Florida’s prescription drug epidemic, already responsible for nearly seven deaths a day, is taking its toll on the youngest, most vulnerable in our communities: newborns.
In 2009, nearly 1,000 babies born in Florida hospitals were treated for drug withdrawal syndrome. They’re irritable. They don’t eat well. They can spend days, even weeks, detoxing.
And the number is skyrocketing.
Janet Colbert, a registered nurse in a neonatal intensive care unit at a Broward County hospital, witnesses with alarming frequency the heartbreaking physical trauma these newborns endure.
“I kept seeing the torture these babies are going through,” said Colbert, 59, of Dania Beach. “This one baby, he couldn’t even feed. He was screaming, his face was just quivering so badly he couldn’t even get his face around the nipple to feed — and I just said I have to do something.”
Last spring, Colbert and two other women, also healthcare professionals, founded the STOPP Now organization (Stop the Organized Pull Pushers). They stage monthly protests at certain Broward County pain clinics they consider to be pill mills doling out excessive quantities of narcotic painkillers.
From 2006 to 2009, there was a 173 percent increase in newborns treated at Florida hospitals for drug withdrawal syndrome, according to Agency of Health Care Administration records obtained by the Orlando Sentinel.
The most recent data show no signs of a slowdown. During the first half of 2010, 635 cases were reported.
While the state records don’t specify which narcotics those babies tested positive for, South and Central Florida doctors say a majority of the withdrawal cases involve prescription drugs.
“We see them here almost daily,” said Dr. Matthew Seibel, a pediatric hospitalist at Arnold Palmer Hospital for Children and Winnie Palmer Hospital for Women & Babies. “It is standard operating procedure around here, unfortunately.”
But doctors, nurses and social workers say cases of “crack babies” are dwindling, while cases of prescription drug dependence are becoming more prevalent.
Colbert, the nurse, said more often than not the babies at her hospital are testing positive for oxycodone and other prescription drugs.
“Prescription drug abuse has become the number one public safety threat to Florida,” he said.
State child-welfare officials in Central Florida have taken notice of the surge. The problem was escalating so much in Orange County that in 2008, the local Department of Children and Families office reinstituted its Drug Dependent Newborn unit. It’s the only DCF unit in the state dedicated to serving newborns dependent on drugs.
Last year, the unit received 206 cases.
In South Florida, all the hospitals with delivery rooms see babies born addicted to painkillers, nurses said. Fifty-five were born addicted to some substance — the state doesn’t break out painkillers — in the first half of last year in Broward and Palm Beach counties, up sharply from 29 in all of 2006, state figures show.
From her experience, Colbert said, those numbers sound low. That may be because some doctors classify cases as maternal drug abuse rather than neonatal drug abuse, she said.
Hospitals prefer to keep addicted babies for at least four weeks to gradually wean them off drugs, rather than send them home to detox, said registered nurse Mary Osuch, manager of the neonatal intensive care unit at Broward General Medical Center in Fort Lauderdale.
“If we don’t intervene, they are more vulnerable to child abuse because they are inconsolable and the parents can’t take it after a while,” Osuch said.
The drugs steal their appetites and cause stomach cramps. When the babies do eat, they get diarrhea. They don’t rest well. And they are irritable all the time, Osuch said.
“It’s so hard to watch them,” Osuch said. “You can’t console them.”
Typically, NICU doctors give addicted babies the sedative phenobarbital to ease the withdrawal, Osuch said. If that doesn’t work, they use methadone or even morphine. Over days or weeks, they reduce the dosage until the baby is drug free and eating and sleeping normally.
Mothers are steered toward parenting classes, counseling and assistance with scheduling doctors appointments and follow-up care for the newborn.
Mores seek treatment
At the Center for Drug Free Living’s Addictions Receiving Facility near downtown Orlando, the number of people being treated for prescription drug abuse — including pregnant women — is on the rise.
Doctors have treated pregnant women with methadone, often prescribed in place of oxycodone for pain management, since the 1960s.
That method still stands today, because women who abuse drugs like oxycodone cannot go cold-turkey while they are pregnant. Doctors say it’s too stressful on the mother’s body, which imposes stress on the developing baby.
Doctors would rather have a steady level of methadone in the developing baby than a mother who takes other drugs, explained Dr. Stacy E. Seikel, medical director at the center.
“When the mother is in withdrawal, the baby is in withdrawal,” she said. “If the baby is in and out of withdrawal the entire pregnancy … the baby can’t grow and mature well.”
Officials say the increase in drug-dependent newborns is further evidence of Florida’s — and the nation’s — growing use of prescription drugs.
Drug addicts and dealers from northern states, dubbed “pillbillies,” travel to Florida, where a plethora of pain clinic doctors are willing to dole out addictive, powerful painkillers and sedatives like oxycodone and alprazolam.
From October 2008 to March 2009, 49 of the nation’s top 50 dispensing doctors of oxycodone were in Florida, with the majority concentrated in Broward and Palm Beach counties, a grand jury reported. And according to one national study, the use of prescription pain medication increased 400 percent from 1998 to 2008.
Colbert, the neonatal nurse, says every time she tries to comfort yet another inconsolable newborn through withdrawals, she wonders why politicians allow the abuse to continue.
“It’s like a side effect no one’s seeing,” she said. “Every time we admit another baby like this, I wonder, why isn’t somebody doing something about this.”
Sen. Mike Fasano, R-New Port Richey, who has been a state leader in the pill mill fight, said he was unaware of this aspect of the prescription drug scourge.
“You don’t realize how there’s that trickle-down effect,” Fasano said. “This is another perfect example of why we have to address this crisis in Florida, this epidemic.”