Opioids are a class of drugs including those derived from opium, such as morphine, heroin, hydrocodone, and oxycodone, and those derived from synthetic processes, such as fentanyl. Opioids block pain by binding to receptors in the brain and other organ systems, mimicking natural neurotransmitters that limit the transmission of pain in the nervous system. In addition to pain relief, opioids can cause sleepiness and euphoria.
According to the report, fetal exposure to opioids can occur through a host of circumstances. Some women enduring acute or chronic pain may not realize they are pregnant and unwittingly introduce their fetuses to opioids as the mother seeks pain relief. Additionally, some healthcare providers encourage women who know they are pregnant to nonetheless continue opioid treatment for pain relief. And, some women struggling with OUD become pregnant and thus expose their fetuses to opioids. Of note, the number of women using opioids during pregnancy has increased from 1.2 to 5.6 per 1000 live births between 2000 and 2009.
According to the NIH, NAS occurs in newborns who are exposed to certain substances in utero (in the womb), potentially causing them to experience withdrawal symptoms after birth. The report mentions that other symptoms of NAS include hypersensitivity, hyperirritability, tremors, vomiting, respiratory difficulties, poor sleep, and low-grade fevers. When these symptoms are specifically due to opioid withdrawal, they are collectively termed neonatal opioid withdrawal syndrome (NOWS). Symptoms typically onset in the first few days after birth, though their duration and severity varies depending on a multitude of clinical factors. NAS occurs in 55 to 94% of infants whose mothers used opioids while pregnant, and was diagnosed in 21,732 newborns in 2012, a five-fold increase compared to the previous decade.
Medication-assisted treatment (MAT), a combination of FDA-approved medications (buprenorphine, naloxone, or methadone) and behavioral counseling so as to treat SUDs, has become a standard method for treatment of OUD. Research suggests that treating NAS with MAT can yield a 55% reduction in the average length of an infant’s hospital stay as compared to those infants not receiving MAT, thus reducing overall healthcare costs.