Amid a national conversation on combating the ills of opiate abuse, a new coalition of Acadiana medical professionals is working to reduce both the number of babies born suffering from opiate withdrawal and the number of mothers prosecuted for consuming the drugs while pregnant.
The NAS Project of Acadiana is focused on educating the public about neonatal abstinence syndrome — a medical term describing the withdrawal symptoms a newborn experiences after having ingested drugs in the womb — and steering pregnant mothers toward any help they need to stay drug-free during pregnancy.
“The goal is to decrease the number of women receiving sanctions for (drug use) and reducing the number of children who are born to addictive substances,” said Brad Farmer, executive director of the Acadiana Area Human Services District.
Newborns whose mothers consumed drugs like heroin, prescription opioids or one of the drugs designed to help with addiction — methadone and buprenorphine — become addicted with the mother as the substances pass through the placenta and into the womb.
Once born, the babies are often confined to a hospital for days, weeks or months and suffer from low birth weight, breathing and feeding problems and seizures. Some babies need methadone and morphine to ween off the addiction.
Along with having an ailing newborn, a mother faces criminal penalties when her child tests positive for drugs, and she may lose custody of the baby. But part of the NAS Project’s focus is encouraging pregnant women to seek treatment before it comes to that point.
“If the ladies volunteer for this and seek help, it doesn’t become punitive,” Farmer said.
Only when a child is born drug-exposed does a mother face criminal penalties for child abuse, said 15th Judicial District Judge Thomas Duplantier, who presides over hearings when the state becomes involved in child protection. He said the majority of newborn abuse cases he encounters involve opiate consumption.
Mothers often hold back confessing about their drug use during pregnancy for fear of those penalties, he said.
“We are kind of walking a fine line. We don’t want women to not get prenatal help. We don’t want them to shun the prenatal work because of their concern that they might get in trouble for testing positive. We don’t want it to be criminal,” Duplantier said.
One effort to reach those mothers before they give birth is underway at the Women, Infants and Children clinic for low-income women enrolled in the federal nutrition program. A counselor is now on-site to assess an expectant mother’s drug use and guide her toward treatment.
Attention to opiate abuse has grown along with an increase in opiate prescriptions, the sales of which quadrupled in the U.S. from 1999 to 2010, according to the Centers for Disease Control and Prevention. The rates of heroin abuse have increased in tandem, as those addicted to prescription opiates often turn to heroin as a cheaper alternative.
Similarly, there was a fivefold increase from 2000 to 2012 in the number of U.S. babies born with neonatal abstinence syndrome, up to about one baby born with the condition every 25 minutes, according to the National Institute on Drug Abuse.
U.S. newborns diagnosed with neonatal abstinence syndrome in 2012 stayed in the hospital an average of 16.9 days — compared with 2.1 days for healthy newborns — costing hospitals about $1.5 billion, the institute estimates. About 81 percent of the bill is funded by state Medicaid programs, as drug-using mothers tend to come from low-income communities.
In Louisiana, about 69 percent of births are financed by Medicaid — the highest percentage in the nation, according to 2010 data from Kaiser Family Foundation.
Official numbers for births involving an neonatal abstinence syndrome diagnosis are still being compiled in the state. A resolution approved during the 2015 legislative session requested the Commission on Perinatal Care and Prevention of Infant Mortality to conduct a study and provide recommendations by March 1 for the prevention, assessment and treatment of neonatal abstinence syndrome.
Follow Lanie Lee Cook on Twitter, @lanieleecook, or contact her by phone at (337) 534-0825.