Vermont's Opioid Crisis Is Taking A Remarkable Toll On Newborns

Aug 16, 2016

A new study shows Vermont's opioid crisis is taking an incredible toll on one population: newborn babies. The study from the Centers for Disease Control and Prevention looked at cases of neonatal abstinence syndrome, or NAS, that can occur in newborns whose mothers are addicted.

Of the 28 states studied, Vermont had the second-highest rate of NAS, but that's been growing faster than anywhere else.

Dr. Anne Johnston, who teaches pediatrics at the University of Vermont, specializes in NAS. She spoke with VPR about the disease.

What is neo-natal abstinence syndrome?

Johnston says NAS is usually due to opioid withdrawal, though it can occur as a result of other drug or alcohol withdrawal.

“Primarily it can manifest as poor feeding, irritability, shaking of the limbs and failure to gain weight appropriately and diarrhea, nasal congestion [and] frequent yawning,” Johnston said.

“Neonatal abstinence syndrome is not a tragedy,” Johnston says, “it is easy to treat. But what is the more challenging issue is getting women into treatment. And I think to talk about neonatal abstinence syndrome in and of itself is is a mistake. One has to always think of, behind every infant who suffers from it there is a mother who is suffering from the disease of opioid dependence.”

What can be done to better reach out to addicted mothers?

“I’ve been treating babies who are exposed to opioids since 2000,” Johnston says, “but we have multiple teams that are working to get these women into treatment."

“I think that that is one of the reasons that you've seen such an increase in the rate of neonatal abstinence syndrome in Vermont is because we are providing greater and greater access to treatment through the alcohol and drug abuse programs, the hub and spoke model,” She says. “And also through our program here at the University of Vermont Medical Center where we have developed … [raised] awareness among pregnant opioid dependent women that they can actually have treatment and that they deserve treatment and that this is the best thing for their unborn baby and for them.”

"Most women who get pregnant and who are using opioids and are dependent upon opioids say 'OK, now I'm pregnant. I'm going to be able to get myself off.' The reasoning of it doesn't follow through to the actual disease of addiction. You can't reason yourself out of an addiction." — Dr. Anne Johnston, UVM Medical Center

Johnston says that a special obstacle in treating pregnant women addicted to opioids is creating a low-judgement environment to properly handle feelings of fear or of shame.

“I would say that all have shame and the shame is particularly bad when you're pregnant and you're using,” Johnston says. “I think that fear dominates … in terms of coming forward. Most women who get pregnant and who are using opioids and are dependent upon opioids say ‘OK, now I'm pregnant. I'm going to be able to get myself off.’ The reasoning of it doesn't follow through to the actual disease of addiction and you can't reason yourself out of an addiction.”

"And of course one of the fears that these women have who are dependent and pregnant is that they'll lose that child," she says. "And so we've worked very, very hard and worked closely with the state to try and get these women into treatment so that they're well established and they can parent effectively and manage parenthood, beautifully."