The United States saw crack cocaine addiction reach epidemic rates in the 1980s; among those dependent were newborns whose mothers abused crack during their pregnancy. Three decades later, the United States faces a new drug epidemic; and once again, babies reach the world in withdrawal.
Prescription opioid analgesics are America’s growing D.O.C.; by 2007, the number of pills prescribed had risen 600% in 10 years. Opioid analgesics are derived from the opium poppy (used as a pain reliever for over 6,000 years) and include Hydrocodone (Vicodin, Norco) and Oxycodone (Percocet, OxyContin) among others. In the United States today, a baby is born with opioid withdrawal around every hour, according to an article published in the Journal of the American Medical Association.
Neonatal Abstinence Syndrome afflicts the majority of babies exposed to chronic opioid use in utero. Symptoms include sleep problems, difficulty feeding and/or eating, and low birth weight, which has been found to play a role in developmental issues. To help alleviate withdrawal, hospitals may stabilize opioid levels in affected newborns using morphine (sometimes used in conjunction with phenobarbital) or methadone.
Many pregnant women attempt to quit opioids cold turkey, unaware that this will likely do their baby more harm than good. This abrupt course of action can damage the fetus, and also increases the likelihood of relapse. Doctors generally advise these patients to maintain a controlled dose of opioids. In the past, this meant a methadone regimen, but patients are increasingly turning to buprenorphine (Suboxone). Methadone can be highly addictive, and is available exclusively at federally licensed clinics, which are scarce in more rural communities. Suboxone has a lower abuse potential, and is not subject to such strict government regulation. Some users report Suboxone to be as effective as methadone in averting cravings; recent studies indicate newborn withdrawal is less likely when mothers are using Suboxone as opposed to methadone.
It is unclear what long-term damage, if any, is done to a child exposed to opioids in utero. In fact, little is known about the effects of most drugs (prescription or illicit) on the developing fetus. Dr. Nora D. Volkow, director of the National Institute for Drug Abuse, calls the lack of information “remarkable.”
Regardless, the drug dependence endured in utero is likely less critical to their development than external circumstances in early life. Proper nutrition, affection, and general stability are all vital components of a child’s physical, cognitive, and emotional growth. Infant opioid dependence occurs disproportionately along socio-economic lines. Nearly 80% of babies in opioid withdrawal were born to mothers on Medicaid (government-funded hospitalization and medical insurance for low-income individuals), compared with just over 45% of healthy babies. Opioid dependent newborns remain in the hospital for an average of 16 days, compared with a 3 day average for healthy newborns. University of Michigan professor Dr. Stephen Patrick has led much of the research on newborn opioid dependence, and has called the treatment of these individuals “a public health emergency;” Dr. Patrick cites a 250% increase in hospital charges for these newborns between 2000 and 2009, and a 400% increase in opioid use among pregnant women over the same period. Columbia University assistant psychiatry professor Carl Hart has noted that in the latter statistic, researchers failed to distinguish between those who abused their prescription and those who took their pills as prescribed; in fact, the study failed to acknowledge the percentage of such women who even held a prescription.
Filed under: Addiction, Conditions and Disorders, Featured · Tags: abuse of painkillers, drug Epidemic, hydrocodone, National Institute for Drug Abuse, newborns, Norco, opioid dependence, Opioids, oxycodone, oxycontin, painkillers, percocet, Prescription opioid analgesics, Suboxone, vicodin