Prevalence of Drug Use in West Virginia Pregnancies

David Chaffin, MD

Sponsor

Office of Maternal, Child and Family Health, West Virginia Department of Health and Human Resources

Selena Johe

Co-Conspirators

Michael Stitely, MD - WVUByron Calhoun, MD - WVU CharlestonStefan Maxwell, MD - Pediatrix Charleston

We Have a Problem

I have no clue about what to do about it.

Background

Range of reported incidence of drug use in pregnancy 10-14%

Dependence on data collection Survey Samples with consent Anonymous sampling

Rising incidence of NAS

25

21

48

52

70

0

10

20

30

40

50

60

70

2003 2004 2005 2006 2007

Participating Hospitals

Bluefield Regional (BRMC)Raleigh General (RGH)Thomas Memorial (TMH)Charleston Area Medical Ctr (CAMC)Cabell Huntington HospitalRuby Memorial Hospital (RMH)Wheeling Hospital (WH)City Hospital Martinsburg (CH)

USDTL CordStat

Drug Class Test Method Cutoff Amphetamines ELISA 5.0 ng/g Cocaines ELISA 2.0 ng/g Opiates ELISA 2.0 ng/g Cannabinoids ELISA 100 pg/g Benzodiazepines ELISA 2.0 ng/g Methadones ELISA 2.0 ng/g Buprenorphines LCMSMS 2.0 ng/g Alcohol ELISA

Study Limitations

No other informationNo account for legal use

Final Result

146 of 759 cord samples positive for drugs or alcohol

759 Samples: Drugs + Alcohol

BRMC 50 samples 16%RGH 83 20TMH 59 19CAMC 133 22CHH 245 18RMH 52 17WH 65 28CH 72 13

759 Samples: Drugs + Alcohol

Drugs AlcoholBRMC 14 % 4%RGH 19 2TMH 10 8CAMC 16 8CHH 17 1RMH 13 4WH 12 15CH 10 5

USDTL CordStat

Drug Class Number Amphetamines 1 Cocaines 0 Opiates 41 Cannabinoids 58 Benzodiazepines 17 Methadones 14 Buprenorphine 0 Alcohol 39

Distribution of Drugs

Opiates

24%

THC

35%

Benzos

10%

Methadone

8%

EtOH

23%

Polysubstance abuse

0

5

10

15

20

25

30

CHH Neonates vs Cord Study

05

10152025303540

Number affected

AmphetaminesBenzodiazepines

CocaineMarijuanaMethadoneOpiatesAlcohol

Mother Cord

Lessons

1 in 5 babies in WV exposed to drugs or alcohol

Polypharmacy is commonThere are regional distributions of drug

use

We have a problem