High Rate of Babies Addicted at Birth in the Northern Panhandle

WHEELING — A higher-than-average percentage of infants from Marshall, Ohio and Wetzel counties were drug dependent at birth last year.

Local health officials cannot explain precisely why Neonatal Abstinence Syndrome is prevalent in the three counties, but they point to community-wide efforts to prevent future cases.

The West Virginia Department of Health and Human Resources has released data for 2017 on babies born with Neonatal Abstinence Syndrome in 28 counties. State officials said figures for the 27 other counties were suppressed because of low occurrence and the need to protect confidentiality.

Marshall County had the second highest incidence rate of NAS in the state, with 102.1 cases per 1,000 live births, or 10.21 percent. Ohio County had 69.9 cases per 1,000 births, or 6.99 percent. Wetzel County had 67.1 cases per 1,000 births, or 6.71 percent. All three counties experienced NAS rates that were higher than the state average. Data for Hancock, Brooke and Tyler counties was not released in the state report.

The state’s highest incidence rate of NAS was in Lincoln County, with 106.6 cases per 1,000 live births, or 10.6 percent. The overall incidence rate in West Virginia last year was 50.6 cases per 1,000 live births, or 5.06 percent.

Dr. Rahul Gupta, state health officer and commissioner of DHHR’s Bureau for Public Health, said hospitals in West Virginia are now required to report NAS cases as part of the mandatory birth score process.

Babies are tracked by county of residence, not their county of birth, he said.

The syndrome occurs after prenatal exposure to drugs is discontinued suddenly at birth. It involves multiple systems in an infant’s body and causes withdrawal symptoms in the newborn.

Dr. David Hess, CEO of WVU Medicine-Reynolds Memorial Hospital in Glen Dale, said, “We know that the entire Northern Panhandle has a problem with opioid abuse. Unfortunately, that trickles down to expectant mothers.”

Both prevention and treatment options are needed for women who abuse drugs before or during pregnancy, Hess said.

Dara Pond, administrator of the Marshall County Health Department, said outcomes are improved when substance abuse treatment is offered in concert with prenatal treatment. She said community partners work together “to integrate substance abuse prevention, early intervention and service delivery into our services at the health department.”

Pond said Wheeling Hospital is one of the health department’s partners. Hospital staff work with local agencies to make “support available for expectant mothers who need it,” she said.

A study conducted at Wheeling Hospital provided early data on the incidence of Neonatal Abstinence Syndrome in the area. Pond said, “It’s been several years since agencies in the Northern Panhandle began to work on this project. We have some different funding and different projects, from campaigns to information dissemination.”

For example, a resource guide for expectant mothers is available to identify treatment providers and provide information on screening, intervention and referral to treatment.

“We’ve been working on this for quite some time now,” she said. “We’re very lucky in the Northern Panhandle that so many agencies have come together to wrap around this issue.”

Regarding the state’s NAS report for 2017, Pond said, “The ability to even release data on this issue is very early in its availability. It will be some time before we’re able to really assess the trend.”

Howard Gamble, administrator of the Wheeling-Ohio County Health Department, said, “The data does allow us and the general public to see how the issue of drugs and the use of drugs during a pregnancy impacts health care on another level.”

When a drug addict becomes pregnant, she endangers not only her life, but also puts her unborn child’s health at risk. Gamble said, “An individual using drugs sometimes does not understand how their individual problem can impact other lives and our general health care system.”

Looking ahead, he said, “Issues with NAS and its impact on our health care system, families and our population will continue to grow.”

From a statewide perspective, Gupta said, “Ever since 2009, we were seeing a lot of babies born with dependency to opioids and other drugs. There was no mechanism to put it all together.”

In 2013, the Bureau for Public Health began a year-long process to develop a definition of Neonatal Abstinence Syndrome and a reporting system for medical providers, he said. During the next year, providers were trained and a birth score program was developed. The state bureau began collecting data in October 2016, with all of the facilities on board.

Gupta said, “The data is really 2017 data. It’s the first time we have well-standardized and current-year data. We are ahead of most states in the nation.”

The reporting allows leaders in local communities to address the issue in counties and regions that have a higher prevalence, Gupta said. In future years, more information from counties will be released “because we’ll have cumulative data,” he added.

“We’re working not just to address NAS, but also working on preventing NAS,” he said, adding, “It’s an opportunity to educate men and women, boys and girls, so addiction does not happen in the first place.”

Communities must work “to prevent the next generation from being afflicted and impacted and victims of the opioid crisis,” Gupta said. “This is the time to think about those babies now.”

However, the need for more drug treatment facilities and programs remains a critical issue.

“Certainly not in West Virginia, not across the country, do we have sufficient treatment options for those anticipating pregnancy or are pregnant,” he said, “But we are making significant progress. This data helps provide data for where help is needed.”

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