Every 25 minutes, a baby is born suffering from opiate withdrawal in the United States.
As the drug epidemic continues to grow regionally, one of its side effects is being extended to the tiniest humans.
Neonatal abstinence syndrome, or NAS, includes the painful withdrawal symptoms that newborns suffer after birth. Although other substances have been implicated, NAS is most often attributed to opioid exposure.
NAS babies often present with low birth weights, respiratory issues, and tremors or seizures.
Currently, the data in Pennsylvania on NAS is limited. The only available statewide statistics are from women who are enrolled in Medicaid.
Still, those statistics show a troubling trend.
Statewide, the total number of neonatal stays related to substance use in 2015 was 2,700 – or 20 per 1,000 neonatal stays. That’s up from 6 per 1,000 a decade and a half earlier, or a 250 percent increase.
Locally, the six county region shows the number of NAS babies reported to Medicare doubled from 40 to 80 between 2010-2013.
Drug exposed babies on the rise
Dr. Mohamed Hassan, neonatologist and medical director of Penn Highlands DuBois’ Neonatal Intensive Care Unit, is on the front lines.
“I have eight babies today (in the NICU) and half of them have NAS,” Hassan said during an interview Tuesday afternoon.
“It’s not fun to see a baby withdraw. You see them screaming all the time, vomiting, with diarrhea. It takes a toll on doctors, nurses and moms.”
Six years ago, about 3 percent of the babies born at the hospital were diagnosed with neonatal abstinence syndrome.
Over the last year, it has increased to nearly 17 percent.
Of those, the majority are dependent on narcotics after being exposed to heroin, as well as methadone and Subutex, medications used for the treatment of opiate addiction.
Hassan said the high number of cases is not necessarily a reflection of drug use in DuBois, but of the region, as he has done extensive outreach to get NAS babies referred to the hospital to be cared for.
Of babies born drug exposed, between 60-90 percent will require therapy, which includes constant monitoring and weaning with morphine sulfate.
“It’s basically like a mini-drug rehab to make their life less miserable those first two to three weeks so they can sleep and eat,” Hassan explained. “We give them medicine to take the edge off and then wean gradually.”
And that care is expensive.
NAS babies stay about 23 days in the hospital at an average cost of about $93,000, compared to normal newborns who stay about three days for $3,000-$4,000.
Despite the cost, Hassan’s goal is to identify addicted mothers before delivery so he can build a relationship with them and provide the best outcome possible.
The mothers sit on a comfortable leather couch in his office and are offered chocolate and water to the break the ice as calming music plays in the background.
The doctor kindly explains the impact drugs may have had on their unborn baby, what treatment would look like, and dispelling myths that they are going to jail or their baby is going to be taken away.
“About 94.4 percent of mothers will accept and have a feeling that this is helping their babies,” Hassan said. “Even a mother on drugs is still a mother. This (treatment) proves they love their baby and they care.”
The hospital is required to report babies affected by illegal substance abuse or fetal alcohol syndrome, but not when they are on a prescribed drugs through a doctor or are on a drug maintenance program.
A baby born with NAS can go on to be perfectly healthy. But Hassan said a lot of factors play into that future including genetics, the amount and kinds of drugs they were exposed to, and the environment they go home to.
Here, babies born with anomalies like NAS, are followed through age two by its development clinic to track their development.
“I don’t like to call babies ‘drug addicts’ because that’s not fair to the baby. Babies are not addicts, they are exposed to drugs and they have no choice in that,” Hassan said. “There are some sad stories out there.”
While the goal is to give mother and baby the tools necessarily to be successful, that’s not always the case.
Pennsylvania’s submission to the federal Adoption and Foster Care Analysis and Reporting System shows that 3,353 infants were removed from their home in 2013. Fifty-six percent were recorded as having parental substance abuse as a contributing factor to the out-of-home placement.
Nearly 99 percent of the children placed in Rob and Lori Dowie’s home in Kersey are “drug babies,” she says.
They’re children who come from homes broken by the ravaging effects of addiction.
Many even suffered withdrawal at birth.
Lori has been a foster parent for 14 years.
As a single parent, she wanted another child and went to Catholic Charities, fostering several before adopting her daughter Chrissy, who was found wandering alone in a Blair County apartment building while her mother was passed out.
Lori speaks with a certain level of pride and emotion when she talks about her adopted daughter, who at 21 is enrolled in college even though she struggles with problem-solving and math as a result of being born with mild fetal alcohol syndrome.
When the Dowies were married, they talked about having children, but there was a pause in that conversation as Rob has a risky and dangerous job as a wild land firefighter.
That’s when they became a “foster, pre-adopt” family.
When asked why they chose the status, Dowie said, “My oldest daughter (Chrissy) was pushed around between three different families. I don’t believe in that.”
Currently, their warm and welcoming home on a secluded country road is filled with four young, wide-eyed children.
Fostering just over a dozen children in their time as foster parents means their home has been a revolving door of support staff and sad stories. The Dowies have run to help children left at the hospital by their mothers, as well as those left homeless when their parents were incarcerated, hospitalized when they got into their parents’ drugs, or those found alone and neglected while their parents got high.
Lori encourages anyone who loves children to consider fostering because the need is ever-present and growing. But she added that she hopes the system continues to change and progress to give children more rights.