No state has been as profoundly affected by the epidemic of substance use and misuse, especially opioid use, as West Virginia. For the last several years, the state’s rate of overdose deaths has been the highest per capita in the country and over double the national rate.
Substance use disorder knows no boundaries and the epidemic has not spared West Virginia’s expectant mothers and persons of reproductive age. Substance use in pregnancy (including the use of tobacco, alcohol, prescription, and illicit drugs) has long been identified by West Virginia healthcare professionals as a major factor contributing to poor health outcomes for mothers and babies. Fourteen percent of West Virginia infants are born with intrauterine substance exposure. Fifty per 1000 babies born in the state are diagnosed with neonatal abstinence syndrome (NAS). This is significantly higher than the national rate of 7 per 1000 births.
The West Virginia Perinatal Partnership established the Substance use During Pregnancy Advisory Council in 2006. Since that time, the Partnership has facilitated trainings on a number of topics, including screening for substance use during pregnancy, medication assisted treatment (MAT), addressing stigma, breastfeeding for substance-exposed newborns, therapeutic handling of substance-exposed infants, assessment of neonatal withdrawal, effects of substances on the neonate, and clinical guidance on treating pregnant patients with opioid use disorder. Additionally, the Partnership established the Drug Free Moms and Babies Program in 2012. The program, which has expanded from a pilot with four sites to a total of 21 currently in operation or development, has consistently seen decreases in illicit substance use and improved birth outcomes among program participants.