Neonatal abstinence syndrome (NAS) is a condition in which a newborn is born to a mother who has taken drugs such as heroin, codeine, oxycodone, methadone, buprenorphine, or another narcotic during her pregnancy.
We have a problem not only for adults—nearly one in four employed Americans between the ages of 18 and 35 has used illegal drugs—but we also have their innocent offspring starting life with an addiction to overcome.
There has been a five-fold increase in the number of babies born with NAS from 2000 to 2012 — with an estimated 21,700 per year as of 2015. Newborns with NAS are more likely to have low birthweight, respiratory complications, and low Apcar scores (which are metrics for the immediate vigor of the newborn). They also stay longer in the neonatal intensive care unit; the average is 16.9 days compared to 2.1 days for a normal healthy newborn.
These “addicted” newborns then suffer from symptoms that include hyperirritability, gastrointestinal dysfunction, tremors, fever, high-pitched cry, uncoordinated sucking, and poor swallowing reflexes.
The additional cost is about $1.5 billion, with over 80% being paid by state Medicaid programs. In 2015, bipartisan legislation titled “
The Protecting Our Infants Act of 2015” was passed by Congress with the goal as follows:
“Because prevention and treatment efforts vary widely from state to state, the new law will help identify evidence-based approaches to care for these babies and their mothers. The law requires the Department of Health and Human Services to conduct a study and develop recommendations for preventing and treating prenatal opioid use disorders and NAS. In addition, the Centers for Disease Control and Prevention will continue to assist states in improving the availability and quality of data collection related to NAS and encourage public health measures aimed at decreasing its prevalence.”
Babies affected by NAS are treated with extra care and vigilant observation. Depending on the baby’s symptoms, the drugs involved, and whether the baby was born full-term or premature, the care can range from extra TLC (tender loving care) such as rocking, reduced noise and lights, to continuing low-dose opioids in decreasing amounts to withdraw the baby from narcotic dependence.
Just as important is treating the mom, who hopefully now has even more reason to give up drugs as she is responsible for a new baby. In a study done in Tennessee, treating moms with post-detox behavioral health follow-up care reduced addiction from about 70% to less than 17%. Increasing contact between the mother and newborn immediately after birth also helps to decrease NAS symptoms.
We live in a wonderful country, but nonetheless, we have real challenges. Helping moms, families, and babies is important for all of us, and being aware of the condition is a good place to start. Preventing addiction in the first place removes the misery and cost later.