Epidemiology

The distribution of increased incidence positively correlates with the increase of prescription drug use. The map below represents the cases of Neonatal Abstinence Syndrome in each state. This was based off of the analysis of the Kids' Inpatient Sample 2012 (Vanderbilt, 2012).

 (Vanderbilt, 2012)

When looking at the map above, Kentucky, Tennessee, Mississippi, and Alabama are the states with the highest incidence of Neonatal Abstinence Syndrome at 16.2 births per 1000 births. This correlates with the amount of Opiate medications being subscribed by medical professionals within the same time frame. The image below represents prescribing rates per 100 persons, in quartiles, by state and drug type during 2012; the south region had the highest rates of prescribing opioid pain relievers and benzodiazepines (Paulozzi, Mack & Hockenberry, 2014).

(Paulozzi, Mack & Hockenberry, 2014)

Over the last five years, Neonatal Abstinence Syndrome (NAS) has increased in the United States. From 2000 to 2012, there was a five-fold increase of infants born with NAS (National Institute on Drug Abuse, 2015). More often than not, people who are addicted to a substance are using multiple. This brings even more risk to the infant who could need numerous detox regimens. NAS is rarely fatal because the infants are taken into critical care and are given the appropriate measures when diagnosed (Kocherlakota, 2014). In an experiment based in Florida, mothers with infants diagnosed with NAS, were on a combination of Opioids, Benzodiazepines, Tobacco, Marijuana, Cocaine, Antidepressants, Barbiturates, Methamphetamine, and Alcohol (Lind, Petersen, Lederer, Phillips-Bell, Perrine, Li, . . . Anjohrin, 2015). When focusing on the Opiate use, the mothers shared different reasons for using, these included; illicit use, drug abuse treatment, chronic pain or unknown (Lind et al., 2015). Populations at greater risk for abusing drugs include: those treating chronic pain, seeking thrill, or treating their tolerance (Women's Health Care Physicians, 2012). When looking at the research study, ethnically the majority of mothers identified as White, non-Hispanic, then followed Hispanic, Black, non-Hispanic and other (Lind et al., 2015). The results in this study are limited to Florida, but it gives a good picture of what is going on with the mothers with infants diagnosed with Neonatal Abstinence Syndrome. 

 Search terms: Neonatal Abstinence Syndrome, Epidemiology, Nationwide

 References

Kocherlakota, P. (2014). Neonatal Abstinence Syndrome. Pediatrics, 134(2). 

Lind, J., Petersen, E., Lederer, P., Phillips-Bell, G., Perrine, C., Li, R., . . . Anjohrin, S. (2015). Infant and Maternal Characteristics in Neonatal Abstinence Syndrome — Selected Hospitals in Florida, 2010–2011. Morbidity and Mortality Weekly Report, 64(8), 213-216.

National Institute on Drug Abuse (2015). Dramatic increases in maternal opioid use and neonatal abstinence syndrome.  Retrieved January 20, 2016, from http://www.drugabuse.gov/related-topics/trends-statistics/infographics/dramatic-increases-in-maternal-opioid-use-neonatal-abstinence-syndrome

Paulozzi, L. J., Mack, K. A., & Hockenberry, J. M. (2014). Variation among states in prescribing of opioid pain relievers and benzodiazepines — United States, 2012. Journal of Safety Research, 51, 125-129.

Vanderbilt. (2012). Neonatal Abstinence Syndrome. Retrieved January 26, 2016, from https://medschool.vanderbilt.edu/nas/

Women's Health Care Physicians. (2012). Retrieved January 26, 2016, from http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Opioid-Abuse-Dependence-and-Addiction-in-Pregnancy

What is Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome (NAS) occurs in newborns when the mother uses and is addicted to opiate drugs while pregnant. The problems arise when the narcotics pass through the placenta to the fetus, resulting in the fetus obtaining the drug effects and eventually becoming addicted like the mother (Lee, 2014). While in the womb, the fetus is receiving the narcotic whenever the mother takes the drug, ensuring no detox symptoms occurring. 
 
(Narconon News, 2011)                                            (Lee, 2014)

The effects of withdrawal start in the newborn after birth because the narcotics are no longer being supplied. Newborn babies have to go through many different changes, and adding detox to those changes only hurts the newborn. The symptoms of detox that can be present in the newborn after birth include; tremors, irritability, high pitched cries, sleep problems, tight muscle tone, seizures, poor appetite, vomiting, diarrhea, sweating, and unstable temperature (Neonatal Abstinence Syndrome, 2016). Along with the effects of detox that these newborns are going through, there are other problems that are at an increased risk including; poor intrauterine growth, premature birth, seizures and birth defects (Neonatal Abstinence Syndrome, 2016). These symptoms of detox and higher risk problems put terrible stress on the infants system, which is brand new to the world as is and trying to figure out how to function outside the womb.

(Wall Street Journal, 2012)

Over the years, there has been an increase of maternal opioid use and from that, there has been a rise in Neonatal Abstinence Syndrome. From the year 2000 to 2012 there was a five-fold increase of newborns being diagnosed with Neonatal Abstinence Syndrome, leading to an estimated 21,732 infants born with NAS in that time span (National Institute on Drug Abuse, 2015). To break it down further, the amount of newborns born with NAS is the same as one baby suffering from opiate withdrawal every twenty-five minutes (National Institute on Drug Abuse, 2015). With the amount of cases of Neonatal Abstinence Syndrome on the rise, there needs to be more attention brought to the severity of this prognosis and more research to provide a more effective treatment for those newborns who are diagnosed.

 References

Lee, K. (2014). Neonatal abstinence syndrome: MedlinePlus medical encyclopedia. Retrieved January 20, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/007313.htm

Narconon News. (2011). Retrieved January 20, 2016, from http://www.narconon-news.org/blog/2012/11/more-on-neonatal-abstinence-syndrome-and-babies-born-addicted/  

National Institute on Drug Abuse (2015). Dramatic increases in maternal opioid use and neonatal abstinence syndrome.  Retrieved January 20, 2016, from http://www.drugabuse.gov/related-topics/trends-statistics/infographics/dramatic-increases-in-maternal-opioid-use-neonatal-abstinence-syndrome

Neonatal Abstinence Syndrome. (2016). Retrieved January 20, 2016, from http://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387

Wall Street Journal. (2012). Born addicted: Treating drug-dependent babies. Retrieved January 20, 2016, from https://www.youtube.com/watch?v=tmgOiHMpENw