Study Shows Dramatic Rise In Number Of Babies Born Addicted To Opioids
WASHINGTON, D.C. (July 14, 2017) – Findings published in the journal Addiction last month show that the number of newborns with neonatal abstinence syndrome (NAS) has quadrupled in recent years, costing hundreds of million dollars more than it did a decade ago.
The findings showed that the $61 million spent to treat NAS in 2003 escalated to $316 million in 2012. Now a baby is born with NAS about every 25 minutes. Last year, a similar study found an 80% higher rate in rural areas than in urban communities.
Babies with NAS spent more than 290,000 days in the hospital in 2012, compared with less than 68,000 days in 2003. By 2012, researchers found NAS was costing the United States over $300 million in hospital care – up from $61 million in 2003. The findings are based on pediatric discharge records from more than 4000 U.S. hospitals.
In 2012, newborns with NAS stayed in the hospital an average of 16.9 days (compared to 2.1 days for other newborns), costing hospitals an estimated $1.5 billion – from just $732 million in 2009, according to research from Vanderbilt University. The majority of these charges (81%) were paid by state Medicaid programs, reflecting the greater tendency of opiate-abusing mothers to be from lower-income communities.
The condition of babies born having withdrawal symptoms is heartbreaking. Many cannot sleep, cry consistently, and have problems latching on to bottles to eat. The standard treatment for these babies are tiny doses of morphine dripped in the mouth with a syringe to make them comfortable. Over 2-12 weeks, the infant is weaned off of the morphine.
But perhaps the most damaging and widely used method of treatment doctors are beginning to rethink. For years, when babies were born addicted, the child was immediately separated from their mother to recover in NICU. Doctors have found that a process called “rooming-in” has decreased the stay for morphine-treated infants from 17 days down to 12. This can reduce costs from $20,000 to nearly $9,000 per stay.
In rooming-in, the child is left to recover with their mother in her room. When the mother is unavailable, volunteer “cuddlers” intervene to assist and hold the baby.
“You cannot substitute the healing that comes from being close to your mother,” says Amber Mohr, Vertava Health Director of Alumni Relations and Doula. “Babies need to be near their mother.”
In another method called Eat-Sleep-and-Be-Consoled, the parent sleeps with the child in the hospital in low lighting and is nurtured from the beginning – only given morphine when absolutely necessary. This method reduced the proportion of infants treated with morphine from 98% to 14%, as reported in a study published in Pediatrics in May. It also decreased the average stay from 22 days to 6 days.
The Yale study of Eat-Sleep-and-Be-Consoled bypassed the NICU and went straight to parent/child contact. In doing so, the hospital cost dropped from an average of $44,824 to $10,289.
“These innovative efforts to keep mothers with their babies to promote healthy bonding supports the recovery process,” says Vertava Health Vice President of Compliance Maeve O’Neill. “Most of these mothers have trauma and loss histories, so we want to provide services that are compassionate and allow the mother to connect with their newborns to promote resilience in recovery for both the babies and the mothers.”
STATE BY STATE
Through May, 44 mothers giving birth at Reid Health in Wayne County tested positive for opioids. The rate easily outpaces 2016, when 58 mothers tested positive for opioids. Assuming the rate of about nine mothers per month continues more than 100 new mothers at Reid would test positive for opioids this year.
Reid, which previously had tested mothers showing signs of drug use, began universal screens for all expectant mothers late during 2015. A sharp increase in mothers testing positive resulted. During 2015, 54 mothers tested positive. The number was 31 in 2014; 11 in 2013; 15 in 2012; four in 2011 and one in 2010.
Comparing 2015 to 2016 data, the number of babies born with NAS in Knox County decreased by 18%. During the same time period, that number dropped by 12% overall in East Tennessee. This is the first time since 2013 that Knox County has seen a drop in the number of babies born drug dependent. UTMC announced in 2016 it has evidence that detox during pregnancy significantly improves the health of the baby at birth.
According to NPR, 1 in 5 babies born at an Ohio hospital have prenatal opioid exposure, and other hospitals have reported that 1 in 8 newborns are exposed to opioids in the womb.
Opioids are the main culprit for NAS in the state, with 15 of every 1000 infants born dependent on opioids. In 2015 and 2016 the neonatal intensive care unit at Kentucky Children’s Hospital was over capacity almost half the time. Nearly 60 babies in withdrawal had to be diverted to other hospitals because there were infants with even more pressing needs like life support or breathing assistance.
In West Virginia, 33.3 babies per 1000 are born with neonatal abstinence syndrome, according to the Centers for Disease Control, which is the highest rate in the nation. At United Hospital Center, 5% of the 1079 babies born last year had NAS and required treatment. The percentage is higher at J.W. Ruby Memorial Hospital in Morgantown. Their positive screen rate is between 25-30%. There were 5,287 babies born there in 2016.
J.W. Ruby’s numbers are approximately 60 per 1000 births and 35-40 per 1000 births are classified as needing medical treatment. In this hospital, mothers can visit 22 hours out of the day in NICU. At UHC, the volunteer cuddler program has 85 volunteers with another 35 on the waiting list. People are lining up to hold the babies.
In Pennsylvania, there is a state law that makes it a crime to maim or kill an unborn baby, and mothers are being charged and prosecuted. The law establishes 3 exceptions: it can’t be used to prosecute people who perform legal abortions, medical personnel or pregnant women for harming their own unborn children.
When legislators were debating the bill, opponents worried it would lead to the prosecution of pregnant women, but decided it couldn’t because of the protection written in. A recent case charging 7 months pregnant Kasey Dischman in Pittsburgh has the ACLU crying foul.
The number of pregnant women who were hospitalized with conditions related to substance use more than doubled between 2000 and 2015, according to research by the Pennsylvania Health Care Cost Containment Council. By 2015, 1 in 30 women who were hospitalized during pregnancy had a substance-related condition, according to the council.
In July 2015, the Arizona Department of Health Services said the rate of the syndrome has increased by 235% from 2008 and 27% since 2013.