Congress should act on treatment for drug-dependent newborns

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A new study confirms an alarming trend observed in hospitals across the US: an exponential rise of babies born with drug withdrawal — the youngest victims of our nation's battle with the prescription drug epidemic.

Research, published last week in the Journal of Perinatology and funded by the National Institutes of Health (NIH) and the National Institute on Drug Abuse (NIDA), found that the number of infants experiencing withdrawal grew nearly five-fold from 2000 to 2012.

On average, the data showed, an infant is born with drug withdrawal every 25 minutes in the United States, accounting for an estimated $1.5 billion in health care expenditures; 80 percent of that is paid for with Medicaid dollars. This, too, amounts to a sharp increase, effectively doubling in cost since 2009.


The toll is staggering. Infants who must endure the pain of withdrawal, known as neonatal abstinence syndrome (NAS), face a myriad of difficulties, including breathing problems, fever, tremors, stiff limbs, difficulty feeding, and preterm birth. And neonatologists across the country have seen the devastating impact it can have on families. Mothers also frequently deal with untreated substance use disorders, histories of abuse, and mental health illness. It is time we as a nation take positive steps to improve the health of mothers and their infants with a public health approach.

Not surprisingly, the rise of NAS occurred in parallel with the rapid rise of the prescription drug epidemic. According to the Centers for Disease Control and Prevention, the number of prescriptions written for these powerful painkillers more than quadrupled over the last decade.

While a public health approach is urgently needed, challenges abound. Just as communities are affected differently by prescription drug use and its complications, the study found that communities are affected differently by NAS. The deepest impact has come in New England, Tennessee, Kentucky, Mississippi, and Alabama, with rates about two-and-a-half times the national average. Another study published last week in the New England Journal of Medicine found that the use of neonatal intensive care units due to NAS has spiked; in fact, more than 40 percent of the beds in some neonatal intensive care units in the US are occupied by infants with the syndrome.


Hospital stays for NAS can last months. Because of the explosive rise in cases, doctors are desperate to find the most effective method of diagnosis and treatment. With little coordinated work among states, health care systems, and practitioners, no medications have been approved by the US Food and Drug Administration.

Incomplete data about NAS births further complicates matters and severely hampers states' ability to identify the scope of the problem and apply public health solutions effectively.

With hospital resources, medical personnel, and taxpayer dollars being stretched at unprecedented levels, the search for a standardized approach to NAS is a race against the clock. As the study shows, one more year without identifying the best standard of treatment for NAS can have devastating effects.

This is where Congress can help.

Congress can pass the Protecting Our Infants Act, cosponsored with Congressman Steve Stivers and Senate Majority Leader Mitch McConnell and Senator Bob Casey and supported by a wide range of medical groups, including the American Academy of Pediatrics. This is the first federal legislation to take far-reaching steps to help the doctors and nurses, hospitals, and health agencies struggling to address the epidemic of newborns suffering from opioid dependency.


The bill requires the Department of Health and Human Services to develop recommendations to prevent and treat prenatal opioid abuse and NAS, review its programming to develop a coordinated strategy to address this crisis, and provide assistance to states in the collection of public health data.

The Protecting Our Infants Act helps us increase efficiency in our hospitals by identifying the best ways to diagnose and treat these newborns and in our state and national health agencies by coordinating programming and ensuring that we have the information we need.

This bill is not partisan or political. But it provides innocent babies the care they desperately need, and helps families rebuild their lives. All that is needed to pass this bill is the advocacy of our communities and the will of the Congress. We have the ability to help thousands of our nation's mothers and infants. Why not start now?

Congresswoman Katherine Clark represents the 5th District of Massachusetts, and is the original House sponsor of the Protecting Our Infants Act.

Stephen W. Patrick, MD, MPH, MS, is an assistant professor of pediatrics and health policy at Vanderbilt University School of Medicine and a practicing neonatologist at the Monroe Carell Jr. Children's Hospital at Vanderbilt.


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