County looks to reduce substance use during pregnancy
By JORDAN W. PATTERSON
CELORON — Earlier this year, Christine Schuyler said there was “a documented problem” of babies being born with withdrawal symptoms in Chautauqua County. However, the concern remained for babies being born with any prenatal exposure to substances and how they are being screened by health officials.
In November, Dr. Ira Chasnoff, an author and national speaker, returned to the area to discuss how to change that problem. The issue of babies being born cognitively impaired, or developing issues during early childhood, can be through alcohol and marijuana use during pregnancy and not necessarily because of NAS, which is caused by opioid use. For county officials and care providers, identifying those who are using substances during pregnancy is the primary focus.
In the early portion of his presentation, Chasnoff said much of the screening process needs to begin “normalizing the questions.”
For example, Chasnoff said asking open-ended questions like “how many cigarettes did you smoke?” as opposed to close-ended questions like “did you smoke cigarettes?” will allow for more truthful answers. Additionally, he recommended asking women questions about the beginning of their pregnancy with the words “when you knew you were pregnant.”
“What you’ve done is you’ve given the woman permission to say, ‘Oh yeah, in the month before I knew I was pregnant I was smoking like a chimney,'” Chasnoff said.
Schuyler, county Health and Human Services director, and George Borrello, county executive, began the morning lecture at the Chautauqua Harbor Hotel before a day-long schedule of events kicked off.
Chasnoff’s time in Chautauqua County continued to focus on pregnant and parenting women at risk for alcohol, tobacco and illicit drug use and the children who are born affected by prenatal exposure. Much of the beginning portion of his presentation early Monday highlighted how prenatal substance abuse prevention can help avoid the costs of prenatal substance exposure and serious emotional and behavioral problems of early childhood.
Sponsors of the event included the county Department of Health and Human Services, UPMC Chautauqua, Chautauqua Alcohol and Substance Abuse Council, Western Regional Addiction Resource Collaborative, The Resource Center, The Chautauqua Center, STEL, Mental Health Association of Chautauqua County, Chautauqua Tapestry and American Association of University Women.
As a result of Chasnoff’s previous visits, the county developed a new system to manage those affected by prenatal exposure. The system known as SART, which stands for screening, assessment, referral and treatment, was announced after Chasnoff’s visit in June where he provided a leadership institute for local officials.
Leanna Luka-Conley, Adult, Children and Family Services deputy commissioner, said the end goal of Chasnoff’s professional development and the county’s efforts is to have a dedicated center to address the ongoing problem.
Luka-Conley described it as a “place where children ages zero to 5 can go get the observation and assessment that they need.”
“I get to work with a lot of children who have fallen through the gaps of the system who have been over-medicated, layered with diagnoses and end up in the criminal justice system,” she said as to why she and county officials are passionate about the issue.
Currently, Chasnoff is developing a screening system known as “4P’s Plus” for the county. The system has already been implemented in Almeda County, Calif. However, Chautauqua County’s new screening system will be specifically tailored for this area. The plan consists of a seven-question screening exam that is designed to provide an in-depth assessment to quickly identify pregnant women at risk of prenatal use.
Luka-Conley said the goal is to ask pregnant women “the question before the child is born in a very non-threatening way to make it normal.”
She added that such a screening method would be in use within the next few months.
Additionally, the county is using Chasnoff’s “Red Flags for Regulatory Problems” tool to assist parents, providers and court officials to identify children who are having difficulty regulating their own behavior. The system consists of forms to guide individuals on potentially linking a child to necessary services who may have been affected by prenatal exposure.
Chasnoff continues his efforts in the county today with a “Train the Trainer” event offered to local care providers about the Reg Flags system and the “4P’s Plus” plan.