This week’s episode left us all with a heavy, heavy heart. That said, I am grateful to the show’s writers and producers that they did not tie up the storyline around Mrs. Berridge’s heroin use in a happy ending bow. While that would have ended the episode nicely and left us all with a warm fuzzy feeling, it would not have been very realistic. 

All too often there is no happy ending when addiction issues are involved. I estimate that most of you reading this have been touched in some way either by your own, or a loved one’s addiction issues. My family has certainly felt the loss and pain of loved ones taken by this thief. 

Nobody aspires to being an addict and pregnant people don’t choose to be addicts. They care about their babies as much as any other mother. Around 5.4% of pregnant women report using opioids not prescribed to them, or other illicit substances, according to a 2022 survey done by the Substance Abuse and Mental Health Services Administration (SAMHSA). Relapse rates for opioid use are so incredibly high… quoted between 70 to 90%. It is so rare that someone can kick an opioid habit, particularly heroin. 

Fear of discovery and being ostracized keeps pregnant people with addiction issues from seeking prenatal care, adding to the risks they carry for themselves and their babies. For those of us on the provider side, when we discover a patient with a substance use issue, we need to remember to call upon our resources, including substance use experts, in the community. If a provider has little to no experience working with patients having substance issues, we need to be humble and facilitate the patient receiving care from an expert in the field. 

The first thing that may come to mind to a provider who has discovered that their patient has substance issues, particularly with opioids, is to have them try to stop cold turkey, which is absolutely the wrong way to approach their care. Stopping opioid use abruptly can cause fetal death. Helping our patients into treatment programs that offer methadone or buprenorphine can be lifesaving for both mamma and baby. 

Whereas breastfeeding a baby whose mother struggles with opioid addiction was unheard of 30 years ago, now we know that not only does it help bond mother and baby, but it can help ease the symptoms for baby of neonatal abstinence syndrome (formerly called withdrawal). 

While so much has been learned about substance use and pregnancy in the past 30 years, we still have so far to go to get to the point where we aren’t having to find homes for babies who have lost their mammas to overdose….