Santana sees her baby twice a week, for an hour at a time. Celebrating the milestone of 30 days of sobriety, she says her 8-month-old daughter motivates her to build a brighter future.
The 32-year-old mother of three, who declined to provide her last name when interviewed, lives in a Las Vegas homeless shelter. A program at Henderson-based Roseman University provides her with transportation to visit her baby in foster care, and with general help getting back on her feet while struggling with addiction and working toward recovery.
Santana says she has made several efforts to stop using methamphetamine and hopes to get custody back. But, having developed her addiction as a young adult and been homeless on-and-off since, she knows there are several obstacles she must still overcome.
“When I had my babies, I didn’t know how to live like a regular person,” says Santana, who’s also mother to twins who live with relatives in California. “I didn’t have work, I didn’t have documents,” she says. “Nobody was helping me. I felt like I was just getting the runaround. Having structure and a job just was not for me.”
Many people with addiction issues encounter barriers that can make it seem impossible to break the cycle, leaving little hope for successful recoveries and driving them back to their old habits.
The pandemic didn’t make recovery any easier. According to reports from UNR-based Overdose Data to Action, opioid overdose deaths among Nevada residents increased 76% from 2019 to 2020, while emergency-room visits increased 15% for drug overdoses and 41% for opioid overdoses in 2020. And unintentional overdoses involving any drug were the leading cause of pregnancy-related deaths in 2020, accounting for nearly 25% during that span.
With the opioid epidemic raging in Nevada and across the country, providers are starting to zero in on barriers to recovery. Focus has shifted to social determinants of health that are beyond the patient’s control—housing, transportation, food, financial stability and childcare—and have been exacerbated by the COVID-19 pandemic. In January, Nevada Attorney General Aaron Ford announced that the state would receive $285.2 million from two legal settlements and a federal grant, which will go toward programs that help mitigate the opioid epidemic.
Empowered at Roseman, which helps pregnant and postnatal moms with opioid and stimulant use disorders, is one such program. Executive Director Dr. Andria Peterson says it emphasizes not just recovery but also supporting patients through stabilization and resiliency.
A pharmacist for 12 years in a local newborn intensive care unit, Peterson says she noticed “huge influxes” of infants being treated for neonatal abstinence syndrome, or withdrawal, around 2015. Those babies and moms would benefit from a support system to connect them with resources for immediate and long-term needs, she determined. Thus, Empowered was born. Since its launch in 2018, the grant-funded program has helped more than 275 women, with 30 women currently in its care.
Through Empowered, mothers like Santana can receive assistance navigating resources in the community, along with individual and group therapy and peer support. There’s also a household-centered home visitation program that concentrates on the entire household to address social determinants to health that can impact recovery. Peterson says the program meets clients somewhere convenient for them—the Empowered office, an obstetrician’s office, treatment centers, the library, their homes or homeless shelters.
Santana says the Empowered’s supportive, non-judgmental approach has made a big difference as she continues on her path to stability. After moving to Las Vegas one year ago, she enrolled in a local transitional treatment program, gave birth to her daughter, graduated from the residential program and began hunting for a job.
But the stress of being a new mom, obtaining identification and employment documents and adjusting to a new lifestyle triggered a relapse, she says. Four months after she gave birth, family services took her baby daughter.
“Being an addict, I have a lot of wreckage in my past. There’s not many people that care to help me out, in my situation,” Santana says, adding that she wasn’t allowed to see her daughter due to COVID-related visitation restrictions. “[Empowered] helped me get somewhere to sleep … I was having a hard time about the guilt of another child born into the system because of me. I just was really appreciative of that.”
Now that pandemic restrictions have lessened, she says, she sees her baby twice a week. She says it feels good to have help getting things done, like getting over to the Social Security office to acquire vital paperwork.
Peterson stresses the importance of providing support during and after pregnancy, when women are prone to postpartum depression and other stressors that can trigger relapses and sometimes deadly overdoses.
“The further out that you get postpartum, the higher the risk, because then it’s compounded by things like postpartum depression,” she says. “You’ll have somebody who had a substance use disorder … if they relapse and use the same amount they were using previously … then they’re at high risk for overdose.”
To educate providers on best protocols for treating pregnant and postpartum women with addictions, Peterson has worked with the Nevada Reproductive Health Network to get obstetricians and hospital networks on the same page for implementing requirements for screening, initiating intervention and connecting patients with resources.
With some help, Santana can keep working toward her goal—a stable life for her and all three children under one roof. “I just have this dream of me getting somewhere to stay like an apartment, having a car and having my life together,” Santana says. “Hopefully, in a year, my baby can be with me. And my family [will be able to] see that I’m doing good. … Then maybe, they’ll let [my twins] come over, because I don’t want them to be raised separately. I want them to be raised together.”
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