They scream and writhe. They vomit and sweat. They shake uncontrollably. They are literally born into suffering.
The heroin epidemic in New Jersey has taken a staggering toll on its residents over the last decade, but in few places is this more apparent than the Neonatal Intensive Care Units around the state. An analysis by NJ Advance Media shows that in some parts of New Jersey, more than one out of every 50 babies in 2014 was born with neonatal abstinence syndrome (NAS) — dependent on drugs their mother ingested during pregnancy. In 2014, the most recent year data is available, 638 babies were born with NAS, a figure that has nearly doubled since 2008.
"It's heartbreaking. You just want to pick these babies up and hold them in your arms," said Sharon Burke, Director of Infant and Toddler Rehabilitation at Children's Specialized Hospital in New Brunswick. "Ten years ago it was a problem, but we'd see it from a variety of medications and drugs — cocaine, alcohol, all sorts of things. Over the last five years, it has really narrowed down to opioid use, and it's increasing."
Statewide, about 6.4 of every 1,000 babies born in 2014 were diagnosed with NAS, according to data from the New Jersey Department of Health. But in areas hit hardest by the heroin and opioid epidemic, the rate is much more troubling. In Burlington, Camden, Gloucester, Salem and Sussex counties, more than 1 out of every 100 babies is born with NAS. In Atlantic, Cape May and Cumberland counties, it's more than one out of 50.
Mothers struggling with addiction can pass on chemical dependencies to their unborn child in pregnancy, Burke said. When a child is born and that link is broken, a newborn can quickly begin going through withdrawal. Neonatal abstinence syndrome is characterized by unconsolable irritability, vomiting, diarrhea, high blood pressure and increased muscle contractions. Serious cases can lead to seizures and research by Children's Specialized Hospital suggest it can cause long-term developmental issues.
"The important thing people need to know is that this is treatable," Burke said. "We need to take a very human approach and not judge mothers. We all make mistakes and this is a big one but it's one we can treat," Burke said. "90 percent of our newborns go home with their biological mothers."
The trend in NAS cases mirror substance abuse trends in New Jersey. Heroin and opioid use has mushroomed in the Garden State over the last decade, killing more than 5,000 and enslaving at least 128,000.
Children's Specialized Hospital's Neonatal Abstinence Syndrome program has has been a leader in treating infants born into addiction and has conducted research on the condition's long-term impacts. Burke said newborns can be treated through a combination of opioid weaning using morphine or an opioid substitute like methadone or Buprenorphine and various therapeutic practices to soothe an infant struggling with withdrawal.
She said it's equally important to treat the mother as well as the child and, while not ideal, sees it as an opportunity for a new mother to use the experience as a catalyst to address their own addiction.
"We're starting to take a stab at really understanding the genetic predispositions and the impact that addiction can have," Burke said. "The more we know, the more we can help these babies live long and meaningful lives."
Burke will be hosting a symposium on NAS at the Children's Specialized Hospital on Sept. 30.
To view specific neonatal heron rates of different NJ counties, please go to this interactive, NJ-area map located at the bottom of the page, here.
By Stephen Sterling - NJ.com/Aug. 12, 2016
Photo, graph: 1-Children's Specialized Hospital; 2-graph -stirzizecarto
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