Statewide Effort Addresses Problem of Babies Born Dependent on Addictive Drugs

Tuesday, November 27, 2012 | 08:02am

NASHVILLE – Weighing in at just over four pounds, one of the newest residents of Tennessee isn’t just premature, he’s dependent on addictive drugs. Within a few hours of the delivery, hospital staff members knew by his seizures, high-pitched cries, tremors, fever and vomiting this innocent baby was another tragic case of neonatal abstinence syndrome, a condition caused when an unborn child is exposed to powerful drugs used legally or illegally by a mother during pregnancy.

“In the last two years alone, more than a thousand helpless, blameless babies in Tennessee have been born dependent on addictive drugs their mothers used during pregnancy,” said John Dreyzehner, MD, MPH, commissioner of the Tennessee Department of Health. “Some of these drugs were prescribed for chronic pain, some for treatment of addiction itself and some were illegally obtained. NAS is one of the most troubling effects of drug misuse and abuse across the United States and we can’t allow it to continue.”

A collection of state leaders known as the Neonatal Abstinence Syndrome Subcabinet Working Group is working collaboratively to reduce the problem in Tennessee. The group has petitioned the U.S. Food and Drug Administration to help combat the rising number of NAS births in Tennessee by adopting a “Black Box Warning.” The warning would appear in the medication reference material used by clinicians and would alert them to have heightened awareness of the possibility of unintended harm to a newborn from the mother’s use of narcotics.

The request to the FDA follows earlier action by the Tennessee Department of Health to make NAS a reportable condition effective Jan. 1, 2013. That move will allow health officials to identify cases more quickly and accurately as part of an expanded effort to reduce NAS births statewide.

Tennessee hospital discharge statistics show the problem is increasing every year, with a ten-fold increase between 2000 and 2010. The problem can affect any woman using powerful drugs during pregnancy, including alcohol. In addition to the impacts on the baby’s health, NAS is also a very costly disease.

Babies suffering from NAS spend much longer in the hospital after birth than healthy babies. The average cost of a baby receiving TennCare benefits born with neonatal abstinence syndrome in Tennessee was $40,931 in 2010. That compares with $7,258 for a baby receiving TennCare benefits not born addicted that same year. 

“Babies suffering from NAS often face a multitude of daunting challenges in their first few weeks of life,” Dreyzehner said. “I’ve talked with many clinicians across Tennessee who have become used to seeing wounds and illnesses, but even the most seasoned healthcare workers have a difficult time watching a helpless infant going through the painful process of withdrawal. We’re hopeful the FDA will accept our group’s recommendation to put this Black Box Warning into effect quickly.”

Members of the Neonatal Abstinence Syndrome Subcabinet Working Group are:   

• John J. Dreyzehner, MD, MPH, FACOEM, Commissioner, Department of Health
• Darin J. Gordon, Deputy Commissioner, Division of Health Care Finance and Administration
• Raquel Hatter, MSW, EdD, Commissioner, Department of Human Services
• Wendy Long, MD, Health Care Finance and Administration Chief Medical Officer
• Kathryn R. O’Day, LCSW, Commissioner, Department of Children’s Services
• E. Douglas Varney, MA, Commissioner, Department of Mental Health and Substance Abuse Services

“The purpose of this work group is to bring attention to the growing NAS problem in Tennessee, to provide more information to physicians and to the general public, and to help develop lasting and meaningful solutions,” Long said. “Our combined resources can promote the development of best practices for prevention and treatment for both mother and child.” 

For more information about neonatal abstinence syndrome, go to:

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