NEWS

Five Ohioans are born daily with drug withdrawal

Jona Ison

In 2014, roughly five Ohio newborns were admitted daily to the hospital with symptoms of withdrawal, up from three in 2010 and not even one a day in 2004.

Exposure to opioids, such as prescription painkillers and heroin, is driving the increase, having grown 15-fold between 2010 and 2014, according to a recent report from the Ohio Department of Health.

In 2014, the most recent statewide data available, Ohio hospitals reported 66 percent of infant hospitalizations for exposure to illicit drugs through the placenta or breast milk were for opioids.

Licking Memorial Hospital reported 12 newborns were born with neonatal abstinence syndrome that year out of 1,137 births at the hospital. There were 19 newborns reported in 2015 with the syndrome out of 1,088 births.

The 1,875 babies admitted for withdrawal from any drug likely is just half of those actually suffering from withdrawal, but others weren’t counted since symptoms such as low birth weight, seizures and problems feeding, weren’t serious enough to require hospitalization. In 2014, the state reports there were 4,349 women who were diagnosed with drug abuse and dependence at the time of delivery.

The increase has led to the creation of an alternative to neonatal intensive care units to treat the babies at a quarter of the costs – which exceeded $105 million in 2014. Ohio’s first-ever neonatal abstinence syndrome treatment facility, Brigid’s Path, is set to open with 24 private nurseries in Dayton this summer.

Executive Director Deanna Murphy described the facility as being home-like and fashioned to provide a setting to minimize irritants to babies in withdrawal, such as bright lights and loud noises. While some neonatal intensive care units, such as Nationwide Children’s Hospital, have adapted units for babies in withdrawal, many are not set up to do so.

Bridgid’s Path will have “low stimulation, a quiet, calm environment where they can withdraw comfortably with one-on-one care around the clock,” Murphy said. “In addition to that, with a supportive environment for their families so that their mothers can come into a nonjudgmental setting and receive linkage to services in their own communities ... Studies show that when these families are supported, when they’re encouraged, when they’re linked to to services that are effective, (success) can happen and it does happen.”

The center will have nurses and use treatment guidelines developed by the Ohio Perinatal Quality Collaborative, which has been credited with the bright spot in the state’s report, a steady decrease in the number of days babies suffering from withdrawal remain in the hospital. In 2014, the average stay was 13.7 days, down a day from 2013 and down 6.4 days since the peak stay time in 2008.

Although hospital stays are declining, the overall cost of treatment for the babies — $105 million in 2014 — continues to climb as the numbers of babies exposed to drugs increases. The bulk of the cost falls onto Medicaid, with it covering all but 172 babies hospitalized with neonatal abstinence syndrome in 2014. According to the report, 2.6 percent of babies delivered to women on Medicaid were admitted with neonatal abstinence syndrome compared to 1.3 percent of all live births in 2014.

This month, the CRIB Act was introduced by U.S. Senators Sherrod Brown, D-Ohio, and Shelley Moore Capito, R-West Virginia, to allow facilities such as Brigid’s Path to bill Medicaid. Ohio Congressmen Mike Turner and Tim Ryan introduced a companion bill to the U.S. House. Such a move would also subject such facilities to the oversight of the Department of Medicaid.

“Unique facilities like Bridgid’s Path are relatively new. This legislation will help support alternative venues for treatment as our nation grapples with addiction,” Brown said. “The opioid epidemic is causing enough damage to our communities overall, we need to do whatever we can to help the most vulnerable Ohioans who suffer really before they are even born as a result of the cycle of addiction.”

The need to be recognized by Medicaid as a provider is vital since the majority of babies born with withdrawal are on Medicaid, Murphy said, adding their ability to treat babies at a cheaper rate than hospitals will lead to savings for taxpayers.

“It’s vital for the long-term viability of our organization as well as the replication of our organization because while we’re opening in Dayton, there’s certainly need across the state, so we’re looking for those opportunities,” Murphy said.

Opioid addiction has been showing no significant signs of slowing across the state, especially as fentanyl, which is 30 to 50 times more potent that heroin, has been flooding the state. Although marijuana continued to be the leading drug birthing mothers were abusing in 2014 at 56 percent, 44 percent of the 4,349 women were dependent on opioids — 11 times more women than in 2004, according to the Ohio Department of Health report.

Ohio continues working on ways to reach and treat pregnant women who are addicted through the Maternal Opiate Medical Support Project. The pilot, in its third and final year, is supported with $4.2 million in state money. A preliminary report of findings is expected to be released this summer.

The project involved four regional sites that aimed to provide medication assisted treatment, either methadone or buprenorphine, along with counseling and other supports, such as housing.

Medication assisted treatment is used with pregnant women because withdrawal can endanger both the mother and baby. The goal of the approach is for the babies to be born with minimal symptoms of withdrawal that don’t require hospitalization and for the mothers to be in recovery to provide the baby a brighter future for them both.

As of November 2015, the Department of Mental Health and Addiction Services reported 82 percent of pregnant women in the pilot had adhered to their medication assisted treatment plan and 18 percent had tested positive for illicit opioids.

jison@Gannett.com

Twitter: @JonaIson

Ohio newborns hospitalized for withdrawal or illicit drug exposure

2004

2009

2012

2013

2014

Withdrawal

199

715

1461

1691

1875

Opioid exposure

63

188

601

835

962

Cocaine exposure

386

234

163

237

193

Hallucinogen exposure

78

67

89

195

309

Source: Ohio Department of Health

Note: Numbers may not reflect unique individuals.