Doc Travels for Abortion Training; Families Wrongly Separated; Jail Opioid Success

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Doc Travels for Abortion Training

Politico followed an internal medicine and pediatrics resident from an abortion-ban state as she traveled out of state for abortion training. Like other doctors — mostly obstetrics and gynecology residents who can no longer get the experience in their states — she turned to an informal network of advocates and medical professionals who help trainees secure temporary stints at hospitals or clinics that offer abortion.

Though her program had given her permission to leave for a month, the resident had spent 2 years looking for a clinic that could take her on, finally landing at Delaware Planned Parenthood through the Midwest Access Project. She cobbled together the funds to travel thousands of miles and stay in an extended-stay motel while she traveled miles to clinics to learn the procedure, while still managing her own patients and studying for board exams.

She gained enough experience to perform an abortion if nothing went wrong, but the resident felt she would still be unprepared to handle complications that require skills developed over many procedures. Still, she told Politico she was surprised that abortion procedures seemed less technical than others she had performed, and wondered why more physicians don’t dispense abortion pills — an even simpler process.

While specialty does not require abortion training, she said it “felt like a moral imperative.” She’d participated in protests against the ban in her state, but she said she “realized there was no reason why I couldn’t actually be at the forefront of this and actually perform abortions myself. And I might have a much more significant impact doing that, because so few residents, so few medical personnel, are able to do that specific role.”

Babies Taken From Mothers After False-Positive Drug Tests

Mothers whose hospital drug urine screens come up positive are sometimes separated from their newborns erroneously, the Marshall Project reported. One mother ate a Costco salad with poppy seed dressing before giving birth, and her drug test was positive for opiates. Another was prescribed lisdexamfetamine (Vyvanse) for her ADHD, and the drug test said she had taken meth.

Many compounds similar to those in illegal drugs are also found in everything from poppy seed bagels to over-the-counter nasal inhalers to common medications like ranitidine (Zantac) and sertraline (Zoloft). Though hospital testing practices and rules about reporting vary, infants can be taken away based on just one positive urine test, according to the Marshall Project.

Gwen McMillin, PhD, of the University of Utah School of Medicine and medical director of a drug-testing lab, said the inexpensive urine drug tests used by many hospitals cast a wide net, and should be confirmed with a more advanced test before the hospital reports a mother to child protective services.

Yet the urine drug screens are cheap and equipment to confirm their results is expensive, sometimes prohibitively so, according to the Marshall Project. Hospitals and staff might not be aware of confirmation tests, or have to wait days for results from an outside testing service. Instead of risking the newborn’s safety and their own legal status by releasing them to a mother who might be using drugs, they often err on the side of caution, the Marshall Project found.

Monthly Shot Helped Prisoners With Opioid Addiction

In Maine, a pilot project provided prisoners addicted to opioids with an extended-release shot of buprenorphine (Sublocade) that would curb cravings for about a month, the New York Times reported. Doing this increased the odds they would keep up addiction treatment after release, and helped ease their transition back into society without symptoms of withdrawal.

Those who got the shot were 3 times as likely to continue treatment compared with prisoners at another rural Maine jail who got daily sublingual buprenorphine. Four of those receiving a daily sublingual drug, which ended when they were released, died within 3 months of leaving jail, three from overdose and one due to suicide. None of those who received the injection died.

Addiction programs in jail — if they are offered to begin with — often opt for cheaper daily treatments, which can be used to treat more prisoners. But it can be difficult to dispense these at precise 24-hour intervals, and could be taken to trade or sell later. The injection, given by clinicians, sidesteps these problems.

A buprenorphine injection, however, costs around $2,000 compared to the $90 to $360 price tag for a month’s supply of sublingual buprenorphine. Medicaid doesn’t typically cover prison healthcare, and the Maine jail was able to provide the injections with grants and funds from the recent national opioid litigation, meaning it will likely run out.