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Research Supports Safe Opiate Detoxification During Pregnancy

Craig Towers, MD, Professor in Obstetrics and Gynecology's Division of Maternal-Fetal Medicine, has shown evidence that maternal opiate detoxification during pregnancy significantly improves pregnancy outcome, without putting the fetus at risk. The results of his research have been published in the American Journal of Obstetrics and Gynecology.

Dr. Towers says opiate addiction is a national epidemic and is especially prevalent in Appalachia. “As opiate addiction increasingly creeps into the pregnant population, mothers expose their unborn babies to drugs that often cause Neonatal Abstinence Syndrome (NAS),” said Dr. Towers. “It is estimated that the cost of caring for a baby with NAS in its first year of life is 15 to 20 times more costly than care costs for a healthy baby.”

Dr. Towers also says the current general practice in obstetrics is to avoid withdrawal of opiate addicted pregnant women for fear this process would harm the fetus, a practice based upon dated and limited data. He says his research is “unique as it evaluates opiate detoxification during pregnancy through four different methods.”

During the study, Dr. Towers’s goal was to determine if maternal opiate detoxification during pregnancy was harmful and if it could significantly lower the incidents of NAS, without putting the fetus at risk. He evaluated the detoxification of 301 opiate addicted pregnant patients, and of those patients, there was no fetal death related to the process.

“It is proven that opiate addiction can cause fetal growth harm as well as addiction and withdrawal,” said Dr. Towers. “Identifying opiate addicted pregnant women, getting them into a program that can first medically withdraw them and then be supported by follow-ups to further aid a drug-free lifestyle is of paramount importance.”

According to Dr. Towers, while detox is slightly more costly than drug maintenance, the nationwide cost for treating one NAS newborn is approximately $60,000. Through monitored detox, if the fetal harm is minimal and the number of NAS cases could be cut significantly, the healthcare cost savings nationwide could be substantial.

“In Tennessee alone, one thousand NAS cases occur annually. Decreasing this by 50 percent, at a minimum, could save approximately $30 million per year,” said Dr. Towers.

Dr. Towers unveiled his research findings at the Society for Maternal-Fetal Medicine’s annual meeting in Atlanta. “Doctors in attendance from around the world received the information well, yet it is a very emotional topic around the country,” he said.

According to Dr. Towers, if a detoxification program is adopted by The American Congress of Obstetricians and Gynecologists, new protocol for maternity care would need to be created.  Dr. Towers said that the results of his research leads to the belief that a focus of maternity care should be shifted to spend more money towards detoxing the opiate addicted mother rather than the baby after delivery.

“In order for this to happen, a behavioral health component would need to be added to the protocol,” said Dr. Towers.

Posted March 29, 2016