UofU clinic hopes to reduce effects of opioids on pregnant women & their babies

“University of Utah SUPeRAD Clinic Helps Addicted Pregnant Women.”

That headline comes from an article published by University of Utah Health Sciences. I was surprised to learn that 20 percent of pregnant women are prescribed opioids in America. My daughter, a fundraiser for Health Sciences, took my wife and me to Daybreak to look at the facility and visit the staff. It is quite a complex and not a dollar was spared in its construction. 

The complex is the brainchild of Dr. Mike McGill, chairman of the Department of Family and Preventive Medicine at the UofU.  Examination rooms run down both sides of a hallway which backs onto an area that houses the staff. Patients go in one door and the staff goes in another. Scattered about are the X-ray room, the bone density room, the MRI room and a holding cell for pregnant women from the prison.

What makes this configuration sing is that all primary-care disciplines — neurologists; general practitioners; dietitians; oncologists; social workers; physician practitioners; RNs; ear, nose and throat doctors; psychiatrists; and a lot of other disciplines are all grouped together.

SUPeRAD is an acronym for Substance Use and Pregnancy – Recovery, Addiction and Dependence at the facility’s Prenatal Specialty Clinic. Dr. Marcela Smith is the clinical director of the program at Daybreak. She explained that there is a child born every 25 minutes in the U.S. with Neonatal Absurdities Syndrome. My wife and I have committed to a three-year grant to provide transportation to those women who need it. You should buy stock in Uber and Lyft right now.

The SUPeRAD at Daybreak is one of only four clinics in the country that is conducting research into the dilemma. Currently, the clinic is in the process of preparing a grant proposal to the National Institutes of Health (NIH) to determine the fathers’ roles in the pregnancy and how they can help their spouses. 

Here is the opening paragraph of the grant proposal: “Opioid overdoses is a leading cause of pregnancy-associated deaths in the United States and Utah. Most deaths (89 percent) occur after delivery. While many pregnant women with Opioid-Use Disorder (OUD) will attempt and achieve abstinence by the second trimester, this can lead to decreased tolerance. Subsequent relapse heightens the risk of overdose and death. Major risk factors for maternal overdose include untreated depression, discontinuation of maintenance pharmacotherapy and loss of continuity with providers. While some protective and risk factors have been identified, few data are available regarding interventions that reduce the risk of relapse, overdose and ultimately death among pregnant and postpartum women with OUD.”

In another article published by University of Utah Health Sciences called “Helping Moms in the Face of Drug Dependency and Addiction,” we learn “pregnant women with opioid disorder often face a number of challenges during their pregnancies: limited options for drug treatment, shame and stigma from family or friends and concern for the effects of drugs on their babies. Women are often more concerned about the risk of drugs on their babies than themselves.”

Now back to the grant proposal to the NIH. Dr. Smith is targeting four areas: the mother, the father, the child and career development. When it comes to the mother, she wants to assess the impact of the father on maternal outcomes. She also wants to find out what the father has to do with relapses and whether or not there are fewer discrete adverse events such as criminal justice involvement when it comes to the child. She also wants to find what effect the father has on improved child outcomes when the father is involved. And finally, when it comes to career development, she wants to find out how to refine the skills that this vulnerable population needs to survive.

I just read that opioids killed 73,000 people in the U.S. in 2017 and roughly 40 percent of those deaths came from prescriptions, according to the U.S. Census Bureau. This equates to approximately 200 deaths a day. 

In 1995, France relaxed restrictions on doctors prescribing buprenorphine. The number of people in treatment rose and overdose deaths fell by 79 percent over the next four years. Do you think that maybe our political elites would do the same?

Robert Pembroke is the former chairman and CEO of Pembroke’s Inc. in Salt Lake City.