Dr. Craig Towers said he was “inundated” with pregnant patients addicted to opioids.
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he → say → opioids
He published a study with promising results from an unconventional treatment.
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He → publish → treatment
Eight addiction and pregnancy specialists raised concerns about Towers’ research in a letter to his employer, the University of Tennessee.
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specialists → raise → Tennessee
A university audit of the study found numerous problems.
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audit → find → problems
Towers retired, citing health and family reasons, but some clinics still use approaches described in his research.
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clinics → retire → research
These highlights were written by the reporters and editors who worked on this story.
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who → write → story
When Dr. Craig Towers moved to Knoxville, Tennessee, in 2010, the high-risk obstetrician encountered a crisis unlike anything he’d seen.
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he → move → anything
Towers, who had practiced for 25 years in California and Wisconsin, found himself caring for an unusual number of pregnant women addicted to painkillers — and delivering newborns who were suffering withdrawal symptoms.
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who → practice → symptoms
Those babies, born shaking and inconsolable and who required weeks of specialized care, were becoming tragic symbols of the region’s raging opioid epidemic.
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who → bear → epidemic
“We were inundated,” Towers later told the Knoxville News Sentinel.
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Towers → inundate → Sentinel
In those initial years in Tennessee, Towers recognized a need — and a research opportunity.
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Towers → recognize → need
Medical doctrine had long held that a pregnant patient with an opioid addiction could not be safely detoxed because withdrawal could harm the fetus, causing physical stress and even triggering miscarriage.
uncertain
withdrawal → hold → miscarriage
Instead, doctors treated patients with methadone or buprenorphine, which are legal replacement opiates that control cravings and have a lower risk of overdose.
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that → treat → overdose
Those drugs can still cause babies to be born in withdrawal, but doctors reasoned that it was better to treat the newborn for those symptoms than risk the baby’s death.
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it → cause → death
Towers, who was hired to work at the University of Tennessee Medical Center’s clinic for high-risk pregnancies and later joined the medical school faculty, questioned that approach.
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who → hire → approach
He began studying the outcomes of women, most of them his patients, who stopped taking those medications.
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who → begin → medications
He ultimately collected data on more than 300 of them.
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He → collect → them
Towers’ research found that detoxing was much less harmful to the fetus than feared, and it prompted changes to how doctors treat pregnant opioid users.
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doctors → find → users
Across Tennessee — in Johnson City, Jellico and Sevierville — and in Daytona Beach, Florida, clinics followed his lead.
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clinics → follow → lead
The News Sentinel honored him as a “Health Care Hero.”
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Sentinel → honor → Hero
CNN’s chief medical correspondent, Dr. Sanjay Gupta, interviewed him about his work and described babies born without withdrawal symptoms as “miracles.”
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correspondent → interview → miracles
In 2019, the medical school granted a request for additional funding for Towers’ work, praising “his many research efforts and leadership that has resulted in national recognition.”
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that → grant → recognition
In the months before he published what would be a groundbreaking study, he described his findings at a university science forum, saying: “I think it’s going to revolutionize what we do.”
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we → publish → what
And then in 2020, soon after the study was published, Towers abruptly stepped back from his research.
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Towers → publish → research
The study immediately caught the attention of specialists in addiction treatment.
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study → catch → treatment
Some of them wondered how the results could be true.
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results → wonder → them
The study, the largest of its kind, enlisted 230 participants, 121 of whom took a daily dose of a drug called naltrexone, which, unlike methadone or buprenorphine, is not an opioid; instead it discourages using by blocking the high.
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it → enlist → high
Naltrexone was effective in keeping most patients off of opiates, the study found.
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study → keep → opiates
But in many other major studies, naltrexone had shown lackluster results.
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naltrexone → show → results
Rates of relapse among nonpregnant patients averaged 72%, according to a systematic review of 13 studies.
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Rates → average → studies
Eight specialists in the fields of addiction and pregnancy started sharing concerns with one another about Towers’ study and then drafted a letter to the University of Tennessee.
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specialists → share → Tennessee
Two of them agreed to speak with ProPublica (the others asked not to be identified).
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others → agree → ProPublica
One was Dr. Mishka Terplan, a practicing OB-GYN board-certified in addiction medicine who’d served on several committees to develop federal and professional guidelines for treating opioid use during pregnancy.
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who → practice → pregnancy
“Dr Towers’ work has been impactful, especially in TN,” Terplan wrote to the university in July 2020, “and I am concerned that each day the article(s) is out there, potential harm to a vulnerable population accumulates through both ethically suspect clinical care and consequently misguided public health.
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harm → write → care
By that time, a university audit had uncovered major problems with Towers’ research.
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audit → uncover → research
The audit found that Towers failed to get university approval for the study, that he provided “inaccurate and/or unverifiable, contradictory source documentation” for a component of the study and that he did not provide research databases or data analysis as requested.
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he → find → databases
Auditors also were unable to determine the extent to which he protected confidential patient health information.
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he → determine → information
For three years, the journal did nothing to publicly address those concerns.
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journal → do → concerns
When the journal did act, in 2023, it published a 78-word correction stating that the study had been improperly listed as a “prospective,” a rigorous type of research that follows patients in real time.
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that → act → time
ProPublica shared Towers’ study, the university’s audit and the journal’s correction with five experts on research ethics and substance abuse during pregnancy.
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ProPublica → share → pregnancy
…and 104 more, not listed.
