A New York Times and an American Med News article gave me reason to pause. Each year approximately 13,500 newborns are born addicted to prescription opiates.

Neonatal abstinence syndrome (NAS) occurs when babies who are born to opiate-addicted mothers who more than likely received their meds from a prescription. The number of pregnant women using opiate drugs has increased five-fold from 2000 to 2009.

The problem had become so rampant in Florida that state legislators finally took action after it became a national embarrassment. To the chagrin of the Florida governor, 1 in 7 people died from prescription drug overdoses and the state held the title as the pill-mill capital of the nation.

Now a law that requiring each opiate prescription be filed in a data base by the prescribing physician. There’s nothing like good old fashion documentation to put physicians in check.

During the 1980’s crack-cocaine addiction was rampant. Despite the socioeconomic stigma, addicted pregnant women willingly came forward requesting treatment in order to save their babies. Addiction was treated as a disease and the mothers received rehabilitation that included medically supervised withdrawal and psychiatric counseling.

Those days appear to be over.  In Alabama and other states, pregnant women’s addictions are now criminalized making it extremely difficult for them to divulge their addiction or receive treatment. The consequences are severe. 31% of newborns born addicted to opiates have breathing problems, 18% have feeding problems and 2% have seizures.

Denial is a terrible disease. Despite significant problems, my medical colleagues are reluctant to address the issue and in some instances, they’re part of the problem. Doing a urine toxicology test takes time, especially if it’s positive. No one wants to call social service.  Why? Because it’s a time-consuming and frustrating process that some physicians would rather avoid. And what are the consequences? 13,500 addicted newborns.

Unfortunately, the problem of NAS will continue until healthcare providers and policy leaders take a pro-active stance. Addiction is not a crime. It’s a disease. Throwing pregnant women in jail is not going to solve the problem and I blogged about that issue recently.  How can we improve this problem?

  • Provide mandatory universal urine toxicology tests for all pregnant mothers, whether in a public or private setting.
  • Perform an immediate referral to social service if the urine toxicology test is returned positive
  • Physicians should not prescribe a 30-day supply of pills for a 4-day problem. This is what causes unintended addictions

Should doctors who prescribe painkillers to pregnant women be liable if the mother becomes addicted? Please, weigh in.