Last Updated: November 10, 2022
Can you be born an addict? Thousands of Ohio babies are every year. For these innocent individuals, opioid dependence isn’t a choice, but rather an inherited, agonizing part of their first months of life. Opioids often have a strangling grip on the people addicted to them that makes it difficult to stop using under any circumstances, including pregnancy. The rise of opioid dependence across the state and country has led to dramatic increases in the number of babies born into the throes of withdrawal, a condition referred to as Neonatal Abstinence Syndrome (NAS).
While the personal and economic costs of rising NAS births are high, the most effective way to combat this growing problem is safe, medically supervised treatment for these infants and their mothers.
Children Born into Dependency
Neonatal Abstinence Syndrome (NAS) refers to the substance withdrawal experienced by the children of opioid users. During pregnancy, opioids pass from the mother’s bloodstream into the placenta. These drugs affect the fetus in much the same way they do their mother, fostering dependence before they’ve left the womb. Early exposure to opioids impacts fetal growth, often leading to low birth weights.
After delivery, babies with NAS are cut off from their usual supply of opioids. In their first days of life, they struggle through classic symptoms of withdrawal, including vomiting, diarrhea, tremors and seizures. These infants are known in hospitals for their high-pitched, urgent cries, likely fueled by intense physical discomfort. Many must be snuggled tightly to feel any relief from their symptoms. When they do sleep, it is usually in short, sporadic bursts. Withdrawal symptoms can last for days or weeks, and may vary in intensity depending on the amount of opioids consumed during the mother’s pregnancy.
These infants are known in hospitals for their high-pitched, urgent cries, likely fueled by intense physical discomfort.
Some children recover from this initial turbulent period and go on to thrive physically and mentally. Others aren’t as lucky. Recent research published in the journal Pediatrics found that NAS may be correlated with low test scores as the child grows, suggesting that the condition could have an impact on cognitive development. By seventh grade, 38 percent of the NAS children studied did not meet minimum standards in at least one testing category. While these scores may be influenced by other factors, including home environment and parents’ education levels, this study reveals the likely reality that NAS impacts children for life.
A Pressing Problem on a State and National Scale
As opioid use in Ohio began to rise in the early 2000s, so too did the number of cases of NAS. Over the past decade, the number of babies born with this condition has increased eightfold in the Buckeye State. To put this in perspective: For every 10,000 live births in Ohio in 2006, 20 infants were born with NAS. In 2015, that number rose to 155 infants per 10,000 live births.
But this isn’t a problem unique to Ohio. According to the National Institute on Drug Abuse, nationwide NAS births increased fivefold between 2000 and 2012, amounting to one NAS birth every 25 minutes. This problem disproportionately affects rural counties, where drug use tends to be common and helpful resources are sparse.
As the number of children with NAS surges, the human costs of this condition begin to translate into lasting economic ones. NAS infants require longer stays in hospitals to receive intensive care and withdrawal treatment. According to the Ohio Department of Mental Health and Addiction Services, this additional care cost the state $105.2 million in 2014 alone. On average, the healthcare of each baby amounts to $56,000, with most spending 16 days in the hospital. These newborns place a significantly larger financial burden on the healthcare system than healthy infants in the country, whose average medical expenses are $3,500 with a two-day stay in the hospital, according to the National Institute on Drug Abuse.
As instances of NAS continue to climb, healthcare professionals scramble to find a lasting solution to this growing problem. The answer seems to lie in ensuring that both mother and child receive compassionate care before, during and after pregnancy.
Compassionate Solutions to a Complicated Issue
NAS is a heartbreaking condition that provokes complicated feelings of compassion and frustration. Showing empathy for infants suffering through withdrawal is a natural response. Understanding the actions of their mothers often does not come with the same ease.
While several hospitals across the state have volunteer programs to help NAS babies cope with their withdrawal period, limited resources are available to newly pregnant mothers in need. Many of these individuals reach out to clinics and hospitals for help, but few are given the medical support they require.
Amanda Hensley, a young mother whose daughter Valencia was recently born with NAS, experienced this when she sought treatment at several healthcare centers and was rejected by all of them. “Nobody wants to touch a pregnant woman with an addiction issue,” she said in a recent interview with CNN.
Professional care is a critical part of halting opioid consumption. Contrary to popular belief, withdrawing from opioids during pregnancy is not the best way to deal with NAS. Quitting cold turkey can lead to preterm labor or fetal death. According to the American Congress of Obstetricians and Gynecologists, the safest, most effective treatment option available for pregnant mothers is medically-assisted opioid therapy. This technique uses stable opioids, like methadone and buprenorphine, to curb cravings and stop the consumption of more dangerous drugs. While these therapies have a high chance of causing NAS, these cases are more manageable and less severe than those associated with the use of harder drugs like heroine.
There are some downsides to almost every method of treatment for pregnant mothers with substance use disorders. However, what’s clear is that safe and effective recovery from opioid use disorder prior to pregnancy is the best way to prevent NAS births.
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