Virginia has responded to the opioid crisis by expanding treatment options, implementing new state policies and health care protocols, and by enhancing substance use treatment programs. The objective of these efforts is clear: to combat the opioid epidemic by reducing deaths related to opioid abuse, and to decrease the number of children born with neonatal abstinence syndrome (NAS). Sadly, the latest data do not reflect a turnaround in rising NAS birth trends. The chart below tracks quarterly NAS births in Virginia hospitals (using ICD-10 code P96.1) from the first quarter 2016 through second quarter of 2017. Contrasting the number (360) of NAS infants in the first two quarters of 2016 with the number of babies (383) diagnosed during the same time frame in 2017 a 6 percent increase in the number of affected infants. The growth in NAS infants has a direct impact on Virginia’s finances considering that, on average, three out of four NAS infants are covered by Medicaid. Hospitalizations for NAS babies tend to be longer than hospitals stays for non-NAS babies. NAS babies are also more likely to be premature. The average hospital cost for NAS infants is $53,400; the comparable figure for all other hospital births is $9,500.1 NAS babies are also more likely to have behavioral and learning issues as they age. Substance abuse is difficult to treat. It requires consistent effort on the part of the addict and consistent support by a community of care providers. Opioid dependent pregnant women are at high risk for sexual violence, homelessness, prostitution and incarceration, and many women do not have safe, drug-free living environments for themselves or their children.2 Each case needs to be treated differently and one solution doesn’t meet all patients’ needs. Options for treatment need to be varied and available. (9/22)
1 Patrick SW, Schumacher RE, Benneyworth BD, et al. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. JAMA : the journal of the American Medical Association. 2012;307(18):1934–1940.
2 ACOG Committee Opinion No. 524 Opioid abuse, dependence, and addiction in pregnancy. Obstetrics and gynecology. 2012;119(5):1070–1076.