Over the last week, there have been quite a few articles in the press detailing the increase in opioid use in the United States, focusing the impact of this epidemic on infants and children.
According to a study published this week in JAMA Pediatrics, researchers tracked newborns treated for opioid-related complications over the past 10 years and documented a dramatic increase in the number of newborns in the United States born with signs of opiate withdrawal or neonatal abstinence syndrome (NAS).
This trend was most obvious in rural areas, where the rate of newborns diagnosed with neonatal abstinence syndrome increased from nearly one case per 1,000 births in 2003-2004 to 7.5 per 1,000 births in 2012-2013. In urban populations, the rate also increased, but less drastically, increasing from 1.4 to 4.8 per 1.000 births over the same period.
The authors of the study consider the possibility that women in rural areas may have less access to effective substance abuse treatment. Previous studies have demonstrated that pregnant women with opioid use disorder who receive treatment — with drugs like buprenorphine combined with an opioid addiction treatment program — have better pregnancy outcomes than women without access to these services. The authors of this study make recommendations to increase the number of rural providers authorized to prescribe buprenorphine and to expand rural mental health and substance abuse services.
The 21st Century Cures Act, passed last week by the Senate, promises $1 billion to address the opioid epidemic. But this legislation has its critics, including Massachusetts Senator Elizabeth Warren, who is quoted as saying:
The funding allotted for the NIH “a fig leaf,” or an insignificant amount. She also insisted that “most of that fig leaf isn’t even real. Most of the money won’t really be there unless future Congresses pass future bills in future years to spend those dollars.”
Seems like a long road ahead of us.
Ruta Nonacs, MD PhD