An increased reliance on prescription painkillers and the resulting addiction has now shown up in the most vulnerable patients -- America's newborns, according to a report in the Journal of the American Medical Association.
The study published Monday says the number of addicted babies -- many suffering from respiratory problems, low birth weight and seizures -- has nearly tripled in less than a decade.
That's one baby every hour in the U.S., according to the study, said lead author Dr. Stephen Patrick of the University of Michigan Health Center Neonatal Intensive Care Unit.
Meanwhile, the number of mothers using opiates has increased fivefold, according to the study. Doctors partially attribute this to an increase in awareness of patients' pain.The increase in babies born addicted also is a burden on public health dollars -- and a wake-up call about the need for better prevention, Patrick said.
"Instead of a burden ... I like to think about as an incentive to do something about it," he said.
The cost: Average costs to care for babies suffering from Neonatal Abstinence Syndrome (NAS) skyrocketed from $39,400 to $53,400 from 2000 to 2009, according to the study.
In addition to seizures and breathing problems, NAS is marked by low birth weight, irritability, muscle cramping, tremors, feeding problems, vomiting and watery stools.
"Generally, babies are soothed by wrapping or holding or being fed," Patrick said. "Typically, these babies can't be consoled."
Babies were in the hospital for an average of 16 days, and 78 percent were covered by Medicaid.
The study doesn't address why their mothers were using drugs, nor did it explore which drugs they used -- though NAS is most commonly linked to opiates, according to the study.
Prescriptions: Dr. Carl Christensen, who runs the Eleanore Hutzel Recovery Center in Detroit, said he sees it all the time: Doctors who too easily prescribe painkillers, and patients who demand them.
The clinic treats more than 100 addicted moms-to-be a year, said Christensen, who also is an associate professor of obstetrics and gynecology at Wayne State University. Most women were prescribed Vicodin and OxyContin to manage pain from injury or disease, Christensen said.
"A lot of patients ... feel they don't have an addiction as long as they can get their prescription filled," he said. Addiction can take hold in as little as two weeks, he said, and women face the daunting task of detoxifying -- a physical struggle, as withdrawal can lead to rapid pulse and breathing, high blood pressure, abdominal cramps, tremors, bone and muscle pain, vomiting, diarrhea, sleeplessness and depression.
It's an emotional struggle, too, because the women face a stigma by admitting their addiction and walking into a clinic, he said.
"Most of them are seeking help. They're very courageous," Christensen said.
Rise in use: The increase in the use of painkillers began more than a decade ago when doctors recognized that patient pain was going untreated, said Christensen.
So in addition to considering temperature, pulse, respirations and blood pressure, doctors began to focus on pain and its management, said Dr. Philip Gilly, medical director at Henry Ford Health System's Maplegrove Center in West Bloomfield, which provides in- and out-patient treatment.
That shift in focus not only addicted patients, it put more half-used bottles in medicine cabinets and on the streets, he said.
"I think narcotics are used for things more often ... and it's socially acceptable," Gilly said. "The people who are predisposed to addiction are exposed to narcotics more often than they used to be."
Patrick said the specific treatment for babies born addicted -- which babies should be treated, with what kind of drug, and with what dosage -- is unclear.
At U-M, methadone, which is less addictive, is used to ease babies' withdrawal.
"You don't want to overtreat it, and we don't have want to undertreat it," he said. "It's tricky. We need more research."