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Yvonne Abraham

Saving opiate crisis’s tiniest victims

She looks like any other newborn: Swaddled tightly, with a shock of fine black hair, her little feet wriggling as she sleeps, her sweet face at peace.

But her three days in this world have been laden with suffering. Hours after she was born, she grew jittery, with worsening tremors. She could not sleep, irritable and inconsolable. She sneezed constantly, her brain struggling to regulate her tiny body. Her muscles stiffened and her limbs went rigid as she cried out for the methadone that coursed through her mother’s veins in the womb.

Here is the smallest, most defenseless face of the opiate-abuse crisis. If the so-called leaders in our dysfunctional Congress can’t overcome their rancor to help babies like this one, we are truly lost as a nation.


“Nothing hurts us more as caregivers than when we see normal-looking babies sneezing, screaming, crying,” said Dr. Jonathan Davis, chief of newborn medicine at Tufts Medical Center, who stood by the baby’s crib last week.

That hurt is growing at heartbreaking speed, accelerated by surging painkiller prescriptions and cheaper heroin: Over the last decade, the number of opiate-dependent newborns has tripled, Davis said. Nationally, about 5 babies per 1,000 hospital births are born with opiates in their systems. In Massachusetts, an estimated 1,300 babies, or 17 per 1,000 births, suffered the symptoms of withdrawal in 2013. Nationally, a baby suffering from withdrawal is born every hour. Ridding them of drugs costs more than $700 million annually, most of it covered by Medicaid.

The baby at Tufts is fortunate her mother — a recovering heroin addict who wants the best for her — lives in Massachusetts. Here, she can receive state-of-the-art care according to standards agreed upon by doctors at some 42 hospitals, all working together .

But even here, there is much to learn about babies like this one. Steady doses of morphine have calmed her. She may need phenobarbital if she doesn’t stabilize. Few of the medicines used to treat these newborns have been approved for patients so young, Davis said. And very little is known about the long-term effects of their treatment.


“We are having a hard time in the medical field getting a grip on how best to handle this,” Davis said. “We need help.”

If doctors in Massachusetts need help, those elsewhere are desperate. Some do things that worry Davis, like discharging babies with methadone to be administered at home. Some cultures continue to see drug addiction as a crime rather than a disease: In Tennessee, a barbaric new law allows women who use drugs while pregnant to be charged with assault. What can that do but drive drug-dependent women to avoid the care their babies need?

It’s a mess out there, and a growing one.

That is where Washington could help. US Representative Katherine Clark, a Melrose Democrat, has introduced legislation that would compel the Department of Health and Human Services to collect reliable data on the size of the problem. And then it must come up with standard practices to ensure that every drug-dependent newborn — from Pembroke to Paducah — gets the best possible care.

The bill is so necessary that Clark has even gotten a Republican co-sponsor — Steve Stivers of Ohio, bless him.

“Nationally, this epidemic is something we cannot ignore,” Clark said. “It’s great to have him as a partner.”


The bill died last session, but Clark has high hopes this year: Senate Majority Leader Mitch McConnell appears to be on board, and that’s big. On Tuesday night, Davis, the Tufts doctor, will be Clark’s guest at the State of the Union address. On Wednesday, they’ll brief Clark’s colleagues in the hopes that they can make good emerge from a Congress that seems to have forgotten how to do it.

If they fail, it will say something very sad: If the suffering of a tiny baby with fine black hair doesn’t unite leaders, nothing ever will.

Yvonne Abraham is a Globe columnist. She can be reached at abraham@globe.com.

Correction: An earlier version of this column mischaracterized the condition of newborns whose mothers used opiates. They are drug-dependent.