Pubdate: Tue, 14 Oct 2014
Source: Times Recorder (Zanesville, OH)
Copyright: 2014 Times Recorder
Author: Laura Ungar
Bookmark: (Heroin)
Bookmark: (Treatment)


One drug-dependent baby is born every hour in the USA, researchers

They are the tiniest victims of the nation's opioid epidemic, born
into agony -- trembling, sweating and crying inconsolably from the
pain of drug withdrawal.

And as their numbers soar, doctors, health officials and drug-control
professionals are pushing to screen all pregnant women for substance

"When a child's first days in this world are in agony, that certainly
should be a concern to all of us," said Van Ingram, executive director
of the Kentucky Office of Drug Control Policy. "We need to do all we
can to prevent this."

Growing support for universal screening is a sign of how big the
problem has become. One drug-dependent baby is born every hour in the
U.S., according to the latest national statistics from a 2012 study in
The Journal of the American Medical Association, which showed the
numbers nearly tripled between 2000 and 2009.

According to the Ohio Department of Health, an average of 2.1 babies
per every 1,000 live births were born with neonatal abstinence
syndrome between 2008 and 2012 in Muskingum County. With an average of
a little more than 1,000 live births every year, about 2.5 babies are
born with complications from drug addiction in the county annually.

To help stem the tide, the American Congress of Obstetricians and
Gynecologists and the Association of State and Territorial Health
Officials are calling for verbal drug screening followed by a urine
test if necessary and agreed upon. The American Medical Association
also endorses universal screening.

Not everyone welcomes the idea. Some pregnancy rights advocates argue
that screening might lead to punishment or loss of custody rather than
treatment and sobriety.

But recovering opioid addict Ashley Kirchhubel, 31, of Louisville,
Kentucky, disagrees. She abused pain pills while pregnant with her
now-3-year-old son, Johnny, hiding her addiction from her obstetrician
even when asked about drug use.

It raged on, and she briefly turned to heroin before entering drug
treatment early in her pregnancy with Isaiah, born Sept. 27. She said
that only by the grace of God was neither born dependent.

If the mother of four had undergone a urine screen, she suspects she
would have gotten into treatment much sooner to avoid losing her children.

"That would've been a good enough reason to stop," she said as her
newborn's tiny fingers curled around hers. "They should screen everybody."

Doctors routinely screen pregnant women for diseases such as HIV and
hepatitis, and some say adding drug abuse to the list would reduce the
stigma of addiction and keep women from being singled out by race,
income or appearance.

The obstetricians' group recommends screening first with a
questionnaire. Those whose answers warrant, or who on examination have
signs such as needle marks from intravenous drug use, would undergo a
urine screening if they consented.

Doctors would have to make them aware of any legal consequences of a
positive screen, such as the need to notify child services.

"Substance abuse screening is critically important in pregnancy," said
Jessica Young, of Vanderbilt University, a fellow with the
obstetricians group. "It's a time for the physician to educate the
patient and help them get into treatment, which can lead to better

Today, outcomes are often grim.

Many drug-dependent infants suffer diarrhea, vomiting, low-grade
fevers, even seizures. They're extra-sensitive to noise and light.
Those born prematurely might experience respiratory distress and go on

First-line therapy for severely affected babies is morphine, although
babies with milder cases might not need medicine. All require
swaddling, rocking and cuddling.

"In the short term, they may have problems feeding or growing," said
Michael Warren, maternal and child health director for the Tennessee
Department of Health. "There's not a lot known about the long-term

Screening could save babies from such suffering and works best when
doctors are not judgmental, so moms feel safe enough to be honest
about drug use, said Paul Jarvis, executive director of the health
officials association. His group also suggests removing financial
obstacles to screening by covering it under Medicaid.  
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