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Another Drug Crisis: Methamphetamine Use By Pregnant Women

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A new study published today finds that a growing number of women in recent years have been using amphetamines like crystal meth during their pregnancy. The rates of use have grown disproportionately in different regions in the country, posing serious health risks to both the mother and the baby. NPR's Rhitu Chatterjee reports.

RHITU CHATTERJEE, BYLINE: The new study found that as the rates of opioid use among pregnant women grew in recent years, so did the use of amphetamines, mostly methamphetamine. By 2015, tens of thousands of pregnant women were using these drugs.

LINDSAY ADMON: In total, we identified 82,000 deliveries that were affected by amphetamine use disorders.

CHATTERJEE: Lindsay Admon is an assistant professor of obstetrics and gynecology at the University of Michigan and an author of the study, which used a database of hospital discharge records between 2004 and 2015. Over this period, she says the rate of meth and prescription amphetamine use increased in three different regions of the country - the South, the Midwest and the West. Rural areas had higher rates than cities with the rural West having the highest rate of all regions.

ADMON: By 2014 to 2015, amphetamine use disorder was identified among approximately 1 percent of all deliveries in the rural western United States.

CHATTERJEE: That's higher than the rate of opioid use among pregnant women in most regions of the country. Admon says that methamphetamine puts pregnant women at a high risk of a range of health problems.

ADMON: So things like blood transfusion, heart failure, cardiac arrest or having a heart attack and then eclampsia, which is sort of the most dangerous form of pre-eclampsia where a woman has a seizure.

CHATTERJEE: And there are risks to the baby, too - for example, a condition called placental abruption which cuts off oxygen supply to the fetus and causes heavy bleeding in the mom. Mishka Terplan is an OB-GYN and an addiction specialist at Virginia Commonwealth University.

MISHKA TERPLAN: This is the first national-level data looking at methamphetamine use amongst pregnant women since what we published in 2009.

CHATTERJEE: His study had looked at rates of pregnant women using the drug but at addiction treatment centers. Since then, he says the national attention fell off of methamphetamine because meth use was thought to be on the decline. But he says health care providers working in certain regions of the country never really saw the drugs go away.

TERPLAN: And many have been noting an increase in amphetamine and methamphetamine use in general as well as amongst pregnant women.

CHATTERJEE: One of those providers is Amanda Risser. She runs a program for pregnant women with substance use disorders at the Oregon Health & Science University in Portland.

AMANDA RISSER: Over half of our patients that are being treated for opiate use disorders also have stimulant use disorders, meaning that they're taking methamphetamines regularly.

CHATTERJEE: She says most patients want to stop using drugs when pregnant. But she says it's really hard to quit meth because the lows from the withdrawals are very strong, and there are no medications to treat this kind of substance use disorder.

RISSER: Really the best treatment for that is time and support and keeping someone in a safe environment.

CHATTERJEE: A safe environment where they don't have easy access to drugs, like the inpatient treatment center at her program. But there aren't many such facilities, says Risser, and most health care providers don't know how widespread the problem is. That's where the new study can help, she says.

RISSER: It really helps our community of providers to build, understand and characterize the scope of the problem.

CHATTERJEE: So that more providers can help take care of this growing problem which affects not one but two generations. Rhitu Chatterjee, NPR News.

  原文地址:http://www.tingroom.com/lesson/npr2018/12/457278.html