Monday, April 30, 2012

Number of US newborns with drug addictions triples - The Seattle Times

DETROIT â€" An increased reliance on prescription painkillers and the resulting addiction has now shown up in the most vulnerable patients â€" America's newborns, according to a report released Monday.

Addicted babies â€" many suffering from respiratory problems, low-birth weight and seizures â€" have nearly tripled in less than a decade.

That's one baby every hour in the U.S., according to the study in the Journal of the American Medical Association, said Dr. Stephen Patrick, lead author and doctor at the University of Michigan Medical Center's Neonatal Intensive Care Unit.

Meanwhile, the number of mothers using opiates has increased fivefold, according to the same study.

It's also a burden on public-health dollars â€" and a wake-up call about the need for better prevention, Patrick said.

Average costs to care for the babies suffering from neonatal abstinence syndrome, or NAS, skyrocketed from $39,400 to $53,400 between the same time period â€" 2000 to 2009, according to the study.

In addition to seizures and breathing problems, NAS is marked by low birth weight, irritability, muscle cramping, tremors, feeding problems, vomiting and watery stools.

"Generally babies are soothed by wrapping or holding or being fed," said Patrick. "Typically these babies can't be consoled."

Babies were in the hospital for an average of 16 days, and 78 percent were covered by Medicaid.

The source of their mother's addiction? The study doesn't address why the mothers were using drugs, nor did it explore what specific drugs they used â€" though NAS is most commonly linked to opiates, according to the study.

Dr. Carl Christensen, who runs the Eleanor Hutzel Recovery Center in Detroit, said he sees it all the time: Doctors who too easily prescribe painkillers, and patients who demand them.

The clinic treats more than 100 addicted moms-to-be a year, said Christensen, who is also an associate professor of obstetrics and gynecology at Wayne State University in Detroit.

Most women were prescribed Vicodin and OxyContin to manage pain from injury or disease, Christensen said.

"A lot of patients ... feel they don't have an addiction as long as they can get their prescription filled," he said. "A lot of them say 'I have pain and as long as I have pain I should be able to take medicine.' "

Addiction takes hold in as little as two weeks, he said, and women face the daunting task of detoxifying â€" a physical struggle, as withdrawal can lead to rapid pulse and breathing, high blood pressure, abdominal cramps, tremors, bone and muscle pain, vomiting, diarrhea, sleeplessness and depression.

The increase in use began more than a decade ago when doctors began to focus on pain and its management, said Dr. Philip Gilly, medical director at Henry Ford Health System's Maplegrove Center, which provides both in- and outpatient treatment.

Patrick said the specific treatment for these babies is unclear â€" precisely which babies should be treated, with what kind of drug, and what dosage. At the University of Michigan, they use methadone; another clinic uses morphine.

"You don't want to over treat it, and we don't have want under treat it," he said. "It's tricky. We need more research."

Doctors say newborns aren't really addicted â€" which connotes drug-seeking behavior that babies aren't capable of â€" but their bodies are dependent on methadone or other opiates because of their mothers' use during pregnancy.

Small methadone doses to wean them off these drugs is safer than cutting them off altogether, which can cause dangerous seizures and even death, said Dr. Mark Brown, chief of pediatrics at Eastern Maine Medical Center.

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