A baby born with neonatal abstinence syndrome (NAS)
Last month, my cofounder and I were invited to the Economic Club at the Ritz Carlton, in Washington D.C. The topic of the discussion was healthcare in America and the invitees ranged from CEOs of healthcare systems to philanthropists wanting to make a difference in an industry that literally has life or death consequences. The panel included the iconic David Rubenstein of the Carlyle Group, Paul Rothman the CEO of John Hopkins Medicine, Craig Thompson of Sloan Kettering, and finally Kurt Newman of Children's National. Within the broad range of topics discussed was the opioid epidemic. It wasn't until Kurt Newman of Children's National spoke that the weight of this epidemic surfaced.
Newman has witnessed, first-handedly, the effects of the crisis on our newborns. Babies born to addicted mother's go through what is called neonatal abstinence syndrome (NAS) as a result of their mother's opioid addiction. They tend to be born with an array of symptoms, such as elevated heart and respiratory rate, seizures, and difficulty sleeping and breathing. Most heartbreaking and devastating of all, they are born dependent on opioids and undergo withdrawals as a result. Unfortunately, there is yet a protocol that can be used to treat babies with withdrawal symptoms but most practices wean them off by administering morphine, methadone, or buprenorphine.
The alarming rates of opioid use amongst pregnant mothers in the U.S. is calling for a new approach to curtailing the effects of the crisis as the number of newborns with NAS continues to increase. According to recent studies, in the last decade, this number has increased by 5 folds. As a result, the NIH is undergoing a series of studies to find a new treatment approach for babies/newborns with NAS.
The issue doesn't stop there. What happens when a newborn is treated and weaned off the opioids safely?
This is where it becomes extremely tricky. In the case where the mother wants to take active measures to keep and care for the child, she must go through a series of steps to ensure the baby is safe and protected. This is troublesome for an addict, especially a mother who just gave birth as it is highly stigmatized, and in turn limits their ability to prove that. It's a catch 22. As a result, if the government intervenes, newborns could potentially be sent to foster care where they can be adopted by new parents.
The second case is when the mother or parents willingly give up the baby due to their addiction. This leads to the same result as the aforementioned: foster care. The alarming rates of children being sent to foster care or adoption correlates with the rates of opioid use amongst pregnant mothers. Today, the foster care system cannot keep up with those rates and in turn is finding it difficult to care for a vulnerable population.
These shocking statistics are an example of just how complex this crisis is becoming and it's clearly here to stay. In the case of newborns, this could potentially affect a generation of Americans who might be at risk of a multitude of mental health diseases, including addiction. Healthcare experts, legislators, and social impact organizations must consider the longevity of this crisis when coming up with solutions. This is not to say that it's a simple solution by any means. In fact, we need multiple solutions when dealing with the issue of newborns. We must take into account the mother who is addicted to opioids and needs access to treatment and recovery, newborns who need to be treated for NAS and potentially finding them a new and safe home while ensuring that they don't go through the same path that their mothers once led, and finally the stigma that is surfacing around mothers using opioids, which is overarching and as a result ostracizes those who are taking active steps to treat their addiction by undergoing treatment.
We need more than just prevention, treatment, and recovery. There needs to be a new approach to account for the devastating effects of the crisis on newborns and their addicted mothers.