Oklahoma's growing addiction to prescription pain narcotics is affecting the state's most vulnerable population: newborn babies.
Doctors at Oklahoma City hospitals have seen a noticeable increase in the number of babies born to mothers addicted to prescription pain pills.
And in some cases, a baby is born addicted to prescription drugs and requires methadone — a drug typically used to wean adults off heroin — to help the babies come down from their withdrawal of the drugs.
“Babies that have been born to drug-addicted mothers have had, for the last nine months or some time beforehand, a steady supply of that particular medication coming into them, and as long as they're getting that they're fairly happy,” said Dr. Doug Dannaway, a neonatologist at The Children's Hospital at OU Medical Center.
“All of a sudden, they're born and not getting that medication. Their body starts going into withdrawal, wanting to know what happened and where is it all.”
Oklahoma ranks among the highest in the nation in the number of people who abuse prescription pain narcotics, according to National Survey on Drug Use and Health. Five percent of Oklahomans 12 or older report using prescription pain relievers for a nonmedical reason.
Nationwide, about 42 women die every day from drug overdose, according to the Centers for Disease Control and Prevention. Between 1999 and 2010, the number of prescription painkiller overdose deaths increased fivefold among women in the United States.
Previous research has shown that women are more likely to have chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer time periods than men, according to the CDC.
Studies also have shown that women may become dependent on prescription painkillers more quickly than men and may be more likely than men to engage in “doctor shopping,” obtaining prescriptions from multiple prescribers, according to the CDC.
More data needed
Although an increasing number of women are abusing prescription drugs, it's not clear what the long-term impact will be on their babies.
Dr. Anthony Shanbour describes himself as rather strict when it comes to his patients using prescription pain relievers while pregnant. He tries to persuade all of his pregnant patients to stop using prescription narcotics.
“I prefer none of my patients be on pain medications, but I know some will be,” Shanbour said. “Some have been (using) for years, and that's really hard, because now they're pregnant, what do you do? It wouldn't be like me or you that just takes pain medicine just when you need it. They have chronic problems, and it's really hard for them to be off.”
Shanbour said one of the obstacles he faces is the lack of data about the long-term impact on children whose mothers use prescription pain narcotics while pregnant.
A 2011 study of all medications approved by U.S. Food and Drug Administration from 1980 through 2010 found that 91 percent of the medications approved for use by adults in general had insufficient data to determine the risk of using the medication during pregnancy, according to the CDC.
Prescription drugs are tested to see whether they're safe and effective before they become available to the public, but pregnant women usually are not included in these tests because of the possible risks to the unborn baby, according to the CDC.
Shanbour said it's not clear what impact a mother's abuse of prescription drugs will have on her child as he or she develops.
“To say how much is too much, nobody knows,” said Shanbour, an obstetrician and gynecologist at Mercy Hospital Oklahoma City.
Although the long-term effects aren't clearly identified, what can happen to a newborn baby is more obvious.
Some babies suffer symptoms of withdrawal, and even though it's rare, some of them have to be treated with methadone.
Dannaway said babies suffering from withdrawal tend to be jittery. Their cries usually are high-pitched, compared with another baby.
The need for the drug overwhelms them to the point that they cannot sleep. They might not understand how to eat. They often suffer from diarrhea and vomiting.
And, even though it's rare, the main thing that doctors worry about is the baby having seizures.
It's a long list of potential suffering that isn't their faults.
Dannaway, who has worked at OU Medicine for seven years, has seen an increase in the number of babies whose mothers abuse prescription drugs. About one-third of the drug cases he sees involve prescription pain drugs.
“Your hydrocodone, your oxycodone, your vicodins, things like that,” he said.
They also see cases in which women on methadone take more than they are supposed to be allotted, he added.
“The body doesn't care what kind of opiate it is ...,” Dannaway said. “There have been some that have been advertised to have less of an effect on a baby than others, but we haven't seen that to a great degree so far. Opiates are opiates, for the most part.”