By now, the enormity of America’s opioid abuse and overdose epidemic is common knowledge. With 78 Americans dying every day from an opioid overdose and with enough painkillers prescribed to give just about every U.S. adult their own bottle of pills, there’s hardly a community that’s gone untouched by the deadly problem. And a new study reminds us that we’ll be dealing with the aftermath far into the future.
The study, published in the form of a “research letter” in JAMA Pediatrics, examined rates of neonatal abstinence syndrome (NAS), a condition that occurs when babies are exposed to drugs in the womb and is most often caused by opioid use. Babies with NAS are more likely to be born with low birth weights, birth defects, and breathing and feeding problems, among other issues. Treating NAS can take months, and the long-term effects are not entirely known. The new study aimed to describe current trends in NAS in the U.S. as well as in the rural state of Kentucky, where overdose deaths reached a record high in 2015.
In examining inpatient data nationally and from Kentucky, researchers found that the national rate of NAS has more than doubled, from 3.6 cases per 1,000 births in 2009 to 7.3 per 1,000 births in 2013. In Kentucky, which like many rural states has been hit particularly hard by opioid abuse, the NAS rate rose from 6.6 per 1,000 births in 2009 to 15.1 in 2013, peaking at 23.4 per 1,000 births in the last quarter of 2014. Between 2011 and 2013, Kentucky’s NAS rates were more than double the national rate.
The study notes that while state and federal efforts seem to be slowing down rates of opioid abuse and overdose, there’s been little impact on rates of NAS. Authors Joshua Brown, Pratik Doshi, Nathan Pauly and Jeffrey Talbert write:
The Protect Our Infants Act of 2015 is a federal, bipartisan law introduced specifically to combat the NAS epidemic. This law, along with several others currently being considered by Congress and covered by national media stories, has succeeded in bringing national attention to NAS. However, it fails to offer any tangible short-term solutions to the rapidly growing problem. Meanwhile, rural states, such as Kentucky, that are disproportionately affected by the opioid abuse epidemic must continue to enforce and supplement policies related to surveillance programs along with coverage for addiction services through state services. Because of the tremendous burden of NAS and the potential for lifelong complications for the neonate, tailoring of interventions to pregnant women or women of childbearing age should be a priority of national and state drug abuse efforts.
In July, President Obama signed the Comprehensive Addiction and Recovery Act of 2016 (CARA), a wide-ranging law designed to confront the opioid crisis by expanding education and prevention efforts, strengthening treatment options and widening access to overdose medications, among other measures. Still, the law needs enough funding to make a sustained difference. The White House has already directed millions to overdose prevention and addiction treatment, but Congress has yet to fully fund CARA.
In signing CARA, Obama said: “My administration has been doing everything we can to increase access to treatment, and I’m going to continue fighting to secure the funding families desperately need. In recent days, the law enforcement community, advocates, physicians, and elected officials from both sides of the aisle have also joined in this call. Now, it’s up to Republicans to finish the job and provide adequate funding to deal with this public health crisis. That’s what the American people deserve.”
To request a full copy of the new NAS study, visit JAMA Pediatrics.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for nearly 15 years.