Rate of Children Born Addicted to Drugs Rose at Start of Pandemic: Canadian Study

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More babies were born with neonatal abstinence syndrome before the height of opioid overdoses that came later, in the heart of the pandemic.

After peaking at its highest rate in years at the start of the COVID-19 pandemic, a new study shows the rate of children born with neonatal abstinence syndrome decreased, surprising researchers.

During the first year of the pandemic (2020–2021), 229 babies in British Columbia (BC) were born with neonatal abstinence syndrome, surpassing the former high of 221 babies between 2017 and 2018. The peak of the opioid crisis also occurred during the pandemic, but researchers said: “The continued increase in opioid-related mortality among males and females in BC was not matched by a continued increase in the incidence of [neonatal abstinence syndrome], which decreased in 2021 and 2022.”

This means that more babies were born with the condition before the height of opioid overdoses that came later, in the heart of the pandemic. The researchers listed possible explanations for this finding as differences in substance use behavior among pregnant women versus other users, fertility rate changes in users, and neonatal mortality among these women.

What Is Neonatal Abstinence Syndrome?

Neonatal abstinence syndrome occurs when a pregnant woman takes drugs such as heroin, codeine, oxycodone, methadone, or buprenorphine. While she is pregnant and using drugs, the substances pass through the woman’s placenta that connects the mother and fetus. During this process, the growing baby can become dependent on the drug.

Should the drug use continue through pregnancy, the baby will be dependent on the drug at birth. Because the baby is no longer receiving the drug after birth, withdrawal symptoms occur. Symptoms and signs vary depending on the drug but can include blotchy skin, diarrhea, excessive or high-pitched crying, fever, increased muscle tone, irritability, poor feeding, rapid breathing, seizures, and sleep problems.

The cross-sectional study, published in JAMA Network Open, noted that the rate of children born with neonatal abstinence syndrome increased uniformly across British Columbia, regardless of women’s socioeconomic status or whether a mother lived in an urban or rural setting. From 2020 to 2021, the rate of infants with neonatal abstinence syndrome born in a low socioeconomic status was 12.9 per 1,000 live births versus the overall rate of 5.6 per 1,000 live births. The rate of infants with drug dependence born into lower socioeconomic status was consistently higher than the overall average between 2010 and 2022.

The rate of infants born in urban areas with neonatal abstinence syndrome did not differ significantly from the rate of all infants born with the condition in British Columbia.

Treating Neonatal Abstinence Syndrome Is Costly

The cost of treating children with neonatal abstinence syndrome is steep. According to the U.S. Centers for Disease Control and Prevention, in 2020, infants exposed to opioids stayed in the hospital for an average of nine days compared to two days for newborns who weren’t exposed. The cost of care for a baby born with the condition averaged almost $8,000 versus $1,100 for a healthy baby.

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Treatment for neonatal abstinence syndrome depends upon the type of drug the mother used during pregnancy, the infant’s overall health and abstinence scores, and whether the baby was born full-term or premature. Sometimes, a newborn will require fluids if they are dehydrated as a result of vomiting or other feeding problems. Often, infants with neonatal abstinence syndrome are fussy and difficult to soothe, requiring extra attention and care. Nonmedical calming methods may include skin-to-skin time and breastfeeding, as long as the mother is in a methadone or buprenorphine treatment program.

Sometimes, an infant suffering from neonatal abstinence syndrome will need medical treatment, such as methadone or morphine, to treat withdrawal symptoms. These infants require additional hospitalization. Treatment often lasts between one week and six months.

The long-term prognosis for infants with neonatal abstinence syndrome includes health problems such as birth defects, low birth weight, small head circumference, sudden infant death syndrome (SIDS), and problems later in life with development and behavior.

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