Neonatal Abstinence Syndrome Is on the Rise

A Closer Look at Neonatal Abstinence Syndrome

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According to the National Institute on Drug Abuse, every 25 minutes a baby is born suffering from opioid withdrawal. Opioid withdrawal in babies is a national health crisis that affects families, babies, and taxpayers.

What Is Neonatal Abstinence Syndrome?

Opioid withdrawal occurs when a baby is born already addicted to drugs because of a mother's drug use during pregnancy. Once the baby is born, he or she no longer is receiving the drugs through the mother, so the baby goes through physical withdrawal symptoms.

This is called neonatal abstinence syndrome or NAS.

A mother can expose her unborn baby to opiate drugs, which include heroin, codeine, oxycodone or Oxycontin, Vicodin, methadone and buprenorphine, throughout her pregnancy in various forms.

Unfortunately, NAS has actually been increasing over the years, up five times the number of babies in 2012 as compared to 2000, when 21,732 babies were born with the syndrome. Then, in 2015, the number of drug-addicted babies rose again. In Ohio, for example, there were 159 babies born addicted to drugs per every 10,000 live births. That number was eight times higher than in in 2005.

The rates of NAS varies by state, but it's also known that mothers in low-income communities and mothers who have unintended pregnancies have higher rates of opioid use during their pregnancies. Some women continue to use opioids before realizing they are pregnant and are unable to stop because of their addiction.

What Complications Does Neonatal Abstinence Syndrome Cause?

NAS has long-term consequences for both families, babies, and society. Babies who are born with NAS are more likely to have physical complications such as low birthweight and breathing problems requiring immediate care. They are also more likely to be born preterm (before 37 weeks), which causes complications on its own too.

The symptoms of NAS include irritability, excessive or high-pitched crying, sleep difficulties, hyperactive reflexes, tremors, poor weight gain, vomiting, and loose stools. The immediate effects of withdrawal also cause sweating, dehydration, fever, tachypnea (rapid breathing), and spotty and blotchy skin, as their body fights against the lack of drugs in their system. Typically, the severe symptoms of NAS appear between 24 and 48 hours after birth.

Long-term, NAS babies are also more likely to have medical, behavioral, and developmental problems as well. Infants who have had exposure to opiates in the womb are more likely to experience poor vision, decreased cognitive and motor development, hyperactivity, attention deficit disorder, and even low memory. If the baby was exposed to methadone use, a common opiate, they are also likely to develop problems in the middle ear, which can lead to hearing loss, which then affects language development.

Because NAS babies also have more health complications and need extra medical care, they also stay in the hospital longer than the average baby, which drives up the cost of their care. For example, in 2012, NAS newborns stayed an average of 16.9 days versus the typical 2.1 days for healthy newborns.

The cost for caring for just one baby with NAS costs an average of $66,700, while the care of healthy newborns costs about $3,500. The majority of the cost of these babies' care was paid by state Medicaid programs, with a total estimated bill of $1.5 billion dollars.

Treatment for NAS

To treat babies with NAS, doctors actually have to give them a small, controlled amount of opioids to keep their tiny bodies from having too many complications from the withdrawals. This allows the medical staff to wean them slowly off the drugs that they have become accustomed to.

They also make sure to keep the babies in rooms with soft lighting and quiet sounds so they aren't over-stimulated as they rest and heal.

The full treatment for NAS can take up to 6 weeks.

The Takeaway

Opioid use during pregnancy is a severe problem that continues to affect many newborns across the United States. Opioid abuse during pregnancy can lead to a baby experiencing neonatal abstinence syndrome and has many costly immediate and long-term health complications.

Unfortunately, NAS is hard to overcome because women who are addicted to drugs during their pregnancy find it difficult to seek help. Although working with a doctor might help them find a treatment plan to wean off the drugs, they might also be afraid of losing custody of their baby or getting prosecuted for using drugs.

Sources:

Barfield, W., (2016, August). The problem with neonatal abstinence syndrome. Centers for Disease Control and Prevention. https://www.cdc.gov/cdcgrandrounds/pdf/archives/2016/august2016.pdf

National Institute on Drug Abuse. (2015, September). Dramatic increases in maternal opioid use and neonatal abstinence syndrome. https://www.drugabuse.gov/related-topics/trends-statistics/infographics/dramatic-increases-in-maternal-opioid-use-neonatal-abstinence-syndrome

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