In the heart of the sun-soaked desert city of Tucson, where vibrant sunsets paint the skies, a saddening tale unfolds within the walls of the Neonatal Intensive Care Unit at S.t Joseph’s Hospital.
Lily is a newborn with untold potential, but little does she know she is stepping into a world marred by a growing epidemic — a battle against opioid addiction. Infants like Lily in the NICU are increasingly suffering from cases of Neonatal Abstinence Syndrome, according to professionals in the field.
NAS is “what happens when babies are exposed to drugs in the womb before birth. Babies can then go through drug withdrawal after birth. The syndrome most often applies to opioid medicines,” according to Stanford Medicine.
Health professionals have seen a rise in the number of NAS cases in recent years. From 2010 to 2017, “the number of babies born with NAS increased by 82%,” according to the Centers for Disease Control and Prevention.
In Arizona alone, there has been an increase of 41% of NAS cased from 2017 to 2021, according to the Arizona Department of Health Services.
“We’ve always had babies, and maybe one or two cases of Neonatal Abstinence Syndrome, but never as many as now,” said Joan McGinnis, a former NICU nurse.
Solving the opioid epidemic is a tall task, so many are first searching for ways to help the babies born out of it. Doctors, pharmacologists and healthcare professionals worldwide are actively seeking superior alternatives to morphine, raising the question: why do we even wean babies off of morphine in the first place?
Most of the world uses some version of the Finnegan system, a neonatal abstinence scoring system. Many healthcare professionals believe this is the best system for determining how much pharmaco-interference is necessary for weaning, but some professionals are questioning its effectiveness. They wonder if there are alternative approaches that could yield better outcomes.
One hurdle includes determining how much of a substance and what substances are in the infant’s system. Conventional methods including urine samples, meconium tests and umbilical cord tissue collection, have proven to be far from foolproof. The inherent limitations of these methods such as false positives, elaborate procedures, etc., often result in inaccurate or delayed results, hindering the timely and effective intervention required to support these lives.
Dr. Matthew Grossman, an associate professor of pediatrics within Yale School of Medicine, shed light on a challenge within the medical community that makes it harder to change approaches to this problem: an inertia persists “where you do what you’re doing today because you did it yesterday.”
However, one approach gaining traction is the “Eat, Sleep, Console” method, which places parents at the center of the care equation. This holistic perspective has yielded promising results, drastically reducing the average NICU stay from 22 days to six days, according to the Association of American Medical Colleges. The essence of this approach lies in the understanding that “parents are the medicine,” emphasizing the vital role of parental care and nurturing in the healing process.
Furthermore, the search for alternatives to the conventional use of morphine has led researchers and healthcare professionals to explore innovative pharmaceutical options. Buprenorphine, a prescription drug primarily used to treat drug dependence, has emerged as a potential substitute for morphine, offering a less addictive and more controlled form of medication for affected infants.
Additionally, the use of Zofran, a serotonin inhibitor commonly employed to control nausea, is being explored as a means to alleviate the withdrawal symptoms experienced by these newborns.
You can find more information on and resources to help with the effects of opioid use on infants on the CDC website at cdc.gov/pregnancy/opioids/treatment.html.
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