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The Tennessee Department of Health this month recorded a troubling milestone: For the 350th time this year, a baby was born in Tennessee dependent on powerful drugs taken during pregnancy. That baby has to endure the painful and often prolonged and very expensive process of withdrawal from addictive drugs.
“For those who care for these drug-dependent newborns in the first few days of life, the most difficult thing to know is that it is almost always a preventable condition,” said TDH Commissioner John Dreyzehner, MD, MPH. “With better educational efforts and improved outreach and treatment strategies for women of childbearing age, we can reduce the rate of drug-dependent newborns and the huge associated costs.”
The number of newborns dependent on drugs has increased tenfold in Tennessee in the last decade. This year alone, 39 hospitals in the state have reported drug-dependent newborns. Tennessee acquired a powerful tool to help reduce its rate of affected newborns when the Tennessee General Assembly last year passed the Prescription Safety Act.
The act requires prescribers and dispensers of some powerful drugs to check the Controlled Substance Monitoring Database before providing drugs to patients. More than 30,000 clinicians across the state are now registered and using the database, checking for past prescriptions to prevent misuse or abuse of prescription drugs. Use of the database has increased more than threefold from last year.
In a recent survey involving 693 prescribers, more than 79 percent indicated the CSMD was useful for decreasing “doctor shopping” to obtain drugs; more than 71 percent reported they changed a proposed treatment plan after viewing the CSMD; and more than 71 percent said they are now more likely to discuss substance abuse issues and concerns with patients.
“Health care providers have an opportunity to reduce the number of babies born dependent on these drugs,” said Michael Warren, MD, MPH, director of the TDH Family Health and Wellness division. “If a woman of childbearing age is in a treatment program requiring some prescribed medications, or if she is battling an addiction to legal or illegal substances, there must be frank conversations with her about preventing unintended pregnancy.”
Besides the physical pain the newborn experiences, the financial cost of newborns dependent on drugs is substantial. While the normal hospital costs for a healthy infant in 2011 were $4,237, the average cost for a newborn dependent on drugs was $62,973, according to TennCare statistics. Beyond the financial impact, the increasing number of newborns dependent on drugs provides evidence of a state and national problem that must not continue.
As these drug-dependent newborns leave the hospital and grow up, there are important and not fully understood questions about what challenges they will have and needs that will have to be addressed.
“The information we have on how these children do in later years is presently not alarming, but it is not reassuring either,” Dreyzehner said. “More research is needed, but the best approach clearly is prevention.”
“Passing this awful milestone of the 350th Tennessee baby born in 2013 dependent on powerful drugs taken during pregnancy is a tragic occurrence, and one that is representative of a troubling epidemic in our state and our nation,” said Douglas Varney, commissioner of the Tennessee Department of Mental Health and Substance Abuse Services. “These babies highlight the growing number of Tennesseans who are addicted to powerful prescription drugs and the damage they can cause. We all need to reach out to these young women and offer hope, treatment and recovery services to help stem this scourge and reduce the number of babies who are needlessly suffering around Tennessee.”
In 61.5 percent of these births, the mother was using at least one substance provided by a health care provider. The majority of those, 41.6 percent, used only prescribed medication, while in 19.9 percent of cases, at least one of the substances being used by the mother was prescribed by a health care provider.
To see weekly updates on newborns dependent on drugs in Tennessee, visit http://health.tn.gov/MCH/NAS/NAS_Summary_Archive.shtml.
The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.