Prevalence of Drug Use in West Virginia Pregnancies

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Prevalence of Drug Use in West Virginia
Pregnancies

• David Chaffin, MD

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Sponsor

• Office of Maternal, Child and Family Health, West
  Virginia Department of Health and Human Resources

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Selena Johe
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Co-Conspirators

• Michael Stitely, MD - WVU
• Byron Calhoun, MD - WVU Charleston
• Stefan Maxwell, MD - Pediatrix Charleston

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We Have a Problem
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I have no clue about what to do about it.
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Background

• Range of reported incidence of drug use in
  pregnancy 10-14
• Dependence on data collection
• Survey
• Samples with consent
• Anonymous sampling

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Rising incidence of NAS
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Participating Hospitals

• Bluefield Regional (BRMC)
• Raleigh General (RGH)
• Thomas Memorial (TMH)
• Charleston Area Medical Ctr (CAMC)
• Cabell Huntington Hospital
• Ruby Memorial Hospital (RMH)
• Wheeling Hospital (WH)
• City Hospital Martinsburg (CH)

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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

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Study Limitations

• No other information
• No account for legal use

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Final Result

• 146 of 759 cord samples positive for drugs or
  alcohol

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759 Samples Drugs Alcohol

• BRMC 50 samples 16
• RGH 83 20
• TMH 59 19
• CAMC 133 22
• CHH 245 18
• RMH 52 17
• WH 65 28
• CH 72 13

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759 Samples Drugs Alcohol

• Drugs Alcohol
• BRMC 14 4
• RGH 19 2
• TMH 10 8
• CAMC 16 8
• CHH 17 1
• RMH 13 4
• WH 12 15
• CH 10 5

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USDTL CordStat

• Drug Class Number
• Amphetamines 1
• Cocaines 0
• Opiates 41
• Cannabinoids 58
• Benzodiazepines 17
• Methadones 14
• Buprenorphine 0
• Alcohol 39

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Distribution of Drugs
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Polysubstance abuse
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CHH Neonates vs Cord Study
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Lessons

• 1 in 5 babies in WV exposed to drugs or alcohol
• Polypharmacy is common
• There are regional distributions of drug use

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We have a problem