Experthelps City Reduce Babydeaths Re-Focus on Substance Abuse, Pediatrician Says

Article excerpt

Byline: Marcia Mattson, Times-Union staff writer

A Chicago pediatrician whose research brought the plight of cocaine-addicted newborns to national attention in the 1980s now is advising Jacksonville health leaders on how to reduce the high infant mortality rate in poorer parts of the city.

The federal Healthy Start program sent Ira Chasnoff, a researcher with the Children's Research Triangle in Chicago, to Jacksonville last week after Carol Brady, executive director of the Healthy Start Coalition of Northeast Florida, asked for guidance in tackling the city's problem.

Chasnoff has been meeting with officials to help plan a strategy.

"In almost every case of child death, substance abuse is involved in some way," Chasnoff said in an interview during his visit.

He said cocaine use among pregnant women declined in the 1990s, but has been replaced by other drugs. Women who abuse drugs tend to use several, such as cocaine, marijuana, alcohol and tobacco, Chasnoff said.

He is advocating that Jacksonville and state agencies set up a system so one caseworker coordinates all services funded by those agencies to a substance-abusing woman and her family, to make sure the family gets what it needs to thrive.

Such coordination, which Brady said currently does not exist in Jacksonville, can save communities $1 million to $2 million a year just in the cost of providing care in a neonatal intensive care unit, Chasnoff said.

Now, both he and Brady said one agency may not be aware that another agency is working with the same family. That wastes money that could be spent on services and makes it tougher to determine whether services like substance abuse treatment are falling through the cracks.

For example, several Jacksonville agencies recently learned they all had employees providing various health and social services to the same 23-year-old woman and her family. The woman is a substance abuser who is in her 10th pregnancy. Only four of those pregnancies survived. Those children are living with their grandmother. Despite all the agencies working with the family, the woman was not receiving any substance abuse treatment.

At least agencies are aware of her substance abuse problem.

As the cocaine problem decreased over the years, too many private and public clinics stopped asking women questions before or during their pregnancy that would alert medical workers to substance abuse, Brady said. Her organization last year issued guidelines doctors could use to learn which patients are abusing drugs or alcohol. …