Pregnant women using opioids in Montana aren’t receiving adequate care, according to a joint investigation by the Missoulian and the University of Montana Journalism School. As a result, more infants in Montana are being born dependent on narcotics. That means they can experience withdrawal symptoms - anywhere from fussiness and trouble feeding to seizures or death in extreme cases.
Montana has one of the highest and fastest growing rates of infants experiencing withdrawal in the country. It rose more than 300 percent between 2008 and 2015. That's nearly nine in every 1,000 births. Joe Eaton is the investigations professor at the Journalism School has been researching this project with his students this past semester.
"Well I think what the students found is that in Montana for women who are addicted and pregnant, they’re having a very difficult time finding care in the state," says Eaton. "And the reason is is that there are very few places that treat pregnant women with addictions. Also there are very few doctors who provide the medications that can best help them to recover from their addictions."
Eaton thinks that may be because there are many ways to become rich as a doctor and providing care for addicts isn't one of them. The limited availability of treatment in Montana means people addicted to drugs often end up in jail. And pregnant women also face the real possibility of having their children taken away after they give birth. As a result, women are discouraged from asking for help at the time when research says they have the best chance for getting off drugs: during pregnancy. But women who try to quit on their own, without medical support, don’t often succeed.
"We already know that medication-assisted treatment is one of the most effective solutions for treating opioid addictions," says Zach Bryan. "It’s no different for pregnant women."
Bryan is one of the many students who worked on the series for the Missoulian. Medication-assisted treatment means combining counseling with a prescription a medication like buprenorphine that alleviates opioid withdrawal symptoms. The American Society of Addiction Medicine recommends medication assisted treatment as the standard of care. However, Montana ranks near the bottom among states in the number of buprenorphine providers.
"I think there’s an especially big problem for pregnant women because there’s a lot of stigma surrounding providing them with drugs during pregnancy," says Bryan. There’s stigma around medication-assisted treatment because some people believe it’s replacing one drug with another drug."
Currently, there are only two treatment centers in the state that regularly see pregnant women. Some rural communities have resisted providing buprenorphine when nearby clinics don’t provide enough support for recovering addicts. Others are scared buprenorphine will bring more drugs into their communities, but those concerns are largely unfounded. Montana recently got a $4 million federal grant to address the lack of treatment here. It’s supposed to fund 18 treatment sites to serve more than 22-hundred clients between now and June of 2019, but for it to work, more doctors need to start administering medication-assisted treatment.
"I think that what the students found is that in the state of Montana we need more treatment centers for pregnant women with addictions, and also more doctors who are willing to sign up to prescribe buprenorphine, which has been proven to be the most effective treatment," says Eaton.