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 Researchers focused on what’s known as neonatal abstinence syndrome,
a condition akin to withdrawal that develops when babies essentially
become addicted to drugs their mothers use during pregnancy.
Nationally, the rate of neonatal abstinence syndrome involving
mothers’ use of opiates - which includes heroin as well as
prescription narcotics like codeine and Vicodin - surged from 2.8
cases for every 1,000 births in 2009 to 7.3 cases for every 1,000
births in 2013, the study found.
At least some of this surge in the case count is due to drug
policies designed to crack down on prescription drug abuse and
combat the methamphetamine epidemic, said lead study author Dr.
Joshua Brown, a pharmacy researcher at the University of Kentucky in
Lexington.
“The drug policies of the early 2000s were effective in reducing
supply – we have seen a decrease in methamphetamine abuse and there
have been reductions in some aspects of prescription drug abuse,”
Brown said by email. “However, the indirect results, mainly the
increase in heroin abuse, were likely not anticipated and we are
just starting to see these.”
The findings of the current study add to a growing body of evidence
pointing to a surge in births of babies suffering from opiate
withdrawal. One report last month from the U.S. Centers for Disease
Control and Prevention found an even bigger spike over a longer
period, from 1.5 cases for every 1,000 births in 1999 to 6 cases per
1,000 in 2013.
CDC researchers also found wide variation in neonatal abstinence
syndrome by state, ranging in 2013 from 0.7 cases for every 1,000
births in Hawaii to 33.4 cases per 1,000 in West Virginia.
“We know that certain states are harder hit by the opioid/heroin
abuse epidemic, with about 10 states contributing half of all
neonatal abstinence syndrome cases,” Brown said. “These states are
often more rural and impoverished areas of the U.S. such as
Mississippi, Alabama, and West Virginia.”
Brown and colleagues looked at Kentucky in particular. Here, the
rate of neonatal abstinence syndrome climbed from 5 cases for every
1,000 births in 2008 to 21.2 cases per 1,000 births in 2014,
researchers report in JAMA Pediatrics.
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While the study didn’t look at health outcomes for babies born
suffering from drug withdrawal, these infants often require
intensive medical care. (See Reuters’ 2015 special report “Helpless
and Hooked” here: http://reut.rs/1NSc7uC)
These babies may have central nervous system issues like seizures
and tremors, gastrointestinal problems and feeding difficulties,
breathing challenges, as well as unstable body temperatures.
Typically, they remain in the hospital for several weeks after birth
and receive low doses of methadone, a medicine designed to wean
addicts off heroin and prescription opiates, Brown said.
Treatment can ease withdrawal symptoms in newborns, but can’t
necessarily address developmental problems these infants may have
later on, said Dr. William Carey, a pediatrics researcher at
pediatrics at Mayo Clinic Children’s Center in Rochester, Minnesota.
“While abuse of prescription opiates has declined, the use of
illicit opiates has increased such that there may be a zero-sum game
at best,” Carey, who wasn’t involved in the study, said by email.
“Since maternal use of either prescription opiates or illicit
opiates is associated with withdrawal in newborns, it is reasonable
to think that any increase in the overall use of opiates would be
linked to an increase in the rate of neonatal abstinence syndrome.”
SOURCE: http://bit.ly/2d4l3zv JAMA Pediatrics, online September 26,
2016.
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