Prescription drug abuse is the nation's fastest growing drug problem. More than seven million people abuse them and death rates have tripled from their abuse in the last decade. However, it is not just adults we need to be concerned with. The 80's epidemic of crack babies is being replaced by something even easier to get your hands on: Oxycodone.
Molly (who wished to remain anonymous) was addicted to oxycodone while she was pregnant. She was first introduced to the drug after she fell off a horse and hurt her back. That accident was the beginning of a long six-year battle with the prescription pain killers for the 29-year-old.
Molly had a heavy addiction and was taking about 20 pills a day. She even began stealing to fuel her addiction. She says, “This little pain pill will change you.”
Molly is among a growing number of mothers addicted to prescription pain killers, such as oxycodone, oxycontin, and vicodin. These addictions affect not only the mothers, but also their babies.
Dr. Jonathan Wispe, a neonatologist at Nationwide Children's Hospital in Columbus, Ohio says, "Opiate addicted babies are really having a full blown withdrawal."
Known as neonatal abstinence syndrome, there are no national statistics to show how widespread the problem is. Currently, states with the worst problems have begun to collect data.
Michelle Waddell, Director of neonatal services at The Children's Hospital of SW Florida says prescription pain killers,” Cross all spectrums: stay at home moms, professionals, teachers, nurses, and doctors."
Dr. Wispe has seen a 300 percent rise in his cases since 2004 and says the addiction, “Is going to be hard to beat."
Waddell has a similar story at her hospital where she has seen a 700 percent increase in NAS babies in the last five years. Waddell says, "It's probably one of the most painful things that I’ve had to sit back and watch."
NAS babies experience withdrawal a few days after being born, just like an adult would when quitting drugs cold-turkey.
"They sweat all the time and their heart is racing all the time,” explains Dr. Wispe.
The baby can also have seizures and risks sudden death. Compounding the problem, pregnant women addicted to prescription medications cannot safely go off of them without medical supervision or they could miscarry.
Molly received treatment two months before her daughter was born. Molly says, "I'm still a little nervous. She's 6-months-old and she doesn't roll over. She doesn't laugh."
It could be years, even decades, before doctors know the long-term impact for Molly’s daughter and thousands of babies like her.
Doctors say the treatment for drug withdrawal in newborns can take anywhere from a couple of days to a few weeks, driving the cost of their medical care into the tens of thousands of dollars.
NAS is so new no one knows yet what the long-term impacts of the syndrome will be.
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BACKGROUND: Neonatal withdrawal syndrome or neonatal abstinence syndrome is when a group of problems occur in a newborn that was exposed to drug abuse in the womb. (Source: nlm.nih.gov) There are two types of neonatal abstinence syndrome: neonatal abstinence syndrome due to prenatal or maternal use of substances that result in withdrawal symptoms in the newborn and postnatal neonatal abstinence syndrome secondary to discontinuation of medications such as fentanyl or morphine used for pain therapy in the newborn. Neonatal abstinence syndrome mostly occurs when the mother takes addictive illicit or prescription drugs. About three percent of the 4.1 million of women able to bear a child who abuse drugs are believed to continue drug abuse during pregnancy (Source: emedicine.medscape.com).
EXAMPLES OF DRUGS ASSOCIATED WITH NEONATAL ABSTINENCE SYNDROME:
* Opiates and Narcotics: Codeine, Heroin, Oxycodone, Morphine, Buprenorphine, Fentanyl, Chlordiazepoxide, , Methadone, Meperidine (Demerol), Pentazocine, Butorphanol (Stadol), or Hydromorphone (Dilaudid).
* Other Drugs: Barbiturates, Diazepam and lorazepam, Caffeine, Cocaine, Selective serotonin reuptake inhibitors (SSRIs), Antihistaminics (Diphenhydramine, Hydroxyzine), Marijuana, Ethchlorvynol, Nicotine, or Meprobamate (Source: emedicine.medscape.com).
SYMPTOMS OF NEONATAL ABSTINENCE SYNDROME: Symptoms depend on the specific drug the mother used during pregnancy, the amount of drug used, whether the baby was born premature or full-term, and how long the drug was used. Some symptoms can occur one to three days after birth or five to10 days and they include: diarrhea, blotchy skin coloring, vomiting, seizures, excessive crying, sweating, trembling, sleep problems, sneezing (stuffy nose), irritability, or poor feeding (Source: nlm.nih.gov).
EXAMS AND TESTS: It is important to get the baby tested because many other things could be the cause of such symptoms. Tests that may be done include: Neonatal abstinence syndrome scoring system, which assigns points based on each symptom and can help determine treatment, urine test (urinalysis), and toxicology screen of first bowel movements (Source: nlm.nih.gov).
TREATMENT: Treatment depends on the baby's overall health and symptoms. Babies are usually watched for vomiting and dehydrating and sometimes receive fluids through a vein. Some need medicine for withdrawal; Benzodiazepines for alcohol withdrawal and Methadone for heroin and other opiate withdrawal. Some doctors prescribe the baby whatever drug they were born addicted to and slowly wean the baby off by lowering dose. Babies who experience feeding problems need high calorie formula that provides more nutrition and smaller portions more often. Treatment relieves symptoms but how well the baby does depends partially on whether the mother continues to abuse drugs (Source: nlm.nih.gov).