Joanne Harrison Clough, a single mother and attorney raising her granddaughter, said that when her daughter, Emily, was pregnant, she sought in-person treatments for opioid addiction. However, no one was willing to accept her as a patient.
“And they said, ‘Well, she could go into early labor, or she could die.’ So, she used to sit in my house, and we‘d call for eight hours a day to rehabs and get turned down. Two phones, two of us, eight hours a day for two weeks, and she would just sob, ’Mommy, nobody thinks I’m worth helping. Nobody even thinks I’m worth helping.'”
Emily died of fentanyl poisoning in December 2016, leaving behind her 9-month-old daughter.
Effectively Treating Addiction
In the late 1990s, pharmaceutical companies told the medical community that opioid pain relievers wouldn’t result in addiction, according to the U.S. Department of Health and Human Services (HHS). That assurance led health care providers to prescribe opioids at increasing rates.For pregnant women, addiction is even more complicated—they can’t simply stop taking drugs. That could harm her unborn child, according to Teresa Russell, director of criminal justice outreach in Dayton, Ohio.
Russell works between the county jail and community health and treatment facilities to find the right help for women.
“We have pregnant females enter the [jail] facility that test positive for opioids,” Russell told The Epoch Times. “When that happens, we just want to work to make sure that they’re started on medication-assisted treatment to prevent withdrawal, and we always begin education on treatment options and maintenance as needed for stability throughout the pregnancy.”
For treatment, either buprenorphine or methadone is used for pregnant women as Russell said the studies show that they’re “safe and effective.”
Russell noted that a crucial aspect of her work is making sure that when an expectant mother is released from jail, she has a place in a community facility to continue her addiction treatment.
“One of the most important things for us, if we have a woman in custody with those needs, is that we have a discharge plan in place that creates a warm handoff to a community-based provider upon release,” she said.
That spurred Montgomery officials—and the community—to action.
“That’s when we had a lot of national news and a lot of highlights put on our county,” Russell said.
“Our county’s drug-free coalition, our community overdose team, families of addicts, and just concerned neighbors and friends, and people, just started getting together and saying, ‘What are we going to do about this?’”
She said that during that first year of the community and officials coming together to implement a plan of attack for addiction and substance abuse, overdose deaths decreased by half.
“Can [increasing opioid abuse be] reversed? Absolutely. I know it can because we’ve done it,” Russell said. “In that first year ... we dropped those [overdose death] numbers from 566 to 280.”
Specifically, she said that in Montgomery County, outpatient addiction services and mental health programs partnered with private physicians or a hospital network, and funding for treatment facilities and programs was increased.
“That program was developed comprehensively to provide medication-assisted treatment and withdrawal treatment to [women and infants] exposed to opioids. It works with everybody—in the criminal justice [system] or not.”
She explained that if a pregnant woman in the community is struggling with addiction and her physician isn’t trained to handle that, there’s an in-place network to partner with another physician with the necessary medical training.
Addressing Mental Health
In addition to treating drug addiction, Russell said Montgomery County had to recognize that drugs are only part of the problem.“For a really long time, we probably didn’t do a great job treating mental health and addiction co-occurring,” Russell said. “But I definitely think that dual diagnosis is more common now than it was when I first came into criminal justice services six years ago.”
Russell said she’s currently seeing more pregnant women addicted to opioids than she was 10 or even five years ago. Now, there’s also the recognition that women abusing opioids are often self-medicating an underlying mental health need.
As a result, Montgomery County is addressing the mental health aspect simultaneously with addiction.
“Previously, if you came into the jail or you went into a correctional setting, or even if you showed up for treatment if addiction was assessed to be the issue, that’s what was put down as a primary need and what was worked on first,” Russell said.
Increasing Treatment Options
In recognition of the lack of treatment options for pregnant women struggling with addiction and substance abuse, in 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) distributed $3.6 million to four grantees in a state pilot program to treat pregnant and postpartum women. The distribution was the first of its three-year award cycle, which will total $10.8 million in the end.SAMHSA stated about the program, “The funds support family-based services for pregnant and postpartum women with substance use disorders, emphasizing treatment of opioid use disorders; help state substance abuse agencies address the continuum of care, including services provided in nonresidential-based settings; and promote a coordinated, effective, and efficient system by encouraging new approaches and models of service delivery.”
Still, Russell said about addressing the rising opioid crisis, “The issue can’t just fall on law enforcement. It can’t fall on local addiction and mental health boards or public health departments in general.
