In 2012, doctors and nurses at an OB-GYN clinic in rural Athens County, Ohio, started observing an uptick in pregnant patients addicted to opioids. The clinic's practice manager, Pam Born, who had lived in the county since 1985, had witnessed plenty of medical problems in her 32 years as a registered nurse, but this was different.
The proportion of babies across rural America born dependent on opioids has soared in the past decade or so. This condition, neonatal abstinence syndrome, causes tremors, vomiting and other withdrawal symptoms, and heightens the risk of health complications. It is also expensive: hospital costs for a baby born with the condition average $66,700, compared with $3,500 for babies without it.
Many providers were trying to treat neonatal abstinence syndrome in babies, Born noticed, but fewer sought to prevent it by managing addiction during pregnancy. So she set out to do just that, enlisting help from several others at the clinic, OhioHealth O'Bleness Hospital Athens Medical Associates Obstetrics and Gynecology.
They started small. Born found a local provider that could offer medication-assisted treatment for opioid addiction, and she reached out to a team of nurse navigators at Ohio University.
At first, these nurse navigators worked to simply connect patients with addiction services because the priorities were to provide prenatal care and medication-assisted treatment to wean patients off opioids.