By Melissa Patrick and Al Cross
Kentucky Health News
Kentucky has a very high rate of opioid-use disorder among women delivering babies in hospitals, according to a study published by the Centers for Disease Control and Prevention.
In Kentucky, 19.3 mothers out of every 1,000 who gave birth in a hospital in 2014 had an opioid-use disorder. Among the 30 states studied, only two were ahead of Kentucky: Vermont, at 48.6 per 1,000, and West Virginia at 32.1. The national rate is 6.5 per 1,000. West Virginia was the only state adjoining Kentucky to be included in the study
Opioid use during pregnancy, whether it be heroin, prescription painkillers or some other narcotic, is associated with pre-term labor, stillbirth, neonatal abstinence syndrome and maternal death.
The study, published Aug. 10 in CDC's Morbidity and Mortality Weekly Report, analyzed hospital discharge data from 1999 through 2014.
Nationally, the number of mothers with opioid-use disorders at delivery more than quadrupled during those 15 years, going from 1.5 cases per 1,000 deliveries to 6.5.
Over the study period, Kentucky's rate went up 1.55 per year, but showed big jumps from 2010 through 2014, going from 7.2 to 9.5 to 14 to 15.7 to 19.3. Over the same five years, the national rate rose from 3.9 to 6.5 per 1,000. The Kentucky numbers represented annual increases of 32, 43, 5 and 23 percent.
Average rate increases in opioid-use disorder among mothers giving birth were highest in Vermont, at 5.37. Maine was second at 4.13, but that did not include any data for 2013 and 2014.
Different state policies might contribute to the variability among states, the report says.
As of July, eight states required health-care professionals to test for prenatal drug exposure when it is suspected, and 24 states and the District of Columbia require professionals to report suspected use among pregnant women. Twenty-three states and D.C. consider substance use during pregnancy to be child abuse, and three states consider it to be grounds for admitting a woman involuntarily into a psychiatric hospital. The researchers note that these strict policies could cause women to try to conceal substance use from their providers.
Kentucky began defining neonatal abstinence syndrome, or withdrawal symptoms, as child abuse this year. The legislature added that to a foster care measure (House Bill 1). Under the new law, such a finding could result in the termination of parental rights unless the mother enrolls in a drug-addiction treatment program within 90 days of the birth.
State caseworkers who learn of babies having neonatal abstinence syndrome make recommendations to family court judges on a case-by-case basis, and removing the baby is not an automatic outcome, John Cheves of the Lexington Herald-Leader reports.
The number of Kentucky babies born with NAS has climbed from 46 in 2001 to 1,115 in 2016, according to discharge data reported to the state Department for Public Health.
The researchers add that while this is the first multi-state look at the prevalence of opioid-use disorder diagnosis among women giving birth, the increasing trends could also be a result of improved screening and diagnosis.
They recommend improved access to prescription-drug monitoring programs, increased substance-abuse screening, use of medication-assisted therapy and substance-abuse treatment referrals.
“State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic,” the report says.
Kentucky Health News
Kentucky has a very high rate of opioid-use disorder among women delivering babies in hospitals, according to a study published by the Centers for Disease Control and Prevention.
In Kentucky, 19.3 mothers out of every 1,000 who gave birth in a hospital in 2014 had an opioid-use disorder. Among the 30 states studied, only two were ahead of Kentucky: Vermont, at 48.6 per 1,000, and West Virginia at 32.1. The national rate is 6.5 per 1,000. West Virginia was the only state adjoining Kentucky to be included in the study
Opioid use during pregnancy, whether it be heroin, prescription painkillers or some other narcotic, is associated with pre-term labor, stillbirth, neonatal abstinence syndrome and maternal death.
 |
| CDC graphic |
Nationally, the number of mothers with opioid-use disorders at delivery more than quadrupled during those 15 years, going from 1.5 cases per 1,000 deliveries to 6.5.
Over the study period, Kentucky's rate went up 1.55 per year, but showed big jumps from 2010 through 2014, going from 7.2 to 9.5 to 14 to 15.7 to 19.3. Over the same five years, the national rate rose from 3.9 to 6.5 per 1,000. The Kentucky numbers represented annual increases of 32, 43, 5 and 23 percent.
Average rate increases in opioid-use disorder among mothers giving birth were highest in Vermont, at 5.37. Maine was second at 4.13, but that did not include any data for 2013 and 2014.
Different state policies might contribute to the variability among states, the report says.
As of July, eight states required health-care professionals to test for prenatal drug exposure when it is suspected, and 24 states and the District of Columbia require professionals to report suspected use among pregnant women. Twenty-three states and D.C. consider substance use during pregnancy to be child abuse, and three states consider it to be grounds for admitting a woman involuntarily into a psychiatric hospital. The researchers note that these strict policies could cause women to try to conceal substance use from their providers.
Kentucky began defining neonatal abstinence syndrome, or withdrawal symptoms, as child abuse this year. The legislature added that to a foster care measure (House Bill 1). Under the new law, such a finding could result in the termination of parental rights unless the mother enrolls in a drug-addiction treatment program within 90 days of the birth.
State caseworkers who learn of babies having neonatal abstinence syndrome make recommendations to family court judges on a case-by-case basis, and removing the baby is not an automatic outcome, John Cheves of the Lexington Herald-Leader reports.
 |
| Kentucky Department for Public Health graphic |
The researchers add that while this is the first multi-state look at the prevalence of opioid-use disorder diagnosis among women giving birth, the increasing trends could also be a result of improved screening and diagnosis.
They recommend improved access to prescription-drug monitoring programs, increased substance-abuse screening, use of medication-assisted therapy and substance-abuse treatment referrals.
“State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic,” the report says.
from Kentucky Health News https://ift.tt/2wAYrjj
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