North Bay's struggle with opioid-dependent babies

Published on Jan 14, 2016

Year after year, North Bay sees more babies born to addicted mothers. Between 2014 and 2015, 48 babies were born to mothers addicted to opiates in the city of just 64,000. While the number seems small, this figure rose from only 22 babies in 2013 and 31 in 2014. The rising count shows no sign of slowing down, putting even more pressure on the city’s already overloaded hospital staff.

“These babies have a significant impact on neonatal units,” explains Dr. Suzanne Turner, a family physician at St. Michael’s Hospital in Toronto who specializes in obstetrical care for women with addictions. “They can be jittery and difficult to soothe. They can have diarrhea, sneezing, vomiting and difficulty feeding. In Ontario, the recommendation is slow doses of morphine.”

Babies born dependent on opiates – a condition commonly called neonatal abstinence syndrome – require close monitoring to prevent seizures. Nurses must be on standby 24 hours to administer narcotics.

Across Ontario,  896 babies were born to women addicted to drugs in 2013-14 according to the Ministry of Health. Compare this to 2010-11, when the number was only 654. During pregnancy, the addicted mothers used methadone, other opiates including heroin, oxycontin and percocets, as well as cocaine and marijuana. But instances in the province’s north appear disproportionately higher, as shown in the following chart.

Chart showing prevalence of neonatal abstinence syndrome by health network areaPrevalence of neonatal abstinence syndrome by health network area, courtesy the Institute for Clinical Evaluative Sciences

Infants with neonatal abstinence syndrome born to women who received prescriptions for opioids in the 100 days preceding delivery stayed in hospital longer (median 19 days) and had more outpatient physician encounters during the year after birth (median 25 visits) compared with infants born to women who had not received prescriptions for opioids.

“That’s a long hospital stay for a newborn,” says Turner. “The regular hospital stay for babies is 24-48 hours.”

Societal strains extend beyond just hospital resources. Babies exposed to methadone often show cognitive and motor delay, according to Astrid Guttmann, chief science officer at Institute for Clinical Evaluative Sciences at Sunnybrook Health Sciences Centre in Toronto (with satellite offices across Ontario).

“Many of them end up in foster care,” she says. “We know these children are going to need close follow-up.”

Having a baby who needs special care can affect parents’ mental health and their ability to cope at work and at home, Turner says. The Ministry of Health also advises that prenatal care, psychotherapy and family monitoring are often necessary.

“It’s a big stress on the family unit when the mom thinks the child is going to be sick,” she says. “Many patients and families may not even live close to the hospital.”

While figures from the Institute for Clinical Evaluative Sciences show a disproportionate number of opioid-dependent baby cases in northwestern Ontario, North Bay addiction specialist Dr. Dell’Aquilla cautions that it doesn’t necessarily mean that incidences are higher in that city — just that reporting and treatment are more widespread.

“What the numbers actually mean is that there are more people in North Bay who have gotten into treatment,” he says. “Several private clinics have been set up and care is accessible. North Bay has the same number of people on methadone as Sudbury but Sudbury is three times the size of North Bay. However when you look at Sudbury it’s underserviced, with less access to opiate replacement therapy.

It looks like Sudbury doesn’t have as big a drug problem because all those people who would benefit from treatment are on the streets.”

Still, Dr. Alan McQuarrie, executive director at Community Counselling Centre of Nipissing, stresses that this is an issue he’s come across more frequently in recent months.

“Our local children’s aid society was struggling with the huge numbers of babies they were apprehending,” he says. “It was much higher than in past years. It put a strain on the child welfare system … they just didn’t have the capacity to care for all these newborns that were coming into care.”

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