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Pregnant mothers, newborns addicted to opiates increases dramatically over past decade

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The rate of mothers abusing opiates during pregnancy—including heroin, methadone and certain painkillers—has increased nearly fivefold in the past decade, according to a new study.  The study also found a threefold increase in the number of newborns with drug withdrawal symptoms, a condition known clinically as neonatal abstinence syndrome (NAS).

The study, published in the Journal of the American Medical Association, used a national database to examine rates of maternal opiate use and NAS, as well as the associated hospital costs, between 2000 and 2009.  

According to the study, the number of pregnant mothers using opiates increased from 1.19 to 5.63 for every 1,000 births per year.  The number of infants with born with NAS increased from 1.20 to 3.39 for every 1,000 births per year.

Meanwhile, the total hospital costs for NAS jumped from $190 million to $720 million per year from 2000 to 2009.  This amount was adjusted for inflation, the researchers said.

Lead researcher Dr. Stephen Patrick, a neonatal-perinatal fellow of the University of Michigan Health System in Ann Arbor, Mich., and Robert Wood Johnson clinical scholar, said he had been motivated to look at national rates of maternal opiate abuse due to his own experiences

“I take care of babies in the intensive care unit, and it felt like we were seeing an increase of babies with NAS in our ICU,” Patrick explained to FoxNews.com.  “I see these babies on a regular basis.  You hear them crying down the hall – it’s easy to identify them.  

“Other states were describing increases as well,” Patrick added.  “We primarily sought out to see if this increase was nationwide.”

According to Patrick, while a recent report from the CDC found that sales of opiates have quadrupled in the general population, the dramatic rise of opiate use in pregnant mothers specifically was surprising, nevertheless.

“It was a very high rate of increase; we were not expecting it,” Patrick said.  “It seems there’s a general trend in the U.S. toward more opiate use and we’re also seeing that reflected in mothers and babies.”

Mothers of all income levels were affected by the increase, though the babies who suffered from NAS were more likely to come from lower income families and covered by Medicaid, according to Patrick.  The researchers looked at the entire class of drugs, meaning they did not differentiate between the use of drugs such as heroine, methadone and pain relievers such as Vicodin and Percocet.  

“It’s important to know these families come from all different walks of life,” Patrick said.  “This problem doesn’t discriminate.  There should be more attention brought to this—researchers need to find ways to treat opiate addiction, and on a state and federal level, we need to think of ways of reducing opiate use.”

Dr. Manny Alvarez, senior managing health editor of FoxNews.com, said he wasn’t surprised by the findings.

“Folks need to realize that the availability of narcotics is out of control, and in my personal experience, I have seen a significant increase of drug abuse during pregnancy—even the demographics have changed,” Alvarez said.  “Many of these mothers are individuals you would not think would fall prey to drug abuse.”

Newborns with NAS are more likely to have respiratory problems, low birth weight, feeding difficulties and seizures.  Using opiates during pregnancy can also increase the risk of stillbirths, according to prior studies.  Depending on how severe the baby’s withdrawal is, doctors treat NAS by slowly weaning the infant off opiates over a period of days or weeks.

For a mother who is abusing opiates during the beginning of her pregnancy, it is not necessarily safe to quit cold turkey.

“Coming off opiates during pregnancy can be harmful,” Patrick said.  “The treatment mainstay is to enroll these mothers into methadone treatment programs to reduce harm to the baby.  Studies show in terms of fetal loss and other outcomes—the result is usually better in these programs.”

Alvarez added, however, there are certain challenges to getting mothers-to-be into these treatment programs.  

“There is no mandatory drug screening in pregnancy,” Alvarez said.  “Perhaps with this new finding, it could encourage screening to become standard practice in pregnancy.” 

Patrick said the study should be considered as an incentive for states to implement opiate monitoring programs and keep an eye on the prescriptions being written, as well as more studies tracking infants born with NAS to see how the condition affected them through childhood and beyond.