Study Notes Spike in Newborn Exposure to Opioids in Rural Areas

A sharp rise in opioid-related complications among newborns in rural communities highlights the severity of the opioid epidemic in these areas. A study, published in JAMA Pediatrics, reveals an increase in the number of babies born with drug withdrawal symptoms.¹

The study also reflects an elevation in maternal opioid use trends in rural counties compared to more urban areas. Study results mirror the rise in opioid prescriptions for pain relief in the United States, as well as an increase in opioid-related complications that result from painkillers and street drugs like heroin. Infants exposed to opioids in the womb are typically born with neonatal abstinence syndrome, and are more likely to experience seizures, low birth weight, and breathing, sleeping, and feeding problems.

Rates of newborns diagnosed with neonatal abstinence syndrome increased from 1 case per 1,000 births (2003-2004) to 7.5 cases (2012-2013), resulting in a nearly 80% surge rate higher than the rate growth in urban areas. Using data from the National Inpatient Sample, the researchers from the University of Michigan C.S. Mott Children's Hospital and Monroe Carell Jr. Children's Hospital at Vanderbilt University noted that rural newborns accounted for more than 21% of infants born with the syndrome between 2012-2013, which is a large increase from the 13% of newborns born with the syndrome in 2003.

Rural infants and mothers affected by opioid-related complications are more likely to be lower-income, have public insurance, and be transferred to another hospital following delivery, the researchers noted.

Since pregnant women treated with buprenorphine combined with an opioid addiction program tend to have better outcomes, pharmacists should focus on utilizing this treatment and expanding access to mental health and substance abuse services for rural mothers. Community hospitals should provide adequate staffing and resources necessary to treat women and newborns affected by opioid-related complications.

Reference

• Villapiano N, Winkelman T, Kozhimannil K, Davis M, Patrick S. Rural and urban differences in neonatal abstinence syndrome and maternal opioid use, 2004 to 2013. JAMA Pediatrics, 2016; doi: 10.1001/jamapediatrics.2016.3750.