Having grown up in Waterville, I enjoyed reading the June 2 Central Maine Sunday while in town celebrating my nephew’s high school graduation. As an addiction-focused primary care physician, I read the interview on page D6 with Chuck Hays, CEO of MaineGeneral Medical Center, with interest. I applaud the hospital’s efforts to improve services for individuals with substance use disorders, but there are factual inaccuracies in his responses that I would like to address.

Addiction is a complex disorder that reflects compulsive use of substances despite consequences. Babies are not able to compulsively use substances; they may be dependent at birth, but not “addicted.” The clinically appropriate description for withdrawal symptoms experienced by opioid exposed newborns is neonatal withdrawal. Neonatal withdrawal should be managed with increased cuddling, soothing, swaddling, and sometimes short-term medication. Data have not demonstrated a clear link between in utero opioid exposure and neurodevelopmental outcomes and do not support the notion that babies experiencing neonatal withdrawal are destined to be “social burdens on the future.” Evidence overwhelmingly suggests that for pregnant women with opioid use disorder, outcomes for mom and baby are superior with buprenorphine or methadone, treatments that may lead to neonatal withdrawal.

While I’m certain efforts are well intentioned, I am concerned that the framing provided by Hays serves to further stigmatize both the illness and its treatment, and runs counter to MaineGeneral’s efforts to engage persons with opioid use disorder. While it is true that there are economic challenges facing medicine, I offer that medically accurate, non-stigmatizing language costs nothing and sets the stage to welcome all individuals to our health care system with the dignity and respect they deserve. I encourage everyone to view the words matter pledge developed at Boston Medical Center’s Grayken Center for Addiction and encourage its adoption at MaineGeneral and organizations across Maine.

 

Marc Larochelle, M.D., M.P.H.

Boston Medical Center


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