Levi was lifted out of his mother’s belly at 10:44 on a May morning, tiny and crying and addicted to opioids. For the past month, he has been lying in a bassinet in a Hamilton hospital’s neonatal intensive care unit. Nurses feed him droplets of morphine and closely monitor him for fever, tremors, rashes and sweat gathering on his neck and brow. By now, they are used to his frenetic, high-pitched cries, an unrelenting and inconsolable wail that indicates a baby going through withdrawal. Nearby, four other newborns — a shocking one-quarter of the nursery’s occupants — are also coming off the narcotic drugs their mothers took while pregnant. It is both a distressing and a familiar sight here at St. Joseph’s Healthcare Hamilton and in neonatal intensive care units across the province. In the past five years, there has been a staggering increase in the number of babies born dependent on prescription painkillers. The incidence of neonatal abstinence syndrome, or NAS — in which a baby is born addicted — has skyrocketed alongside the epidemic use of legitimate and illicit opioids, particularly drugs that contain oxycodone, the active ingredient in OxyContin and its replacement, OxyNeo. In 2003-04, Ontario tracked 171 babies born with NAS. In 2010-11, there were 654 — nearly a fourfold increase. Experts say that with Ontario having the highest narcotic use in Canada and among the highest in the world, the tide of addicted babies is in no way abating (via Toronto News: Ontario’s surge in babies born addicted to opioids - thestar.com)
jeez.. I live in this province & had no idea..
- many women who become addicted to opioids start off with a legitimate prescription for the painkillers, perhaps for chronic pain or injuries suffered in a car accident. The highly addictive nature of the drugs means pain control can quickly turn to dependence.
- The fear of withdrawal or being “dope sick” also kept her away from treatment. “It’s like having the flu times 20,” she says. “The pain in your bones is the worst … the pain in your legs is so bad you want to cut them off. You are sick to your stomach, you can’t eat, you sweat … every bad feeling you can possibly imagine you have from opioid withdrawal.”
- Doctors know how to treat babies going through opioid withdrawal with morphine and other drugs. In some mild cases, swaddling and cuddling babies and keeping them in quiet, darkened rooms is enough to ease the symptoms of withdrawal, says Knoppert of the London Health Sciences Centre. Unrecognized, NAS can be cause life-threatening episodes, such as seizures.
![“It is excruciating,” said Dr. Trescott, who oversees primary care at Group Health. “These are often very good clinicians who just have this fatal flaw.” (via Opioid Painkiller Prescriptions Pose Danger Without Oversight - NYTimes.com)
High-strength painkillers known as opioids represent the most widely prescribed class of medications in the United States. And over the last decade, the number of prescriptions for the strongest opioids has increased nearly fourfold, with only limited evidence of their long-term effectiveness or risks, federal data shows.
“Doctors are prescribing like crazy,” said Dr. C. Richard Chapman, the director of the Pain Research Center at the University of Utah
Studies link narcotic painkillers to a variety of dangers, like sleep apnea, sharply reduced hormone production and, in the elderly, increased falls and hip fractures.
in 2008, the most recent year with available data, 14,800 people died in episodes involving prescription painkillers.
The long-term use of opioids to treat chronic pain is relatively new. Until about 15 years ago, the drugs were largely reserved for postoperative, cancer or end-of-life care.
At the same time, pharmaceutical companies began to promote newer opioid formulations like OxyContin for chronic pain that could be used at greater strengths than traditional painkillers. Sales of painkillers reached about $8.5 billion last year, compared with $4.4 billion in 2001, according to the consulting firm IMS Health. Along with Purdue Pharma, the maker of OxyContin, other producers include Johnson & Johnson and Endo Pharmaceuticals.
the strength of the average daily dose of the most powerful opioids prescribed to patients treated through the workers’ compensation program had shot up by more than 50 percent. The number of patients taking the drugs in large quantities had grown to 10,000. Doctors often increase opioid dosages because patients can adjust, or develop tolerance, to the drugs and need greater amounts to get the same effect.
“Doctors end up chasing pain” instead of focusing on treating the underlying condition, she said.
“If doctors understood how hard it is to get patients off of these drugs, they would not prescribe them to begin with,” [ Dr. Ballantyne ] said.
Dr. Ballantyne, 63, once embraced the wider use of opioids. Her transition to skepticism began about a decade ago, when she noticed that hospitalized patients taking high dosages screamed when they were examined — as if the drugs had increased their sensitivity to pain. (..) “I think that after 20 years of a failed experiment that there are not many people supporting this except for the die-hards and the pharmaceutical industry,” she said.
“It is not just our sex lives that go away; it is our ability to get things done,” said Dr. Chapman, of the University of Utah.
Danish researchers have published a study indicating that chronic pain patients getting nondrug treatments recover at a rate four times as high as those on opioids. “These drugs don’t seem to be even doing what they are supposed,” said Dr. Per Sjogren, a pain expert in Copenhagen who led the study.
The obstacles to lower opioid use remain formidable, however; both insurers and public agencies must be willing to pay for other treatments, which can be costly.
The Food and Drug Administration indicated in 2008 that it might require that doctors receive several hours of mandatory training in the use of opioids as a condition of prescribing them. But in 2010, the agency backed away from that stance in the face of opposition from some medical and patient advocacy groups. In addition, although the Obama administration announced plans last year to introduce legislation containing such a mandate, it has yet to do so.](http://25.media.tumblr.com/tumblr_m288hapsOF1qzh8lfo1_400.jpg)
