Neonatal Abstinence Syndrome: The Youngest Victims of Opioid Dependency
Opioid abuse has reached epidemic levels in the United States. It has crossed all racial, ethnic, and socio-economic lines, affecting all communities. The problem continues to get worse. It has been reported that Americans consume 80% of the world’s opioid supply. As illicit prescription pills are becoming more expensive, heroin abuse is resurging.
An unfortunate consequence has been an increase in the number of babies born with drug dependence. If they are not treated, they can suffer through an agonizing drug withdrawal process known as neonatal abstinence syndrome, or NAS. The illness can be so severe that the infants can develop seizures and even die.
Fortunately, good, effective, safe treatments are available and are consistently delivered by compassionate, dedicated care teams of physicians, nurses, social workers, and case managers. They ensure the health of the mother and the infant, and provide conducive environments for transitioning to a healthy newborn period, both within the hospital during the acute phase, and at home after discharge.
While all the care providers with which we partner deliver positive outcomes, we noticed that some babies spend more time in the hospital than other babies, which led us to study what variables exist that led to those different lengths of hospitalization.
We found that babies that were started on treatment with methadone and then discharged home with mom to finish treatment with methadone typically had a much shorter hospitalization than infants that completed their entire treatment course with morphine while in the hospital.
According to a 2012 Journal of the American Medical Association publication, it is estimated that the total cost to treat NAS in the United States in 2009 was approximately $720 million. Since the incidence of NAS has continued to increase in the past half-decade, it is reasonable to believe that cost now exceeds $1 billion per year.
Quality care includes treatment that is not only safe and effective, but also cost-efficient. One of the ways to control costs associated with NAS is by reducing the amount of time a baby needs to spend in the hospital without sacrificing safety. Being able to go home sooner with mom has other benefits as well, such as bonding, breast feeding, and minimizing exposure to hospital-related problems.
The opioid epidemic is now widely recognized and great efforts are being made at the local, state, and federal levels to curtail it. In the meantime, we must make certain that babies born with NAS, our most vulnerable victims, continue to receive the quality care they deserve.
I co-authored an observational study on NAS that was recently published in Population Health Management. The retrospective data analysis examines a population of infants with NAS from a large Medicaid health plan. The primary objective of the study is to assess the average length of stay in the NICU and to determine the variables that may account for differences in inter-institutional lengths of stay. To read the full study, visit the Knowledge Center page of our website.