Temple launches Center of Excellence to address opioid use in pregnancy.
Pregnancy is a brief but powerful window of opportunity to identify and treat opioid addiction. However, drug treatment options are limited as many programs don’t accept pregnant women, which can lead to continued drug use, withdrawal or harm to the developing fetus. Through an innovative partnership with Wedge Medical Center, a North Philadelphia mental health and drug/alcohol treatment facility, Temple will work to narrow this treatment gap as a newly designated Center of Excellence which will serve more than 300 pregnant women each year. The Temple Wedge Opioid (TWO) Treatment Program brings together experts in addiction medicine, high risk pregnancy and mental health care to provide state-of-the-art care to pregnant women and their partners.
“Neonatal abstinence syndrome occurs when babies experience withdrawal after birth because the mother used opioids during pregnancy,” says Laura Goetzl, MD, MPH, Professor of Obstetrics, Gynecology and Reproductive Sciences at the Lewis Katz School of Medicine (LKSOM) at Temple University and Director of the Division of Maternal-Fetal Medicine at Temple University Hospital. “Over the past decade, rates of maternal opioid use have skyrocketed, which has led to many medical issues with their babies as well as increased costs of care.”
Funded by a $500,000 grant from the Commonwealth of Pennsylvania, the Temple/Wedge Center of Excellence offers evaluation by experts in high-risk pregnancy and psychiatry, and offers much-needed access to drug treatment, counseling, and specialized prenatal consultation. Rather than simply treating the addiction, the Center will treat the entire person, integrating behavioral health, primary care and, when needed, evidence-based, medication-assisted treatment.
“Referrals come from primary care providers, emergency departments, inpatient care and correctional facilities,” says Laura A. Hart, MD, Assistant Professor of Ob/Gyn at LKSOM and the Medical Director of the Center of Excellence. “During the first visit, we examine patients to determine whether they could be treated with buprenorphine, a legal medication that is used to treat opioid addiction.”
In addition to screenings and maintenance treatment, the TWO Program also provides a gateway to psychiatric evaluation and helps patients create a mental health treatment plan.
“Somewhere between one half to two-thirds of our population has some sort of psychiatric disorder either because of, or prior to, drug abuse, which is then worsened by the drugs,” says Mary Morrison, MD, MS, Vice Chair for Research in Psychiatry at LKSOM and Psychiatric Director of the Center of Excellence. “Psychiatric treatment can include medication and therapy in the outpatient setting and may also involve helping patients meet basic needs such as food and shelter.”
Once evaluated, most patients return to their primary obstetrician, but those with significant mental health issues can also be referred by their provider to receive combined obstetric and psychiatric care at Temple’s Episcopal Campus. All patients will receive ongoing buprenorphine therapy, counseling and drug testing through Wedge.
“Temple and Wedge also educate local obstetricians and work with other maternity programs to make sure we’re all offering the best care,” adds Dr. Goetzl. “What we’ve really created is a central hub in North Philadelphia that addresses the dire need for community-based multidisciplinary care of pregnant women battling opioid use disorder.”