Study shows rise in some prenatal exposure to opiates

A new study from a state epidemiologist looks at infants who were exposed to opiates before birth. Unlike previous studies, it goes beyond the sharp rise in cases for a portion of the population to explore what happens next.

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From 2004 to 2015, for Medicaid-eligible births, there was a nearly seven-fold increase in the rate of Neonatal Abstinence Syndrome. NAS is when babies are in withdrawal from drugs after being born. In 2004, 2.7 out of every 1,000 live births in this group had NAS, and in 2015, it was 18.4.

However, state maternal and child health epidemiologist and study author Abigail Newby-Kew said these numbers do not reflect the entire state.

The study only looks at Medicaid-eligible births because that’s the most complete, long-term data set available, she said during a phone interview. It cannot be used to draw conclusions about rates for the entire population.

The study has other limitations, too, because NAS isn’t always diagnosed the same way in each hospital.

“Symptoms vary greatly based on just the type of drug the mother was using, the amount of the drug the mother was using,” Newby-Kew said. “It’s very possible that an infant might not display symptoms until they are already outside the hospital. In that case the hospital could miss it entirely.”

The study does mirror national trends. The number of kids born with opioids in their systems is on the rise. This study then goes a step further, to see what happens to the babies once they leave the hospital.

“It’s not a problem that ends once a kid makes it out of the hospital,” Newby-Kew said. “Both the child and the mother are going to need additional support down the line.”

That could include substance abuse treatment for the parents or developmental learning assistance for the child. Newby-Kew said the long-term impacts of prenatal exposure to opioids is still unknown and needs more research.

Newby-Kew said that at the moment, there aren’t many ways to find out what happens to these families, but one available data set is from the Office of Children’s Services. Federal and state laws require medical providers to report children who are prenatally exposed to substances to child protection services, though not all do.

There were 541 cases diagnosed during the 12-year-long study period. It’s unknown if the mothers were using the drugs legally or not. Nearly two-thirds of the cases were reported to OCS, and about 140 kids were temporarily or permanently taken from their homes.

The agency does not automatically remove a child from a home where people are using substances, OCS operations manager Travis Erickson said during a phone interview.

“When there are substances involved, we assess the impact of those substances on the parents’ ability to care give for the children,” Erickson said. “And so we’re really looking beyond ‘are there substances being used’ to things like ‘how does that change the parents’ behavior.'”

The assessments include talking to medical providers and law enforcement agencies, and seeing what sort of safety nets the family has in place.

Erickson said that although there is a well-known rise in opioid use statewide, for OCS “alcohol is still by far and away the most common underlying substance that causes child abuse and neglect.”

After being told innumerable times that maybe she asked too many questions, Anne Hillman decided to pursue a career in journalism. She's reported from around Alaska since 2007 and briefly worked as a community radio journalism trainer in rural South Sudan.
ahillman (at) alaskapublic (dot) org | 907.550.8447  |  About Anne

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