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Infants in withdrawal

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Friday, May 4, 2012 9:29 PM

As Colorado lawmakers debate, once again, the state’s part in the “war on drugs,” one of the most ubiquitous claims is that adult recreational drug use (as opposed to sales and trafficking) is a crime without victims.

Research results released this week in the Journal of the American Medical Association soundly refutes that claim.

The number of pregnant women using opiate derivatives increased fivefold in less than a decade, and number of infants born dependent on the opiates their mothers used during pregnancy tripled over the same time period.

The raw numbers still are not large — increasing from 1 per 1,000 babies sent home from hospitals in 2000 to more than 3 per 1,000 in 2009 — but opiates also are not, by far, the only drugs of abuse in this country.

There’s cocaine; the Denver Post says this is the 21st century version of what was known as the “crack baby” epidemic of the 1980s. That problem, though no longer visible, still exists.

There’s meth, creating a new problem for a new generation.

There’s the elephant in the room: alcohol, with its well-known effects on fetal development.

This study quantified only the opiate problem (which includes prescription pain medications as well as illegal drugs), but it provides a clear view of a group of innocent victims. The result of their mothers’ addiction is neonatal abstinence syndrome, and it can cause seizures, breathing difficulties, dehydration, feeding and digestive problems, sleep disruption, irritability and developmental delays. Those are the symptoms health care workers can observe; no one knows what a newborn is feeling.

The cost of treating the infants’ withdrawal is tremendous, averaging $53,400 per child. Medicaid pays for more than three-fourths of that.

The current political climate, as polarized on reproductive rights as on nearly every other topic possible, mainly encourages everyone to choose up sides, but this should not be framed as an issue of choice. Drugs take away choices and hamper the ability to make good ones. Overwhelmingly, these children are born to mothers who regret the way their addictions have affected their infants but who were unable — and yes, perhaps, unwilling — to change that trajectory. Stigmatizing their actions does little to prevent or solve the problem.

According to the New York Times, “Experts agree that the best approach is to deal with women’s drug addictions before they are pregnant.” That’s easier said than done, and it’s a chicken-and-egg dilemma, because women may not be motivated to seek assistance until they learn they are pregnant.

No obvious solutions are visible. Jailing mothers whose infants show signs of withdrawal creates other problems, and despite anti-drug war rhetoric, it has never been a preferred response. Removing infants from their parental custody also does not address the root issue. Fear of legal consequences, though, may deter women from seeking treatment, which is difficult during pregnancy. Under the best of circumstances, rehabilitation programs don’t always work.

Education is the idea most often suggested. It may very well be the best one available, which isn’t saying much.

Awareness helps, though. Every woman of childbearing age should consider the consequences of chemical dependency on the next generation, because those consequences are severe indeed.

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