Rise in Neonatal Abstinence Syndrome Cases Outpace Projections

Curbing growth in prescription drug abuse is an issue with which health care providers, states, and this nation are grappling. While Americans are just 4.6 percent of the Earth’s population, Americans consume 80 percent of the global opioid supply, 99 percent of the global hydrocodone supply, and two-thirds of all illicit drugs.1 With the increasing use of prescription drugs, the incidence of neonatal abstinence syndrome (NAS) remains an ongoing problem in newborn populations. Babies born to mothers with substance use disorders (SUD) typically have expensive neonatal stays, short-term suffering, and long-term behavior problems. Last year, the VHHA data and analytics team predicted a rise in neonatal abstinence syndrome despite state efforts to contain the effect of maternal drug dependency by improving access to care. A previous Research Corner item based on 2013 and 2014 statistics predicts the number of NAS infants to quadruple by 2018. A recent tally of Virginia newborns diagnosed with NAS in 2016 in the statewide inpatient database (using ICD-10 codes P96.1 and P96.2) found 773 infants out of 95,608 (or 1 percent of) live births in 2016 had a diagnosis of NAS. The annual increase since 2012 means that the number of children diagnosed with NAS has quadrupled in four years instead of six years as previously predicted. Available data about infants born with NAS reveals several noteworthy trends, including:
• While Southwest Virginia has more infants diagnosed with NAS, no area of the state is immune (see image below).
• The majority of NAS babies (65 percent) are full term.
• Babies with NAS have an 11-day average length-of-hospital stay. Typically, healthy newborns are sent home in two to three days. (5/26)

1 Manchikanti L, Singh. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse and nonmedical use of opioids. Pain Physician.2008; 11 (2 suppl): S63-S88.

NAS chart