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Spike in maternal opiate use, infant withdrawal
by Staff Minority Nurse Writer
Researchers at the University of Michigan Health System, Ann Arbor, and the University of Pittsburgh found maternal opiate use had increased nearly five-fold between 2000–2009. Researchers call the increase an "epidemic," and subsequent neonatal abstinence syndrome (NAS) and hospitalization costs saw substantial growth as well.
The study cites research from the Substance Abuse and Mental Health Administration showing just over 16% of pregnant teens and 7.4% of pregnant women aged 18–25 used illicit drugs. When those drugs were used during pregnancy, newborns experienced a higher risk of "adverse neonatal outcomes," including low birth weights, as well as withdrawal symptoms such as respiratory and feeding problems, seizures and tremors, and increased irritability. Among those fetuses exposed to heroin or methadone, 60%–80% displayed these and other NAS characteristics.
The number of newborns experiencing NAS increased three-fold during this same period, from 1.2 to 3.39 per 1,000 hospital births annually—that's roughly one birth every hour. Medicaid covered almost 80% of the infants and their mothers, and 36.3% lived in the lowest-income areas. Associated hospital costs for these newborns, who "experience longer, often medically complex and costly initial hospitalizations," increased by 35%, from $39,400 to $53,400 per year. Total costs, as adjusted for inflation, grew from $190 million to $720 million.
The researchers called for increased public health measures, particularly regarding initial exposure to opiates, and considerably more research. Results of this study can be found in the Journal of the American Medical Association. It was presented at the Pediatric Academic Societies Annual Meeting in May. Visit http://jama.ama-assn.org for more information.