A lot of misinformation and stigma surrounds the use of methadone as treatment for opiate addiction, but the problems are even more apparent when the patient in the treatment program is pregnant. Methadone, the most common treatment for opiate addiction in the United States, is a synthetic opioid that can ease withdrawal symptoms for dependent persons without creating a “high.” Typically, patients at methadone clinics will visit at least once a day to receive a prescribed dose of methadone, often in liquid form. Over time, patients may be allowed to take doses home and many are eventually weaned off the treatment. The goal of methadone treatment for pregnant women is to help them avoid the negative consequences of illicit drug use, including overdose and withdrawal, both of which can jeopardize the pregnancy. Without having to worry about illicit drug use, a woman is in a better position to engage in prenatal care.
Katie Clark, a research assistant at the Yale School of Public Health, began to notice the stigma surrounding pregnant women through her work at an opiate treatment center. “While I was working as a counselor I started to tailor my caseload to work with predominantly pregnant and parenting women. They shared with me that they were looked down upon, by other people in their lives and people in treatment, because they were in methadone treatment during pregnancy. Even though medically, they were doing the best thing for themselves and their pregnancies, this was not the message they were getting from those around them.”
As Katie explains, even within hospitals and drug treatment programs, pregnant women are often judged for methadone use. “People see an infant in withdrawal and start making comments like ‘how could you do this to your baby.’ In one case, a social worker tried to charge a mother with child abuse because she was in treatment during her pregnancy.”
Just as women are cautioned against alcohol use while pregnant, many people assume that women should immediately stop using opiates as well, but actually, quitting opiates can be very dangerous. “Opiate withdrawal can jeopardize the health of the baby and the mother and even cause miscarriages,” says Katie. “Methadone has been used as treatment for pregnant women for 30 years to keep mothers and babies stable during pregnancy.”
In her work, Katie also challenges that myth that babies are “born addicted” to opiates. “There is no such thing as a baby born addicted to opiates, but babies with opiate-dependent mothers can show withdrawal symptoms once they are born, such as diarrhea, stiffness, or not eating or sleeping well,” says Katie. “A baby experiencing withdrawal is usually kept at the hospital and, if clinically indicated, put on medicine to make them comfortable. Doctors will keep the babies in the hospital until they are weaned off the medicine.”
Katie created a website, www.methadoneandpregnancy.com to answer questions about methadone, pregnancy and opiate addiction. “Ideally I’d want more people to be trained on how to work with pregnant women in methadone treatment. There is a lot of stigma and misunderstanding about this population and that can lead to poor health outcomes. If we can educate people more, it will lead to better health outcomes for mothers and infants.”
Voices from the Harbor is an audio documentary Katie created about women’s experiences with pregnancy, opiate addiction and methadone treatment. In the documentary, four women speak of their experiences with addiction, pregnancy, stigma and recovery. Visit http://vimeo.com/41050651 to hear their powerful stories.
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About this project
I’m a one-woman film crew and this project is very dear to my heart. Please help me continue to tell this important human rights story.
Also, April is National Sexual Assault Awareness Month.
In this documentary, 11 North Carolinians, current and former sex workers and/or advocates, share their experience with the common goal of reducing violence perpetrated against sex workers. Sex workers often do not report crimes committed against them because they do not want to incriminate themselves; criminalization of sex work protects the perpetrators. What types of violence do sex workers experience? What can sex workers do to avoid violence? What else can be done to make sex work safer?
This first video was created in six weeks in partnership with the North Carolina Harm Reduction Coalition. Funding has run out, however.
Help me create new footage showing these and other current and former sex workers in their daily lives, facing the challenges they discuss in the interviews, and to continue to edit extant footage to address sub-topics such as the philosophy behind decriminalization of sex work, using communication to avoid violence, condom use for sex workers, and transitioning out of sex work if one chooses to do so.
I recently received feedback on this work from MediaStorm’s Eric Maierson, which, when implemented, will greatly help to finesse the project. I also recently began doing volunteer work for the Duke Center for Documentary Studies, which will put me in touch with master filmmakers who can give me further direction on this work.