The U.S. Centers for Disease Control and Prevention recently reported a dramatic spike in documented opioid use by mothers at delivery hospitalization. From 1999-2014, the rate of babies born to opioid addicted mothers quadrupled. 15 years ago, 1.5 babies out of 1,000 were born to mothers addicted to opioids. By 2014, that number had climbed to 6.5 babies out of 1,000.
These numbers are based on national statistics, and the numbers were lowest in the District of Columbia, with 0.7 out of 1,000 babies born to addicted mothers. But in my home state of Vermont, the rate of babies born to opioid addicts was the highest. A staggering 48.6 deliveries out of 1,000 were considered opioid use disorder births.
I have witnessed one of these 48.6 Vermont births firsthand when I supported a friend who fostered a methadone-addicted baby for the first month of her life. While mom was trying to stay clean, she used methadone and smoked pot—even at the hospital. The baby was immediately taken from the mother’s care and sent home with my friend. Instructions on how to deal with rigidity, screaming, and tremors were given. The goal was to rehabilitate Mom so Baby could be returned to her care. It was heartbreaking to know my friend could provide a safe and drug-free home, but the hope was sobriety and reunification.
This information is devastating and hard to swallow, but we need to better understand this epidemic. We need to examine how our most vulnerable became the victims of drug addiction before they were even born.
How We Got Here
It can be easy to form opinions that shame and judge addicted mothers who deliver stillbirth babies or those with neonatal abstinence syndrome (NAS) — complications due to withdrawal-like symptoms babies experience after birth. Pregnant women aren’t supposed to have deli meat, too much caffeine, or even a glass of wine, yet these mothers are abusing prescription pain killers, heroin, and fentanyl throughout their entire pregnancies. It’s awful and unacceptable. But we need to see the whole picture and not just the one that makes us point fingers, shake our heads, and write off these mothers as “junkies.”
As an alcoholic myself, I can promise you I never once decided I wanted to be an addict. It was not a decision I made. Yes, I chose to take that first drink. But the need to keep drinking felt out of my control. I am confident the women addicted to opioids did not choose to become drug-seeking and baby-harming people. They are humans with a disease. They are out of control addicts who need our help.
A new study has linked opioid use with manual labor. With hard labor like construction, roofing, and fishing jobs comes pain, and with pain comes the need for relief so people can continue to work. Work is what pays the bills, buys food, and covers the cost of housing.
Without an income—sometimes even with one—people cannot support themselves or their families. So many people turn to their doctors. In the late ’90s, the big drug companies promised relief through opioid pain pills. They also promised they were not addictive. Doctors prescribed opioids at a rate that easily fed into the increasingly addictive nature of the drugs they thought were helping their patients.
Misuse, abuse, and overdose numbers climbed. And as people started to rely on pills, they became desperate. Prescription overuse turned to stealing from family and friends and to street drugs and cheap heroin. Vermont is a very labor-driven state, full of farmers and forestry workers, so it is no surprise to me that the rate of opioid born babies is high.
I am not excusing the heartbreaking reality of addiction’s impact on babies. Nor am I saying all opioid addicts follow this path from pills to dirty fixes. Curiosity, recreational use, and emotional pain play parts too. People self-medicate in many ways and for many reasons. An addict often cannot stop self-medicating, even when pregnant.
Babies born to opioid-addicted mothers suffer from varying degrees of NAS. Symptoms can be seen as early as 24 hours after birth or not until up to 10 days later. Vomiting, sweating, diarrhea, tremors, high pitched crying, and loss of appetite are some of the problems opioid addicted babies face. These babies are miserable. Their health is at risk and so is their safety. It is hard to predict what the long-term impact of NAS will be because of so many external variables, one of them being the removal from their mother and family. Child protective services often intervene and remove a child from parental custody shortly after birth.
The National Institute on Drug Abuse sites that the CDC “estimates that the total ‘economic burden’ of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.” The high rate of babies born to opioid-addicted mothers ripples through our justice, welfare, employment, and medical systems. The financial and logistical impacts of an addicted mother on her child compound the physical effects of the drug itself.
How We Make It Better
If there was an easy solution, then opioid addiction would not be considered our country’s greatest health crisis. Compassion will not fix this problem, but it’s a good place to start. We need to see all addicts as people who need help. If addicts can come out of the shadows of shame and fear, they can hopefully find access to mental health and recovery services. But we need to provide affordable and accessible mental health and recovery services too.
We need to address the reasons for opioid use. We need to find better ways to treat pain management. And we need to utilize drugs that treat opioid addiction. Methadone, buprenorphine, and naltrexone are available but underused medications that could help opioid addicts lead functional and healthy lives.
We need to provide ongoing support, care, and sometimes tough love to moms who want to be better for their children and who want to lead lives without the use of opioids. If we are going to see the rates of babies born to moms with opioid addiction drop, we need to treat the opioid addiction crisis first.
The Substance Abuse and Mental Health Services Administration offers a free national hotline 24 hours a day, 365 days a year. The hotline (1-800-662-HELP) provides referrals to local facilities and support groups; treatment and referral services are available in English and Spanish. Please call 1-800-662-HELP (4357) if you or a loved one needs help.