Top NIH administrator highlights rise of newborns addicted to painkillers

The epidemic of opioid addiction in the United States has spilled over to affect newborn babies, with the number of infants born suffering from opioid withdrawal tripling in a decade, the director of the government’s institute for drug abuse said this week.

In an editorial published Tuesday in the British Medical Journal, Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH), wrote that a rise in opioid prescriptions to pregnant women has resulted in a steep increase in the number of babies born addicted to the drugs, a condition called neonatal abstinence syndrome (NAS).

NAS is characterized by irritability, seizures, shaking and trouble eating and sleeping. The number of babies born with the syndrome had increased to 3.39 per 1,000 births by 2009, up nearly threefold from 1.2 per 1,000 births in 2000, according to a 2012 study. The total percentage of visits to neonatal intensive care units attributable to NAS shot up to 4 percent in 2013 from 0.6 percent in 2004, Volkow wrote.

“The rise in NAS is also likely to be a consequence of increased opioid prescriptions — estimates indicate that 14 to 22 percent of pregnant women in the U.S. receive an opioid prescription during their pregnancy — as well as an increase in the prevalence of opioid use disorders among pregnant women,” she added.

Dr. Stephen Patrick, a neonatologist at Vanderbilt University School of Medicine and one of the researchers for the studies on neonatal abstinence syndrome cited by Volkow, said his team found that by 2012 an infant addicted to drugs was being born every 30 minutes, costing $1.5 billion annually in health care treatments.

“I think what we’re seeing is a spillover of the broader opioid addiction problem to the pregnant population and the neonatal population,” Patrick told Al Jazeera.

He said that while short-term opioid use during pregnancy is safe, the majority of the women involved were likely drug abusers before they got pregnant.

“When I talk to families, some of the stories that I hear are things like an adolescent may have started using it at a party, or [taken it] from a medicine cabinet in someone’s home, or they had an accident and were prescribed opioids and became dependent,” Patrick said.

Fortunately, he added, NAS treatment is straightforward — an infant is given a painkiller such as morphine and slowly tapered off the drug.

Volkow warned in her op-ed that while scientists don’t know the long-term effects of opioid abuse on fetal brain development, some mothers have reported that their children have cognitive impairments. As a result, she said, pregnant women should avoid opioids unless absolutely necessary.

“Opioids should be reserved for pregnant women with severe pain that cannot be controlled through more benign means, and ideally limited to a short-term use,” she wrote.

The Obama administration in 2015 signed the Protecting Our Infants Act, which will help fund more research on maternal drug addiction and the long-term affects of in-utero drug exposure to children, and will develop strategies to treat the problem.

Patrick said that during the crack cocaine epidemic of the 1980s, both the addicted mothers and their babies were stigmatized. He stressed that opioid addiction — like all drug addiction — should be treated as a medical condition, not a personal deficiency.  “We ought to treat it with a public health approach as opposed to a criminal justice approach,” he said.