Generation O, The Other 1%
While occasionally still noteworthy in the National news, the Opioid Epidemic gets far less attention these days. Stories that do air center around overdose deaths. But what about the births? The births of babies exposed to opioids in their mother’s womb. They have a lifetime ahead of them, and due to traumatic injuries, it’s likely to be more challenging for the baby and their caregiver.
What started in 2010, with an 82% increase in Neonatal Abstinence Syndrome (NAS) from the rate just two years earlier, is still at a crazy high level. Recent data from the Healthcare Cost and Utilization Project (HCUP) show that by 2020 over 6 newborn babies per every 1000 in the U.S. were hospitalized for NAS. That’s close to 1% of overall births!
After the substantial increase in the early years of the opioid epidemic, HCUP reports continued consistent growth through 2017. While 2018 saw the first downturn in the incidence of NAS, the decline has been minimal. NAS levels are still significantly higher than pre-crisis numbers.
Depending on where you live, it may be easier to forget how much damage prenatal opioid exposure is still causing. Cases of NAS are not evenly distributed. Eastern states like Delaware, Maine, and Vermont consistently care for over 20 babies per thousand with NAS. During peak years of the opioid crisis, these states had numbers as high as 36 per 1000 newborns, or 3.6% of all hospital births. West Virginia takes the notorious title of largest per capita cases of NAS with an all-time high in 2017 of 56 babies per 1000. The incidence of autism diagnoses in the U.S. that same year was under 20 per 1000.
I use the comparison to autism diagnoses to contrast the knowledge and attention of the general public. We all know families with members who have autism. We've seen fundraising campaigns and can identify the puzzle piece symbol for this condition. Babies with a Neonatal Abstinence Syndrome diagnosis have long-term outcomes too; disabilities that require governmental and school system services and the need for funding to cover these services. Yet most people are unaware that members of this population live among them.
So how many actual kids is this? HCUP data shows that 15,085-27,085 children per year were hospitalized at birth with NAS since 2010. Those 27,085 born in 2017, at the peak of this problem, are in first grade now. It’s likely their caregivers are yet unaware of the learning challenges they are saddled with. In Junior High/Middle School (grades 6-8) our nation is educating 48,000 of these children. I suspect their caregivers are now aware of the academic and behavioral struggles that are often seen by this age.
Our 1% is still hidden. As researchers continue to study these kids and learn precisely how trauma and opioids changed their neurons and brain chemical systems, we will be able to harness the tools necessary to support them. Caregivers who are aware of their child’s newborn diagnosis can better understand them and society can recognize the children who emerged from this scarring epidemic. Overdose deaths are not the only news to report in this continued epidemic.
Access the Healthcare Cost and Utilization Project data, which is managed by the U.S. Agency for Healthcare Research and Quality, here: https://datatools.ahrq.gov/hcup-fast-stats/
