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New call-in line in Maryland helps doctors treat pregnant women with addictions

When Melissa Ward was just starting to see patients with addictions a few years ago at Pascal Crisis Stabilization Center in Crownsville, she called experts at the University of Maryland School of Medicine to ask about prescribing Suboxone to treat their opioid dependence.

“As a new prescriber,” she said, “I was fearful of the medications.”

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When a pregnant woman came in, she said she had even more questions, which the Baltimore medical school’s experts helped her troubleshoot.

Now, the school has dialed up the expertise it offers for women with substance use issues who are about to have, or have just had, a baby.

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Ward said having a resource like that would come as a big relief to even veteran treatment providers unaccustomed to seeing pregnant women, or obstetricians and other providers unaccustomed to treating those with addictions.

That’s the point of the new line — help more providers to treat more patients, wherever they show up.

Called MACS for MOMs, the line is a state and federally funded expansion of a program launched in 2017 called the Maryland Addiction Consultation Service. It can be reached at 855-337-MACS (6227) or www.MACSforMOMs.org.

Officials say it’s coming at an important time as overdose deaths for opioids such as heroin and fentanyl are rising during the coronavirus pandemic.

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The U.S. Centers for Disease Control and Prevention found the number of pregnant women with opioid use disorders at labor and delivery more than quadrupled from 1999 to 2014. And a Washington State University study published earlier this year found that the number of pregnant women using opioids has grown since the pandemic began, as well as the number using alcohol and marijuana.

The line is available for obstetricians, midwives and primary care doctors, as well as treatment providers, because they haven’t necessarily ever been asked, and may not be inclined, to provide care for those with addictions, said Dr. Katrina Mark, an associate professor in the University of Maryland School of Medicine’s department of obstetrics, gynecology and reproductive sciences.

Mark, who plans to respond to questions on the line, said medical providers need to become comfortable treating those with substance use disorders. Even if patients are advised to seek addiction services, stigma may deter them from going to a treatment center.

“Addiction service providers aren’t necessarily comfortable when a patient becomes pregnant, and an obstetrician isn’t necessarily comfortable taking care of a patient’s addiction,” she said. “But it’s important to have people who can do both.”

Dr. Christopher Welsh, a University of Maryland associate professor of psychiatry, helped launch the main MACS line and mans it with a handful of other addiction experts.

He said sometimes the doctors are looking for resources or even help with a billing question, in addition to questions about specific patients’ treatment. Some callers are seeking training to use treatment medications, which have federal requirements. In those cases, in-person and virtual training can be arranged.

The help line was expanded to help pregnant women and new mothers after Maryland won some funding through Medicaid, the federal-state health program for the poor. (The MOMS in “MAC for MOMS” stands for Maternal Opioid Misuse.)

Welsh said officials have just begun spreading the word to doctors and drug treatment centers about the program and hope it will help expand treatment access for pregnant women, who can face judgment in public.

He said many pregnant women start taking better care of themselves and want to stop smoking, drinking and using drugs, but withdrawal is hard to manage alone. More providers need to be willing to help, Welsh said.

“We’re just in early phases of reaching out to providers,” he said. “We want to let them know there are resources.”

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