The number of babies born dependent on prescription painkillers like Oxycontin tripled in the last decade along with higher costs to treat their withdrawal symptoms, research showed.
The surge in newborns with withdrawal symptoms from 2000 to 2009 was accompanied by a five-fold increase in the number of mothers using the opiate drugs during pregnancy, according to a study today in the Journal of the American Medical Association. The average hospital bill to treat the babies jumped 35 percent to $53,400 in the same period, the research found.
Sales of opiate painkillers such as Oxycontin and Vicodin increased four-fold during the decade, according to the study. The findings are a call for greater effort to limit the drugs’ abuse, said Stephen Patrick, the study’s lead author. One baby born every hour in the U.S. is addicted to the drugs, according to the study, the first to look at the number of infants born with opiate withdrawal.
“There’s a rapid rise in newborns with signs of withdrawal that demands attention from a public health perspective,” said Patrick, a fellow at the University of Michigan’s Division of Neonatal-Perinatal Medicine in Ann Arbor, in an April 27 telephone interview. “We really need to think of, as a country, the way we use opiate pain medicines and limit their abuse when possible.”
Kids Inpatient Database
The researchers looked at data from the Kids’ Inpatient Database, put together by the Agency for Healthcare Research and Quality. The database includes a nationally represented sample of pediatric hospital discharges.
The number of newborns diagnosed with opiate withdrawal, or neonatal abstinence syndrome, rose to 3.39 for every 1,000 hospital births in 2009 from 1.2 per 1,000 in 2000. The number of mothers using or dependent on opiates rose to 5.63 for every 1,000 hospital births in 2009 from 1.19 in 2000.
More studies are needed to better understand how to treat these babies to limit their withdrawal symptoms and shorten their hospital stay, as well as the long-term consequences of being dependent on opiates at birth, they said.
“We don’t have good research on long-term outcomes,” Patrick said. “What we really need are big, well-done studies that follow these babies more than just a couple of years into school time and further.”
Pregnant mothers addicted to the prescription painkillers, if they enter treatment, usually continue to receive opiates, such as methadone, since stopping the drugs could harm the unborn child and result in a miscarriage, said Marie Hayes, who wrote an accompanying editorial in the journal. After they’re born, the babies are often treated with methadone to ease their withdrawal.
The average stay in the hospital for these babies is about 16 days compared with three days for babies born without dependence on the drugs, Patrick said. Total hospital charges nationwide for treating the withdrawal syndrome rose to $720 million in 2009, adjusted for inflation, from $190 million in 2000, the study showed.
Newborns dependent on opiates were more likely to have increased irritability, tremors, respiratory problems, feeding issues and seizures and be born at low birth weight, the study showed. Almost 78 percent of the cost for caring for the babies with the withdrawal syndrome by 2009 was charged to Medicaid, the U.S. government health program for low-income people.
More Research Needed
Hayes, who wrote the accompanying editorial, said more research is needed on how to better treat these babies, and identify those most at risk of withdrawal because of genetics, as the use of opiates rises. From 60 percent to 80 percent of the babies born to mothers abusing these drugs have the withdrawal syndrome, she said.
“We try to detoxify as rapidly as possible but sometimes that leads to a long stay because we’ve been tapering off maybe for some infants too rapidly,” Hayes, a professor of psychology and neuroscience at the University of Maine in Orono, said in an April 27 telephone interview. “We need individualized medicine. We need clinical trials to find out which drugs to use. We need prenatal management, how we treat the mothers.
‘‘The withdrawal of the dependent child is actually an area of care which we don’t know as much as we need to know. It’s a potpourri of risk for these infants at the time they’re born,” she said.
The research was funded by the Robert Wood Johnson Foundation Clinical Scholars Program.
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