New addiction program promotes respect and understanding, not judgment

By Abi Plawman, MD

My first experience with addiction came when I was a little girl, sitting in a church basement with my crayons and coloring book while the adults around me drank coffee, ate cookies and talked about themselves. I didn’t know then that I was attending an Alcoholics Anonymous meeting with my mother.

Years later when I was studying medicine at the University of Washington, I received state-of-the-art training to be a physician. Yet very little of my medical education covered addiction. Even less addressed the complex issue of pregnancy and addiction — nothing about how to manage withdrawal, how to prescribe maintenance medications to ease women off their addiction, or how to address the behavioral and psychological impact of addiction coupled with the emotional and physical intricacies of pregnancy.

One of my first interactions with a pregnant woman who was struggling with addiction came during my residency. Innocently, and what I considered sensitively, I asked one of the moms-to-be how she felt her maintenance drugs were affecting her baby. The doula who was in the room with us confronted me in the hallway afterward, opening my eyes to how that seemingly simple question might trigger a host of negative emotions and threaten the recovery of a young woman trying so valiantly to stay sober for the sake of her child.

I was inspired. I knew that so much more could be done to give these brave women a voice, to be their partner in charting healthier lives for themselves and their children. Today, I am incredibly proud to have helped found a unit at MultiCare Good Samaritan Hospital dedicated to the comprehensive care of pregnant women seeking recovery from addiction — the Substance Treatment and Recovery Training Inpatient Unit, or START.

In both inpatient and outpatient settings, the program addresses the complex and interconnected issues that can threaten sobriety — stigma, domestic violence, mental illness, homelessness, financial insecurity, family and partner issues and much more. We also help these young women prepare to be moms by offering parenting classes and other support.

In addition, the program provides valuable training to health care providers, who learn how to establish positive patient relationships built on respect and understanding rather than judgment and misperceptions.

The fact is, addiction is not about willpower. Addiction literally changes the wiring in your brain. It makes it impossible to “just say no” without the kind of holistic support that our program can provide — especially if drug abuse has been a part of a woman’s life for many years.

For example, imagine a woman who’s living with domestic violence. She seeks solace from a horrific and seemingly hopeless situation by abusing drugs. After years of addiction, she finds herself unexpectedly pregnant, her coping and reasoning skills compromised by the drugs’ effects on her brain and her ongoing violent relationship posing a daunting battle to get clean.

Our program addresses these deep-seated emotional and social issues as well as the physiological approach to detoxing women’s bodies. We assure them that they can have a healthy pregnancy, they can learn to be to be good moms, they can get off drugs and stay off drugs.

A woman I’ll call Maggie is a great example. She came to me about five years ago, pregnant and still actively using drugs, angry and frustrated at the doctors and nurses who she felt had judged and discounted her. We worked together to help her feel more empowered, develop her skills in self-advocacy and address her addiction so she could deliver a healthy baby.

Almost five years later, Maggie returned so I could deliver her second child. Now a successful small business owner with a husband and supportive family, she had remained clean and sober. Her strength and beauty were evident in every smile.  She was articulate and confident. And she was still aware that recovery is a lifetime commitment, a lifetime challenge.

Donate to the START inpatient unit

I am inspired every day by the strength and courage of the women I work with. And I’m inspired by the generous community members who support Good Samaritan’s program for pregnancy and addiction. Together, we can help stem the opioid crisis and give moms and babies a real chance to become stable, contributing members of our community. Donate.

Abigail Plawman, MD, is a family medicine and obstetrics provider who practices at MultiCare East Pierce Family Medicine.