They are the opioid epidemic’s littlest victims, and their stories are heartbreaking. For infants born to opioid-addicted mothers, the first few moments in this world can be horrifying, but the effects can also follow these children to their homes. The condition is known as Neonatal Abstinence Syndrome (NAS), and its effects can be absolutely chilling.
The symptoms can leave newborns shaking uncontrollably, crying at the slightest stimulus and sometimes unable to eat. It’s a disheartening sight for any parent and the nurses who care for them. It’s also a sight that is far too common for comfort.
According to data from the Centers for Disease Control (CDC), one infant is born with NAS every 25 minutes.
West Virginia, Vermont, and Maine have the highest rates of NAS with more than 30 cases for every 1000 births. Even those number are dated while the job of making the data publicly available has fallen largely to reporters.
An in-depth investigation by Reuters in 2015 discovered that the last year for which data was collected on NAS cases was 2013. In that year alone, nearly 30,000 newborns were diagnosed with opioid-related NAS, and that information was far from readily available. It was obtained through over 200 FOIA requests for local, state, and federal records on infant deaths despite the fact federal law demands those numbers be kept up to date.
A law passed in 2003, called the Keeping Children and Families Safe Act, outlined requirements for states to report cases in which newborns were diagnosed with NAS and notify child protective services. Unfortunately, those regulations only apply to illegal substances, which has become a major loophole in the system in the wake of the prescription opioid epidemic.
The CDC has found that one-third of women aged 15-44 in the US are prescribed opioids and up to 22 percent of those women fill opioid prescriptions during pregnancy. That’s a pattern of use which is seriously concerning since even the smallest level of exposure can put a child at risk. As a study conducted in collaboration with Harvard Medical School found; 55 to 94 percent of newborn babies whose parents used opiates show symptoms of NAS.
But the truly troubling aspect of NAS cases is that the danger can follow these infants home. While the illness itself is curable, doctors know that many of the parents are not prepared to care for their babies once they leave the hospital. According to the CDC, 86 percent of pregnancies that result in opioid-dependent children are unplanned.
As a result, doctors are obligated to inform child services when a family is sent home. Yet in their investigation, Reuters uncovered 110 cases since 2010 in which a newborn was sent home with their parents and subsequently died of causes that were unrelated to their NAS.
“Being born drug-dependent didn’t kill these children.” The report states, “What sealed their fates was being sent home to families ill-equipped to care for them.”
Indeed, many states don’t comply with the federal requirements and those that do have crafted laws which contradict the 2003 law and enforce punishments for the parents.
Among these states is Alabama, where instances of NAS are among the highest in the country and state law finds these cases to be, “chemical endangerment of a child.” If found guilty, the mother could serve up to 10 years in prison, and that’s only if the baby survives. If the infant dies, that penalty can be raised up to 99 years. According to records obtained by ProPublica and AL.com of the 1,800 women arrested since the state regulations were passed in 2006, 479 women have been charged.
That threat of facing life in prison may seem like justice to some – especially when a child is involved – but it can also deter mothers from seeking help for their addictions.
As a result, doctors are reluctant to report these cases to the proper authorities because many of them believe that punishing the parent is prioritized over helping the child.
The non-profit National Advocates for Pregnant Women (NAPW) seems to agree. In an open letter to the media and policymakers, medical professionals from across the country warned of the dangers of enacting harsh punishments.
“Demonizing pregnant women,” the letter states, “creates an environment where punishment rather than support is the predominant response, and will inevitably serve to discourage women from seeking care.”
They also go on to criticize the coverage of these cases in the media and suggest that terms like “crack baby” and “victim” not be used in reports, though it’s difficult to see how NAS diagnosed infants are not victims in some way. The NAPW claims that reports of the illness are wildly overblown and that the media is doing more damage than good.
Still, throughout the legal and healthcare structure it seems that there are several gaps that need to be addressed and media coverage appears to have shone a light on those shortcomings. If any good can be gleaned from these stories, it’s that doctors and lawmakers have begun to take notice. The hope is that it won’t be long before they also take action.