As the opioid epidemic continues to rage across the United States, members of the next generation are feeling the effects, as are the hospitals that care for them.
The incidence of newborns with neonatal abstinence syndrome (NAS), most often caused by mothers-to-be using opioids while pregnant, has quadrupled in recent years.
The problem is also costing hundreds of millions of dollars more in in-demand hospital resources than a decade earlier.
Those findings, published in the journal Addiction last month, showed that the $61 million spent to treat NAS in 2003 ballooned to $316 million in 2012.
A sprawling epidemic
That fight against NAS has become a costlier front in the sprawling battle to fight an opioid epidemic that is killing 91 Americans per day.
Deaths due to opioid overdoses have risen fourfold since 1999, according to the Centers for Disease Control and Prevention (CDC).
Likewise, cases of NAS increased fourfold between 2003 and 2012, according to the new study — and fivefold since 2000, according to a 2015 study.
That means, with an estimated 21,732 babies born with NAS in 2012, an affected baby is born about every 25 minutes in the United States.
And the opioid epidemic has spread since then, with signs of an increase in the use of heroin and other illegal drugs as prescription pills are more tightly prescribed.
Treating the symptoms
That also means hospitals are struggling to treat thousands more infants for NAS symptoms.
Those symptoms can depend on the type of opioid the mother used, and how long and how frequently she used it.
NAS symptoms can include low birth weight, tremors, and feeding and sleeping problems. Those typically require a hospital stay, sometimes up to a week.
During that time, the newborn is given opioids and other medications to treat opioid withdrawal.
With treatment, those withdrawal symptoms can disappear quickly. However, the long-term effects of being born with NAS can include developmental delays, problems with cognition and motor skills, along with other issues in early childhood, according to a study.
Heavy cost for all
The millions spent trying to avoid or mitigate those long-term problems in the days and weeks after birth are shared by patients’ families, hospitals, private insurers, and government insurers like Medicaid.
Government insurers may bear a particularly heavy burden, as most cases of NAS have been occurring in lower income rural areas of the country.
A study published at the end of last year found NAS cases had jumped from about one case per 1,000 in 2003-2004, to more than seven cases per 1,000 in 2012-2013 in rural areas, 80 percent higher than the increase in urban areas.
More than three-quarters of babies treated for NAS are covered by Medicaid, according to Dr. Tammy Corr, a neonatologist at Penn State’s Hershey Medical Center, and lead author of the study published last month.
“In an era of increasingly constrained healthcare resources, state budgets will need to grapple with how to balance their budgets to provide the resources to care for these infants while addressing many competing interests,” she told Healthline.
Babies with NAS spent more than 290,000 days in the hospital 2012, compared with less than 68,000 days in 2003, according to the new study.
That can potentially use up resources and time that just a few years ago would have been available for other needs.
“Cost is a necessary focus in an era of limited resources and rapidly changing reimbursements,” Corr said.
As long-term action is taken against the opioid epidemic, more cost-effective treatments for NAS will be needed in the short-run, the study concluded.
Corr noted there are a number of ongoing trials for NAS treatments going on right now that include prenatal interventions to help mothers-to-be avoid opioids during pregnancy.
Others are focusing on medications that may shorten the amount of time the newborn needs to be in the hospital.
And other research is focusing on nonpharmaceutical solutions to reduce hospital stays for babies with NAS.