Colorado is second in the nation in the abuse of prescription pain relievers, according to the Substance Abuse and Mental Health Services Administration (SAMSHA). And now the impact is being felt in hospital nurseries.
The number of newborns suffering from drug dependency at birth more than doubled in the past five years at the Children’s Hospital Colorado in Colorado Springs. The numbers have also leaped at Parkview Medical Center in Pueblo; that hospital treated 18 babies in 2013, up from only two babies four years earlier.
Colorado isn't alone: Drug dependency among infants is growing nationwide. It's traumatic for infants, and it's expensive to help a baby who's dependent, which happens because of exposure in utero. That's causing one prominent doctor in this field to call for more money to be spent preventing drug abuse by expecting parents.
Dr. Stephen Patrick, a neonatologist at Vanderbilt University in Nashville, Tennessee, says drug-dependent infants often experience tremors, fever, irritability, wakefulness and feeding problems. "It’s like having a colicky baby times five," Patrick says. These infants often require lengthy treatment with methadone or morphine; a quiet, calm environment is also helpful.
When these babies are born, they experience something like "quitting cold turkey," Dr. Mary Laird says. Her practice, Pediatrix Medical Group, compiled the data at Children’s Hospital in Colorado Springs and at Parkview Medical Center and provided it to Colorado Public Radio. Colorado does not require hospitals to screen infants for drug dependency, nor is there a requirement that hospitals report to the state numbers of drug-dependent newborns, making Laird's data that much more important.
Laird says that the types of drugs found in infants’ bodies has changed as prescription drug abuse has grown. "We certainly still see babies dependent on heroin and methadone," says Laird, who is also a neonatologist at Children’s Hospital in Colorado Springs. "But we are now seeing a tremendous number of babies that are exposed in utero to prescription drugs -- opiates like Vicodin, Percocet and Tramadol. Those numbers have really increased."
The increase in exposed infants at Children’s Hospital in Colorado Springs and at Parkview Medical mirrors a national trend. According to a study in the Journal of the American Medical Association (JAMA), authored by Patrick and others, the number of newborns suffering from drug withdrawal at birth grew from 1.2 percent of all newborns in 2000 to 3.4 percent in 2009.
Most doctors avoid calling a newborn "addicted" because it implies behavior, Patrick says. These infants are physically dependent and are sometime called "substance-exposed" or "infants having drug withdrawal."
In some cases, symptoms of drug withdrawal don’t present for several days, at which point the infant may have already been discharged from the hospital. Knowing a baby has been exposed to drugs during pregnancy can prevent a premature dismissal and the distress of a newborn going through withdrawal untreated. The most effective way to know is to ask the mother about substance use during pregnancy.
Length of hospital stays can vary with the severity of the cases, according to Laird. "It can absolutely last for weeks. Our average length of stay on those medications and supportive therapies is around 21 days and we certainly see babies stay quite a bit longer than that in extreme circumstances," she says.
The average cost of a hospital stay for a baby in withdrawal was $53,400 in 2009, and the total cost nationally was $720 million, according to Patrick’s JAMA study. "I honestly believe that too often our health care system reacts to problems," Patrick says.
"We react to the infant that’s in my neonatal intensive care unit instead of putting those dollars on the front end towards public health interventions to limit prescription drug abuse before pregnancy," he says. "I feel like pregnancy is too late. And certainly in my neonatal intensive care unit is too late."