By Jillian Payne
More than 1,900 newborns across the state of Pennsylvania were born suffering from drug withdrawal in 2017.1 The Pennsylvania Health Care Cost Containment Council recently shared data that looked at each county throughout Pennsylvania and analyzed the rate of neonatal abstinence syndrome (NAS) per 1000 newborns.
Geographically, Western Pennsylvania assumes much of this burden. Allegheny County has a rate of 15.6 per 1,000 babies born with NAS, which is close to the statewide average. Other western counties such as Greene reports 76 babies per 1,000 who are born suffering from withdrawal symptoms.1
Maternal use of both licit and illicit drugs during pregnancy can result in the newborn experiencing NAS, which occurs when a pregnant women passes a drug addiction to the fetus, who will then experiences withdrawal symptoms upon birth. These babies are most often born prematurely, underweight, and showing signs of respiratory depression, or trouble breathing.
They tend to stay in the hospital five times longer than the average newborn and can be in so much pain that they cannot be touched. Excessive or high-pitched crying, irritability, poor feeding, sleep problems, slow weight gain and seizures are all characteristics of a baby with NAS.2
Treatment for these newborns depend on factors such as the types of drugs abused, the overall well-being of the newborn, as well as how premature the baby was born. Once born, the baby will usually starting presenting with symptoms within 48 hours; however, withdrawal symptoms can also initiate as late as five to seven days after birth.2 Doctors often keep suspected babies under observation until they can rule out NAS. Once a baby is diagnosed a typical treatment strategy includes a gradual weaning of a single opioid, usually morphine, which can take up to 30 days.2
The Pennsylvania Health Care Cost Containment Council, which monitors different conditions and diseases and their financial burdens, estimated that NAS-related hospitalizations stays amounted to $14.1 million in payments to Medicaid in 2017.1 Responding in part to this alarming statistic, Governor Tom Wolf declared the heroin and opioid epidemic as a statewide disaster emergency in January 2018. As part of the Governor’s 13 initiatives, Pennsylvania will start compiling statistics on children born with withdrawal in state wide data collections in order to demonstrate the ways that drug addiction affects Pennsylvanians.1
Western Pennsylvania is aware of this epidemic and is trying to provide addicted mothers with the help they need while pregnant. Allegheny Health Network launched a new program called “Perinatal Hope” which provides personalized and complete care through medication-assisted treatment as well as OB care. By providing early substance abuse treatment to mothers, this program has shown that 95% of their newborns are not born with withdrawal symptoms and do not need treatment.3
Newborn babies are the youngest and most fragile patients within our current opioid epidemic. Pregnant women with substance abuse issues are encouraged to seek guidance from their healthcare provider, especially since abrupt stoppage of the substance without supervision could cause severe complications with the pregnancy. Being open with your doctor and working together to make a plan of action can ensure the best quality of care that both mom and baby need.
For more information about the Perinatal Hope program please visit: https://www.ahn.org/specialties/womens-health/pregnancy-and-newborn-services/perinatal-hope-program
For more about treatment referral and information on substance abuse, please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) 24-hour free national helpline at 1-800-662-HELP (4357).
- Lancianese A. More Pennsylvania Babies Born Addicted To Drugs, Report Finds. 90.5 WESA. http://wesa.fm/post/more-pennsylvania-babies-born-addicted-drugs-report-finds#stream/0. Published March 28, 2018. Accessed May 14, 2018.
- Pennsylvania Patient Safety Authority. Addressing the Rise in Neonatal Abstinence Syndrome: A Multifaceted Approach | Advisory. Pennsylvania Patient Safety Authority. http://patientsafety.pa.gov/ADVISORIES/Pages/201512_125.aspx. Published December 2015. Accessed May 14, 2018.
- Study: Pa. Newborn Drug Withdrawal Cases Up 1,000 Percent Over Last 17 Years. CBS Pittsburgh. http://pittsburgh.cbslocal.com/2018/03/28/pa-newborn-drug-withdrawal-cases-up-1000-percent/. Published March 28, 2018. Accessed May 14, 2018.
This article was written by Jillian Payne, a student pharmacist at Duquesne University School of Pharmacy, and reviewed by her faculty advisor, Dr. Jordan Covvey.
Jillian is currently a sixth year pharmacy student at Duquesne University School of Pharmacy. She currently works as an intern at West Penn Hospital. She is an active member of the professional pharmacy sorority Lambda Kappa Sigma, and the American Pharmacist Association (APhA). She is currently enjoying her APPE rotations and seeing all the different opportunities that await her after graduation.
Dr. Covvey is an Assistant Professor in Pharmacy Administration at the Duquesne University School of Pharmacy. She earned her Doctor of Pharmacy from the University of Kentucky in 2010, and then completed residency training at Virginia Commonwealth University Health System in 2011. She subsequently passed her board certification in pharmacotherapy (BCPS) and was selected as a recipient of a Fulbright grant to complete a Doctor of Philosophy at the University of Strathclyde Institute of Pharmacy and Biomedical Sciences in Scotland. She currently teaches in the public and global health curriculum for pharmacy students at Duquesne, and her research area is in the utilization of healthcare data, such as electronic medical records, for quality improvement in prescribing.