Opioids & Neonatal Abstinence Syndrome

The opioid epidemic is having massive impact, not only on addicts and their loved ones, but also our communities and our resources. Regardless, there is no more innocent victim than a baby born addicted to or in withdrawal from narcotics.

Along with the increasing number of people suffering from addiction, there is a shocking increase in newborns diagnosed with Neonatal Abstinence Syndrome (NAS). The rise in NAS corresponds directly to the increase in opioid abuse in this country. Opioid abuse has been alleged to be linked to the prevalence of drug companies marketing, and doctors over-prescribing, highly addictive prescription drugs. Often people who develop a dependence on prescription opioids find their doctors no longer will fill their prescriptions, and instead they turn to cheaper street drugs (like heroin and fentanyl) to feed their addiction.

Neonatal Abstinence Syndrome occurs in 55 to 94% of babies born to mothers addicted to or being treated with opioids during pregnancy. Pregnant mothers taking drugs such as oxycodone (OxyContin), methadone, buprenorphine, codeine, heroin and/or fentanyl pass these substances through the placenta to the fetus. Once exposed, the baby becomes dependent upon the drug(s). Once the baby is born, he or she many suffer withdrawal symptoms requiring additional hospitalization and treatment.

NAS side effects include:

• Low birthweight
• Preterm delivery
• Diarrhea
• Excessive (high-pitched) crying
• Excessive sucking
• Abnormal heart patterns
• Seizures
• Sleep problems
• Tremors
• Vomiting
• Rapid breathing
• Visual disturbances
• Feeding problems and problems gaining weight
• Skin mottling

Some newborns may have to undergo pharmacologic treatment with morphine, methadone or buprenorphine. Others may be admitted to the Neonatal Intensive Care Unit (NICU) or be admitted for prolonged hospitalization.

Sadly, there are indicators that the opioid crisis is only growing. Recent statistics show that opioid overdoses increased by 30% from July, 2016 to September, 2017. Consider other data on the opioid epidemic:

• In 1996, Purdue Pharma introduced OxyContin (virtually the same chemistry as Heroin) which is a dopamine releasing drug (relieves pain, causes pleasure, slows breathing).
• Since 1999, prescriptions increased well more than 300%. Approximately 70 out of 100 adults have received a prescription for an opioid.
• FDA Approval of opioids was for VERY FEW INDICATIONS (e.g. end-stage cancer, traumatic pain) and for very short durations.
• FDA approval was NOT FOR CHRONIC PAIN (which some research indicated was ineffective in 1989).
• Many manufacturers and distributors of opioids allegedly commenced campaigns to mis-educate physicians about addiction rates and to “sell” them on the fact that millions suffer from chronic pain and are under treated.
• In 2016 there were 64,000 overdose deaths (175 per day).
• Nationally the rate of NAS more than doubled from 2009 to 2013 from 3.6 per 1000 births to 7.3
• In Kentucky the rate of NAS rose from 6.6 to 23.4 per thousand by the first quarter of 2014.

In response to the opioid epidemic sweeping the country, cities, counties and states have sued opioid pharmaceutical companies and distributors alleging that they should be held responsible for the tremendous financial burdens the municipalities face as the result of the drug epidemic. Many of these drug companies and distributors failed to educate the medical community and the public about the risks of opioids and instead focused on marketing campaigns to increase the usage of their drugs.

Meanwhile, families are being destroyed by this public health emergency. Babies are being born addicted to these dangerous drugs and are experiencing serious neonatal health problems and possibly life-long side effects, not to mention massive current and (possibly) future medical costs.