The public health issue of babies born addicted 

Drug and substance misuse has become a serious public health issue in the United States, particularly among women of childbearing age.5

Women comprise approximately 30% of the population addicted to illicit drugs, with the majority aged 15 to 44 years.5According to the National Institute on Drug Abuse, illegal drug use among pregnant women increased from 3% in 2002 to 4.4% in 2010 and was highest among 15- to 17-year-olds (Table 1).

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Table 1. Illicit drug use reported by women aged 15 to 44 years* in a survey by the National Institute on Drug Abuse, 20104

Age Group Percentage of Women
15 to 17 years 16.2%
18 to 25 years 7.4%
26 to 44 years 1.9%

*Drug use reported within one month of the survey.

One serious and concerning consequence of this increase is the growing number of infants who are born addicted and develop the complex disorder known as NAS, a condition that develops in 50% to 95% of newborns exposed prenatally to illicit drugs.5

Although maternal use of benzodiazepines, amphetamines, cocaine, or barbiturates is associated with NAS, the syndrome most commonly occurs in infants exposed to opioids, afflicting as many as 60% to 80% of those exposed to heroin or methadone (Dolophine, Methadose).5,6The incidence of opiate-associated NAS increased more than threefold between 2000 and 2009, which paralleled the nearly fivefold increase in mothers using or dependent on opioids.6

Not surprisingly, NAS is associated with increased health-care utilization costs (Table 2). One study cited a 35% increase in neonatal hospital charges between 2000 and 2009, although the mean length of stay (LOS) for NAS remained unchanged.5Nationally, total hospital charges for NAS more than tripled by 2009.6That year, an estimated 13,539 newborns in the United States developed the condition, a statistic equivalent to approximately one infant born per hour with signs of drug withdrawal.5

Table 2.Trends in the incidence of NAS and related health-care utilization and expenditures

2002 2009 P for trend
NAS rate (per 1,000 hospital births per year) 1.20 3.39 <0.001
Mean hospital charges $39,400 $53,400 <0.001
Length of stay 15.8 days 16.4 days 0.06
National total hospital charges $190 million $720 million <0.001