Baby C.E. was born addicted to opioids, the first days of his life spent writhing in pain while he detoxified from the drugs his mother took while pregnant with him. His mother had been prescribed opioids before she was pregnant, became addicted, and ultimately started using heroin to feed her cravings.
As a result of being born addicted – a condition known as neonatal abstinence syndrome (NAS) – C.E.’s future is likely plagued with continuing developmental, physical, medical, occupational and psychological issues that could cost hundreds of thousands of dollars throughout his lifetime. Sadly, C.E. is not alone in his suffering. He is one of a growing number of babies born in the United States with NAS, a heartbreaking complication of the nation’s opioid epidemic.
In August, a lawsuit was filed on behalf of 13-month-old C.E. in Niagara County, New York, targeting manufacturers and distributors of opioids alleging they misled doctors and patients about the dangers and highly addictive nature of these drugs. The case seeks long-term medical monitoring and health care for all children in New York born with NAS whose mothers had been prescribed opioids either before or during pregnancy.
NAS babies suffer
The opioid epidemic spares no demographic, not even with our most vulnerable citizens – our children and babies.
From 2000 to 2012, an estimated 21,732 babies were born suffering from opioid withdrawal – which represents a five-fold increase during this time period. This is the equivalent to one baby born with NAS every 25 minutes, according to the National Institute on Drug Abuse.
Babies born addicted stay in the hospital longer than babies who were not exposed to opioids in utero – 16.9 days compared to just 2.1. Hospital costs are also greater for NAS babies – $66,700 on average compared to $3,500 for those who were not exposed.
Most babies born addicted begin to suffer symptoms of opioid withdrawal within 72 hours of birth, but some may not show signs until weeks later. Symptoms of NAS can last from one to six weeks and include:
- tremors, seizures, and overactive reflexes;
- fussiness, excessive crying or having a high-pitched cry;
- poor feeding or slow weight gain;
- breathing difficulties including breathing fast;
- fever, sweating or blotchy skin;
- trouble sleeping and yawning a lot;
- diarrhea or vomiting;
- congestion and sneezing.
NAS also increases a baby’s risk of being born low birthweight and jaundiced. These babies are also more likely to require treatment in a neonatal intensive care unit (NICU).
Long-term complications from NAS include behavioral and cognitive problems, developmental delays, motor development problems, hypersensitivity, and hearing or vision impairment. Compared to babies born to mothers who did not use opioids, NAS babies are at greater risk of child abuse and neglect, future drug use, sudden infant death syndrome (SIDS) and sudden unexpected infant death (SUID).
Oftentimes, babies born with NAS are forced into foster care. Of the estimated 465,000 babies and children in the country’s foster care program in 2016, 92,000 of them were there due to opioid-related issues, according to the Department of Health and Human Services (HHS).
What are opioids?
Opioids are a highly addictive class of painkillers that include street drugs like heroin as well as prescription medications like OxyContin, codeine, morphine and fentanyl. Legal versions of these drugs provide necessary treatment for people suffering from severe pain due to cancer or serious injuries. However, more and more often, these potent drugs are being prescribed for lesser ailments. According to HHS, about 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Around 80 percent of people who use heroin first misused opioids.
Questionable marketing techniques and misleading information about the addictive powers of opioids from drug manufacturers and distributors has led to a significant increase in the number of people addicted to opioids, as well as a spike in the number of overdose deaths. According to the HHS, 11.2 million people were misusing opioids in 2016, and more than 2 million were classified as having opioid use disorder (OUD). More than 42,000 people died from opioid overdose that year.
The financial toll is also devastating. In 2015, the Council of Economic Advisors, the agency charged with advising the President on economic issues affecting the U.S., puts the cost of the opioid crisis for substance abuse treatment, criminal justice, reduced productivity, and lives lost at more than $500 billion.
The opioid epidemic is a public health crisis that has affected every state in the nation.
In Alabama, more opioid prescriptions were written per capita than in any other state in the country, according to HHS. In 2013, Alabama providers wrote 141.1 opioid prescriptions for every 100 people – about 6.8 million prescriptions. This is almost two times higher than the average U.S. rate of 79.3.
Despite a near-17 percent decline in opioid prescriptions written in the state in 2015, an estimated 120.3 prescriptions per 100 persons were still doled out. This translated into 756 overdose deaths in the state the following year.
Higher rates of opioid prescriptions also correlate to a higher incidence of newborn abstinence syndrome. In the South, NAS is three times higher than the national average, according to Dr. Stephen Patrick, a researcher at Children’s Hospital at Vanderbilt University. In Alabama, cases of NAS increased from 170 in 2010 to 345 in 2013. The counties with the highest percentage of babies born addicted were Chilton, Winston, Shelby, Cullman and Walker.
Fighting for justice
New York’s Baby C.E. isn’t the only NAS victim to file a lawsuit against opioid manufacturers and distributors. In February, a lawsuit was filed in Louisiana on behalf of a baby identified as K.E.R. Similar to C.E.’s suit, K.E.R.’s case seeks financial support for long-term treatment for babies born with NAS in the state of Louisiana.
Many infants born addicted to opioids have joined hundreds of local governments, Native American tribes, and institutions in a multidistrict litigation (MDL) in the U.S. District Court for the Northern District of Ohio. The MDL blames opioid manufacturers, distributors and pharmacies for fueling the opioid crisis in America and seeks compensation for overdose deaths as well as economic damages sustained as a result of the companies’ reckless marketing of the drugs.
In June, U.S. District Judge Dan Aaron Polster, the judge presiding over the MDL, rejected a motion by attorneys representing NAS babies for them to get a separate track in the MDL. The separate track would provide these babies with a trust to fund treatment and research related to NAS, as well as direct compensation to victims to cover out-of-pocket costs for opioid-weaning treatments required for babies born addicted.
In August, attorneys renewed their push for a separate MDL track for NAS babies, telling Judge Polster that these vulnerable victims of the opioid crisis have no dedicated representation in the pool of plaintiffs. Since the attorneys made their first request for a separate track three months prior, more than 5,000 babies were born addicted to opioids, they argued. Currently, NAS babies make up the largest category of plaintiffs in the MDL.