and urged its staff to empathize with addicted patients.
These no-cost changes have resulted in measureable success: Foster care placements have dropped by almost 70 percent, the length of an intensive-care stay for drug-exposed newborns has been cut by more than half, and the bills covered by Medicaid have similarly been reduced.
Further, Montana’s medical community must work on increasing the number of doctors certified to prescribe buprenorphine, a medication used to treat opioid addiction. When combined with counseling, the prescription drug can more than triple the rate of successful recovery. Yet the “Addicted and expecting” series revealed that Montana has few certified physicians, and in fact, only one such doctor in the entire 120-mile stretch between Missoula and Kalispell.
On the bright side, the state is already on solid footing to make progress on this point, having recently secured a $4 million Substance Abuse and Mental Health Services Administration grant aimed at improving medication-assisted treatment. Montana should track this progress carefully to ensure this treatment is made available where it is needed most.
Next, Montana must push to expand the number and type of treatment beds available to pregnant women who want to kick their addiction. At the moment, only one inpatient center in Missoula and another in Billings regularly admit drug-addicted pregnant women. Other options in the state tend to be located long distances away, or have long waiting lists.
However, women who already have children are not able to take them to inpatient centers and are unlikely to leave their families for treatment. Residential programs like the Carole Graham Home in Missoula do accept women who have children, but are limited by federal rules that do not extend Medicaid to facilities with more than 16 beds. Montana could apply for an exemption, as five other states have, but has yet to do so. It should do so without additional delay.
Also at the federal level, Montanans must demand more funding for treatment centers, another area in which the state lags behind national averages. Difficult as it is for addicts to gain admittance to one of very few treatment programs accepting new patients, it is even more difficult for pregnant women. Only 7 percent of Montana’s treatment providers offer programs for pregnant women or new mothers; the national average is 21 percent.
Montana’s state leaders, including Gov. Steve Bullock and Attorney General Tim Fox, should be at the forefront of efforts to encourage the efforts that are working, and to make the necessary changes to those that are not. Montanans from every corner of the state can encourage our legislative leaders to study the problem and prepare to propose focused legislation in the 2019 session.
As House Majority Leader Ron Ehli, a Republican state representative from Hamilton, noted, “There’s nothing more important. Doing something now is going to reap huge benefits down the road.”
Doing nothing, on the other hand, is sure to result in more tragedy.
-- THE MISSOULIAN