The rising opioid epidemic in America affects not only adults: Every 25 minutes, a baby is born suffering from opioid withdrawal, also known as neonatal abstinence syndrome (NAS), according to the National Institute on Drug Abuse (NIDA).
Babies in the womb exposed to opioids by their mothers have a higher risk of developing educational disabilities in the future, according to a recent study by the Centers for Disease and Control (CDC).
Dr. Lauren Melissa Jansson, director of pediatrics at the Center for Addiction and Pregnancy at John Hopkins Medicine, said NAS cases have risen in America in recent years due to the opioid epidemic.
“I do think we are seeing a rise in the NAS syndrome in infants and I think it’s likely driven by the overprescribing of opioids leaking out to communities,” she said.
The occurrence of NAS in newborns from opioid-dependent mothers ranges between 70 percent to 95 percent, according to a Substance Abuse and Mental Health Services Administration report, based on research from 2008.
Dr. Mary-Margaret Fill, a CDC epidemic intelligence service officer and one of the authors of the report, said this is the first study in the United States that links opioid withdrawal in babies to educational disabilities.
“Children with opioid withdrawal were significantly more likely to be referred for a disability evaluation and meet criteria for an educational disability,” Fill said.
She said that given the number of babies being born with opioid withdrawal each year, the association is concerning.
From 1999 to 2013, the overall incidence of NAS among 28 American states increased by 300 percent, from 1.5 per 1,000 hospital births in 1999, to 6.0 per 1,000 hospital births in 2013, according to a morbidity report released last year.
The CDC report on NAS compared 1,815 infants from Tennessee born in the years 2008 to 2011 with a history of NAS to 5,441 infants with no history of NAS. They found that children with a history of NAS were more likely to be referred for disability evaluation, 351 out of 1,815 (19.3 percent), versus 745 out of 5,441 (13.7 percent). The report found NAS infants were more likely to meet criteria for a disability, developmental delay, and speech or language impairments, compared to those without.
Tennessee also experienced a 15-fold increase in NAS-affected infants between 2002 and 2012.
Fill said that while the report data was limited to only Tennessee, “it is possible that similar results could be found in other parts of the country,” Fill said.
Jansson said that while the study show that children with NAS are more vulnerable to educational delays, “I think it’s very individual from child to child. It really depends on maternal functions and services available.”
Laura Goetzl, professor and director of maternal-fetal medicine division at Temple University, said the key is to stop NAS from occurring in the first place.
“I think this study shows that there can be long-term effects. … Once the baby has NAS, I think people don’t really know how to treat that,” Goetzl said.
NAS can cause withdrawal symptoms than can include fever, vomiting, seizures, sleep problems, and other central nervous system issues.
According to the NIDA, newborns with NAS have longer hospital stays than normal newborns, with an average of 16.9 days compared to 2.1 days.
The costs for the additional hospital days adds up to an estimated $1.5 billion, with the majority of these costs (81 percent) being paid through state Medicaid programs—confirming that pregnant opioid abusers tend to come from lower income communities.