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Wash U’s Pregnancy CARE Clinic Sees Increase In Polysubstance Abuse

Washington University's Clinic for Acceptance, Recovery and Empowerment (CARE) is one of two clinics in St. Louis that provides care for pregnant women facing the challenges of an opioid use disorder.
DAVID KOVALUK | ST. LOUIS PUBLIC RADIO
Washington University's Clinic for Acceptance, Recovery and Empowerment is one of two clinics in St. Louis that provides care for pregnant women facing the challenges of an opioid use disorder.

Washington University’s Clinic for Acceptance, Recovery and Empowerment treats women who become pregnant while dealing with an opioid use disorder. It provides prenatal care, substance abuse treatment and extended postpartum support. 

On Tuesday’s St. Louis on the Air, the clinic’s medical director said there is a high demand for these services in the St. Louis region.

“We started as a half-a-day-a-week clinic, and volume has expanded so much that we are opening a second half-day in addition to our original,” said Dr. Jeannie Kelly. “We have seen a pretty high number [of clients] in our clinic.”

Lately, they are seeing more patients who are addicted to multiple types of drugs, otherwise known as polysubstance abuse. About a third of the clinic’s patients have some sort of concurrent polysubstance use going on, and there’s been a rise in patients with addictions to meth.

Dr. Jeannie Kelly is a high-risk obstetrician and medical director of the Clinic for Acceptance Recovery and Empowerment.
Credit Washington University School of Medicine in St. Louis
Dr. Jeannie Kelly is a high-risk obstetrician and medical director of the Clinic for Acceptance Recovery and Empowerment.

“We are seeing quite a high uptick in methamphetamine use. It’s back here in Missouri and St. Louis,” Kelly said. “Unfortunately, there’s not a medication like buprenorphine or methadone (medications used to treat opioid use disorder) that works for meth misuse, and that’s tough … It's a real challenge for us right now.”

Kelly emphasized that there is a reason for the increase in drug addiction in the area, and that vulnerable populations use drugs because they are not getting satisfaction in other areas of their lives.

“They use it because it feels good. It’s this huge dopamine release, and that’s the same feeling you get when your kids hug you or when your boss tells you you did a really awesome job,” she said. “When you don’t have any of that in your life because things are bad, you’re always going to be looking for sources of it. … We’re all in need of some extra dopamine, and unless we can provide it in other ways with meaningful relationships and stable jobs, this is always going to be a problem.”

Despite the uphill battle, the CARE clinic is doing well. 

“Our follow-up rate is over 80% right now for our moms into that postpartum period, so we think we have a pretty successful program going,” Kelly said. “Watching a mom who has been, when she comes in, in dire straights, walk into our clinic with her baby who is healthy — who is under her custody, and the both of them are in a really good place in both of their lives — there’s nothing more rewarding than that. It keeps us going.”

Hear Sarah Fenske’s conversation with Kelly:

St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill, Lara Hamdan and Joshua Phelps. The engineer is Aaron Doerr, and production assistance is provided by Charlie McDonald.

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Emily is the senior producer for "St. Louis on the Air" at St. Louis Public Radio.