Mothers face challenges of recovery

Crystal Tetro started using opioids to ease the pain she felt after two failed knee surgeries in 2002. The opioids were coupled with Alprazolam, which she was taking for anxiety brought on by relationship difficulties.

As the years went on, she continued taking the drugs, and she was prone to seizures whenever she stopped. She said she broke her nose three times because she shook so violently.

Alprazolam belongs to the class of drugs called benzodiazapines, whose prolonged use can, like opiod use, result in physical dependency.

Last year, Nassau County had 177 reported deaths from overdoses, including eight in Valley Stream. Six Valley Stream residents died from overdoses in 2016.

When Tetro got pregnant in 2016, Tetro knew she had to seek help. She went to Zucker Hillside Hospital in Queens, which houses the Addiction and Recovery Services program, treating 400 recovering addicts from Queens and Nassau. “I was 100 percent afraid,” Tetro, a 35-year-old Hicksville resident, said. “I didn’t think I was that bad, and I didn’t realize how bad I was until I came here and got the help that I needed.”

The Addiction and Recovery Services program provides the slow-acting opiate methadone to patients with opioid addiction. Methadone does not give patients the same high as other opioids when administered in limited dosages, nor do they usually suffer the same acute withdrawal symptoms as they are weaned from the drug, according to program director Patricia Hincken. She said that with the medication, patients can have successful careers and relationships. She added that the program is especially helpful for pregnant women, even though they may be hesitant to take any medication.

“They’re afraid their children will have withdrawal, and sometimes they do,” Hincken said. “But it’s easily treated, and the children do very well.”

To treat a baby with neonatal abstinence syndrome, or opioid dependency, doctors have to give both mother and baby a decreasing amount of another opiate, buprenorphine, which Joseph Marino, the medical director of Long Island Jewish Valley Stream, said decreases a baby’s length of stay in a hospital.

The six babies out of every 1,000 live births that are opioid-dependent can be identified by their shrill cries, diarrhea and seizures, Marino said. “They have pretty similar significant symptoms of withdrawal that you see in adults,” he said, adding that in some cases the babies might have cognitive issues or a lazy eye syndrome. No longitudinal studies have been completed about the long-term effects of babies born with opioid dependency.

When mothers stop taking opioids cold turkey while pregnant, they can miscarry, or their babies can be born premature, which can cause long-term neurological problems. “We would much rather have a mom that is using opiates go to full term and then treat the neonatal abstinence syndrome, because that is a treatable syndrome,” Marino said.

Substances such as opioids cause the brain to overproduce the neurotransmitter dopamine that is associated with feelings of pleasure, according to the Hazelton Betty Ford Foundation website. When substances are withheld, the brain continues to overproduce dopamine, causing physical symptoms of withdrawal and craving. Methadone and buprenorphine act as opioid “agonists,” blocking or reducing the effects of excess dopamine.

Tetro continued to take methadone while she was pregnant with her son Vincent, who was born without any withdrawal symptoms, she said. In fact, he was eating more than any other baby in the neonatal intensive care unit, she added.

Now, Vincent is an energetic 19-month-old, who was running around Zucker Hillside Hospital last week, playing with anything available.

Meanwhile, Tetro continues to take 45 milligrams of methadone, a drug she may be on for life, according to Hincken. “It can be just like insulin for a diabetic,” she said. “It can be a life-long medication for some people.”

In fact, when patients stop using methadone, they may be at higher risk of overdoses, Hincken said. “One of the things that people struggle with . . . [is that] people will say to them, ‘When are you going to get off?’ and people who go off of the medication have more than double the risk of fatal overdose, because methadone, buprenorphine and vivitrol protect you from an overdose,” she said.

Another mother, who asked to be referred to simply as Danielle to protect her identity, said that as part of the program, she was put on a low dose of methadone, and whenever she started to feel uncomfortable, her advisers in the program would increase her dosage.

She started to go to the clinic after using heroin for about nine years, because she discovered she was pregnant with a daughter. “I didn’t want to continue using, knowing I was pregnant,” she said. “It took me a little bit to stop using, and the methadone in the program really helped a lot with that.”

Danielle, who is originally from Valley Stream and now lives in West Hempstead, goes to Zucker Hillside twice a week to pick up her methadone and to speak to her counselor. Her daughter, now 2 years old, is doing well, she said. She had another daughter only a few weeks ago. “If I would have kept using, I wouldn’t have my first daughter with me,” she said. “So I am very grateful for the program for helping me stay clean.”

She encouraged other mothers with opioid addictions to try the program. “The best thing to do is to get help,” Danielle said. “The longer you wait, the worse the situation can get, and coming to get help could only make anything better.”