The opioid epidemic is increasingly touching the tiniest of lives, according to new research, and doctors who treat those affected say the impact is heartbreaking.
More babies of mothers addicted to opioids are being born dependent on the drugs themselves, driven by a sharp surge in rural areas of the country. The newborns come into the world suffering from what medical experts call neonatal abstinence syndrome (NAS), a term for the constellation of health problems a baby experiences as it’s withdrawing from exposure to narcotics inside its mother’s womb.
The number of cases neonatal abstinence syndrome and maternal opioid use increased five-fold in the United States between 2000 and 2012, according to a research letter in JAMA Pediatrics written by scientists from five leading pediatric hospitals in the U.S.
Dr. Terrie Inder, chair of pediatric newborn medicine at Brigham and Women’s Hospital in Boston, told CBS that the data highlights a major public health threat.
“This has exploded. We are dealing with an explosion of a national health issue,” said Inder, who was not involved in the research.
For the study, the scientists analyzed information from a national database that tracked births and deliveries between 2004 and 2013. Hospital codes enabled them to determine the number of babies born with NAS and the number of mothers on opioids.
While the phenomenon is happening in rural and urban areas alike, rates are climbing at a much faster rate in rural and small-town America than in cities, they wrote. The incidence of babies with NAS increased from 1.2 to 7.5 per 1,000 hospital births among rural infants and from 1.4 to 4.8 per 1,000 hospital births in urban infants.
Framed as percentages, about 21 percent of newborns with withdrawal symptoms in 2012-2013 were from rural counties, up from 13 percent in 2003-2004.
Ten years ago, the condition was predominantly found in disadvantaged communities, often in urban settings and linked to illicit drug use, said Inder. Now, it’s touching women and newborns from all economic brackets and geographic areas.
“The increase that you see in the JAMA data relates to a more widespread use of pain medications across all social classes. Now, we are equally likely to see a mother from a middle class or upper middle class background who was unaware that taking these medicines could lead to that type of consequence for her baby,” Inder said.
Neonatal specialists are in “survival mode” when it comes to caring for these babies, said Inder, who would like to see a national plan set in place with improved communication between neonatal specialists and obstetricians, “to help us to deal with this escalation, this problem we didn’t anticipate was coming.”
Babies with NAS and their mothers are separated after birth so that the newborns can be treated for withdrawal. On average, the babies stay 24 days in the hospital.
“The babies, they are really unsettled, they really suffer, just like adults do when they withdraw from narcotics. The babies are very irritable and sometimes have high heart rates, sweating, flushing, diarrhea. They cry a lot. Often they need someone to really hold and cuddle and nurture them and support them,” Inder said.
“Those crucial weeks of feeding, bonding and caring are interrupted. It’s very impacting for both the mother and the baby,” she added.
The mothers suffer, too, some unaware that the painkillers she’s been taking could cause addiction in her baby.
“These are mothers that have gotten opiate drugs prescribed by a prescriber. You can imagine the anxiety, guilt, and all those emotions that really affect attachment, the way a mother and a baby should be bonding,” Inder said.
The study authors called for more funding to deal with the painkiller crisis in rural areas.
“This geographic disparity highlights the urgent need for policymakers to appropriate funding for clinicians and programs that could improve access to opioid prevention and treatment services for rural women and children,” they wrote.
Dr. Siobhan Dolan, medical advisor to the March of Dimes and an OB/GYN at Montefiore Medical Center in New York City, said obstetricians — particularly those in rural areas — need to stop stigmatizing painkiller addiction and treat it as a medical condition, identifying moms and babies at risk.
Dolan said she’s heard women talk about their personal experiences with NAS at conferences.
“There’s a lot of blame and shame. We need to take it out of ‘blame and shame’ and just medicalize it. We can’t stick our heads in the sand anymore,” Dolan told CBS News.