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