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Opiate use by U.S. mothers and increases in neonatal abstinence syndrome

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Neonatal abstinence syndrome (NAS) can occur in newborns exposed to addictive drugs while in the mother’s womb. The syndrome occurs most commonly with opiate use — from prescription painkillers to illegal drugs such as heroin — prior to and during pregnancy. According to the Substance Abuse and Mental Health Services Administration, the rate of illicit drug use among pregnant women age 18 to 25 is 7.4%, and among pregnant teens is measured as high as 16.2%.

A 2012 study from the University of Michigan and the University of Pittsburgh published in the Journal of the American Medical Association, “Neonatal Abstinence Syndrome and Associated Health Care Expenditures: United States, 2000-2009,” analyzed information on 7.4 million discharges from 4,121 hospitals in 44 states, to measure trends and costs associated with NAS over the past decade.

The study’s findings include:

  • Between 2000 and 2009, the number of mothers using opiates increased from 1.19 to 5.63 per 1,000 hospital births per year.
  • The overall rate of newborns being diagnosed with NAS tripled over the decade. In 2000, NAS was diagnosed at a rate of 1.2 per 1,000 births per year. In 2009, the rate was 3.39 per 1,000 hospital births, equivalent to 13,539 total cases. This means that, as of 2009, approximately one infant born per hour in the United States had signs of drug withdrawal.
  • Newborns with NAS were 19% more likely than all other hospital births to have low birthweight and 30% more like to have respiratory complications.
  • Mean hospital charges for births with a diagnosis of NAS increased from $39,400 in 2000 to $53,400 in 2009; 77.6% of charges for NAS were covered by state Medicaid programs.
  • Between 2000 and 2009, total hospital charges for NAS cases, adjusted for inflation, are estimated to have increased from $190 million to $720 million.

“Newborns with NAS experience longer, often medically complex and costly initial hospitalizations,” the authors conclude. “The increasing incidence of NAS and its related health care expenditures call for increased public health measures to reduce antenatal exposure to opiates across the United States.”

Tags: children, parenting, drugs, addiction

    Writer: | Last updated: May 11, 2012

    Citation: Patrick S.W., Schumacher R. E.; et al. "Neonatal Abstinence Syndrome and Associated Health Care Expenditures: United States, 2000-2009," Journal of the American Medical Association, May 2012, Vol 307, No. 18, 1934-1940. doi:10.1001/jama.2012.3951.

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    Media analysis

    Read the study-related Bloomberg News article titled "Infants Born Addicted to Opiates Tripled in Past Decade."

    1. Reporter's use of the study: Evaluate what the reporter chose to include and exclude from the study. Would the audience have acquired a clear understanding of the study's findings and limits from this article?
    2. Reporter's use of other material: Assess the material in the article that is not derived from the study. For example: Does the reporter place the study in the context of other research and to what effect? Does the reporter include reactions to the study from other researchers or interested parties (e.g., political groups, business leaders, or community members) and are their credentials or possible biases made clear?

    Study analysis

    Read the full study titled "Neonatal Abstinence Syndrome and Associated Health Care Expenditures: United States, 2000-2009."

    1. What are the study's key technical term(s)? Which ones need to be put into language a lay audience can understand?
    2. Do the study’s authors put the research into context and show how they are advancing the state of knowledge about the subject? If so, what did the previous research indicate?
    3. What is the study’s research method? If there are statistical results, how did the scholars arrive at them?
    4. Evaluate the study's limitations. (For example, are there weaknesses in the study's data or research design?)
    5. How could the findings be misreported or misinterpreted by a reporter? In other words, what are the difficulties in conveying the data accurately? Give an example of a faulty headline or story lead.

    Newswriting and digital reporting assignments

    1. Write a lead, headline or nut graph based on the study.
    2. Spend 60 minutes exploring the issue by accessing sources of information other than the study. Write a lead (or headline or nut graph) based on the study but informed by the new information. Does the new information significantly change what one would write based on the study alone?
    3. Compose two Twitter messages of 140 characters or fewer accurately conveying the study’s findings to a general audience. Make sure to use appropriate hashtags.
    4. Choose several key quotations from the study and show how they would be set up and used in a brief blog post.
    5. Map out the structure for a 60-second video segment about the study. What combination of study findings and visual aids could be used?
    6. Find pictures and graphics that might run with a story about the study. If appropriate, also find two related videos to embed in an online posting. Be sure to evaluate the credibility and appropriateness of any materials you would aggregate and repurpose.

    Class discussion questions

    1. What is the study’s most important finding?
    2. Would members of the public intuitively understand the study’s findings? If not, what would be the most effective way to relate them?
    3. What kinds of knowledgeable sources you would interview to report the study in context?
    4. How could the study be “localized” and shown to have community implications?
    5. How might the study be explained through the stories of representative individuals? What kinds of people might a reporter feature to make such a story about the study come alive?
    6. What sorts of stories might be generated out of secondary information or ideas discussed in the study?