Copyright © 2021 Roswell Daily Record
Copyright © 2021 Roswell Daily Record
Abraham Lichtmacher, M.D., and Kelly Wascher, RN, MS, from Lovelace Health System in Albuquerque visited Lovelace Regional Hospital in Roswell recently to inform the hospital and the city about its Giving Respect and Compassion to Expecting Moms program (GRACE), which Heather Harper, Lovelace Regional Hospital CEO, said could eventually be adopted in Roswell.
With a focus on expectant mothers struggling with substance-use disorders involving opioids, the free program assists with prenatal care, delivery and postpartum support. If there is interest to participate or questions, the potential participants can call 505-727-5000 to discuss the program in more detail or visit the Lovelace website.
“The biggest message is, we are early in our development and we are beginning to assess how we can help Roswell,” Wascher said. “What can we do? How can we come alongside your current providers, whether they be OB/GYN, the methadone clinics, or the Suboxone providers — the people who are providing that medication to the pregnant patients.”
Last year at Roswell’s Lovelace, Harper said there were 964 births, but the hospital was not aware of how many births involved substance-use disorders.
“I think it is really going to help the folks,” Harper said. “The moms (especially) that don’t have any hope or anybody to help them — to know that drug addiction is a serious issue.”
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Dr. Lichtmacher is the chief of Womens’ Health Services for Lovelace Health System. Calling the program a statewide support mechanism, Lichtmacher and Wascher said participants can have prenatal care at Lovelace in Roswell and could have their delivery in Albuquerque. Participation is voluntary in all instances and involves nonjudgemental care.
“For the pregnant patient, don’t stay away because you are afraid that you are going to be stigmatized or whatever,” Lichtmacher said. “It’s the best thing you can do for yourself and your baby to get the treatment that you need.”
Launching after extensive planning in April 2017, Lichtmacher and Wascher said the program has delivered 90 babies with substance-use exposure and supported around 40 mothers with opioid addictions involved in this program. Lichtmacher said there was plenty of preparation and months set aside for comprehensive training and sensitivity training for the hospital staff. Wascher said the program was designed for opioid addictions because they can be treated medically, unlike other exposure to marijuana, methamphetamine or cocaine.
“You can’t open a newspaper or turn on a TV without hearing about an opioid problem across the country,” Lichtmacher said regarding what he called skyrocketing death rates for opioid overdoses.
Wascher and Lichtmacher both agreed they are passionate about this program and said the local hospital received the presentation of the program well and sees the need for Roswell.
Harper said the hospital is seeing an increase in opioid addictions in expectant mothers and it would be silly to not recognize the overall substance abuse in Roswell. For the participants, Harper said she wants them to know the hospital is here to help and hopes they do not feel ashamed or disgraced.
“What we want to do is make sure that we can connect those expectant mothers who do have drug issues with somebody that can provide them care and help them and their newborns who are addicted to the opioids,” Harper said.
According to Lichtmacher, only 15 percent of people with opioid addictions are being treated nationally, which leaves 85 percent untreated. Wascher said those who are pregnant with a substance-use disorder are very motivated to get the help they need and Lichtmacher agreed that pregnancy provides an opportunity for the mothers be inherently motivated.
To treat an opioid addiction, Lichtmacher said methadone and buprenorphine are administered by trained physicians, not midwives, with a waiver from the Drug Enforcement Administration (DEA) to prescribe buprenorphine. Lichtmacher added that 36,000 practitioners have a DEA waiver nationally, but only half have prescribed buprenorphine.
“If we are able to do that, we hope to improve the outcome for both the pregnant patients as well as the babies that come out of that,” Lichtmacher said. “Depending on statistics, 30 percent to 80 percent of these babies are going to go through withdrawal. That’s the scary part though. The patient is addicted, whether involuntary or voluntarily, licit or illicit, but the baby is also addicted. The baby doesn’t have any say about it.”
Lichtmacher said the program gives clinical algorithms for dosages and is organized for when a newborn goes through withdrawals.
A “navigator” with a social services background assists the GRACE program participants to create an infrastructure of support for resources after the baby is born for whatever the family may need. Many of the women with a substance-use disorder can have a range of challenges like psychiatric trauma or sexual abuse, to lack of social network, according to Lichtmacher and Wascher.
The goal, if the patients are on stable dosing, Lichtmacher said, is to help the parents as if it were a normal delivery with baby-friendly practices such as breastfeeding, skin-to-skin, and mother and baby interaction. Participation helps with dealing with Child Protective Services and making sure the patient can maintain a family structure after delivery with continual support from the navigator and other resources.
From November to December, Wascher said there were 10 deliveries with opioid addicted moms and all 10 were able to take their babies home.
Harper said the local Lovelace is looking for a navigator to come to Roswell in the future, but for now, the program is just beginning and training for local staff will take place eventually. Either training will come from Albuquerque or locals will travel north to gain training. Harper said the hospital can handle deliveries with withdrawals, but implementing the program will help with this care. If a patient is not able to be treated locally, Harper said the sister hospital in Albuquerque will send resources until the program is fully fledged.
Eventually, Lichtmacher hopes the program will continue exporting the numerous resources statewide, increase awareness of what can be done for these women and their children involving prenatal, obstetric and postnatal care in addition to treatment for the addiction during pregnancy. He also said the goal of the program is to return the patient back to the community if the care and treatment are successful.
“We want to help these patients,” Lichtmacher said. “We want to serve this community. Lovelace has been part of the New Mexico community for almost 100 years I guess now — and this is one of the several programs we have to give back to the community and to support the needs of the community.”
Lichtmacher said 43,000 people died of opioid overdoses in the country and 497 died in New Mexico of substance overdoses in 2016, three-quarters of which were opioid-related. The GRACE program is seeing a shift nationally where substance-use disorders have become a more predominant problem related to maternal mortality, according to Lichtmacher.
“We think it is important to help the parents and the children — and do it with a respect and dignified manner,” Harper said. “That’s kind of why the program got started.”
City reporter Alison Penn can be reached at 575-622-7710, ext. 205, or at firstname.lastname@example.org.
Multimedia-Crime reporter Trevier Gonzalez contributed to this story and can be reached at 575-622-7710, ext. 301, or at email@example.com.