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Rate of Ontario newborns suffering withdrawal now 15 times higher than 20 years ago
The rate of babies being born in Canada’s province of Ontario suffering from opioid withdrawal has soared to more than 15 times what it was 20 years ago.
Newborn withdrawal, called neonatal abstinence syndrome (NAS), grew in Ontario from about 0.3 per 1,000 live births in 1992 to 4.3 per 1,000 in 2011 – in all, nearly 3,100 infants born suffering the same frightful withdrawal symptoms that adult addicts go through when kicking opioid dependence.
And newborn babies don’t have whatever tiny bit of comfort there might be in at least knowing why they’re in so much pain and that it will eventually be over.
Two major facts point at a most disturbing situation:
- Nearly all the mothers were dependent on prescription opioids like oxycodone, hydrocodone and morphine from their physicians, not street drugs like heroin or illicit opioid painkillers.
- Most of the increase occurred in just the past 5 years – over 1,900 babies, 2/3 of the total 3,100.
The past 5 years has seen negative publicity at an all-time high about the dangers of overprescribing opioid pain killers. Canadians should have expected their doctors to back off from the unhealthy rates of prescribing opioids that occurred through the 1990s and early 2000s. But it appears some Canadian doctors didn’t get the memo, as the saying goes.
The research, published in the Canadian Medical Association Journal, says women were prescribed opioids both before and during pregnancy. Principal researcher Dr. Suzanne Turner, a physician at St. Michael’s Hospital in Toronto who specializes in providing obstetrical care for women with addictions, said the study suggests that many women were prescribed opioid painkillers to treat pain prior to or during their pregnancies, and then at some point a dependence or an addiction was identified and they were switched to methadone.
Current medical opinion holds that methadone withdrawal is a little easier on newborns. Although switching one dependence (painkillers) for another (methadone) hardly sounds like treatment for most people. But in the case of pregnancy, an opioid- dependent mother-to-be must not attempt to detox because it is dangerous to the fetus.
“That’s really important because we know that methadone is actually good in [such a] pregnancy because it stabilizes mom, and babies are more likely to be born at term and at high birth weight and healthy.”
Of course, Turner’s use of the term “healthy” doesn’t mean that these newborns don’t face a week or two of methadone withdrawal hell, unless they are carefully weaned from a replacement drug such as morphine.
“The concern to me is how do we address the fact that they were prescribed opiates prior to pregnancy and is there something we can do at that stage to prevent the transition to addiction and then requiring methadone,” she asked. “This is a treatable condition. If the babies get morphine, which is typically the standard of care, they’re not in withdrawal and then we slowly wean them off that dose of morphine over time.”
Addiction to prescription opioids now exceeds heroin addiction as the most common reason to offer methadone as a “treatment.” Turner says that preventing addiction by using alternative pain-relief therapies when possible would pay dividends for both mothers and their babies. “It speaks to the fact that doctors need to be aware there is the risk of addiction if women are prescribed opiates prior to pregnancy, and if they’re of child-bearing age, those risks should be assessed.”
Turner added that doctors and other caregivers need to counsel women that using any opioid during pregnancy can lead to NAS. She said this is especially important information for women with addictions because of the uncommonly high risk of unplanned pregnancies.
Here at Novus, we deal with opioid/opiate painkiller dependencies and addictions on a daily basis. If you or someone you care for needs help with opioid dependence, don’t hesitate to call us. We’ll help you find the right solution for your situation.
Image courtesy of arztsamui at FreeDigitalPhotos.net
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