Cameron McCoy is a very happy baby. He likes to smile, clap his hands and sit on his mom, Teosha McCoy’s, lap. McCoy is 27 and used heroin for eight months while she was pregnant with Cameron. But Cameron wasn’t born dependent on drugs.
McCoy lives in temporary housing run by Volunteers of America Mid-States for new and pregnant moms in recovery.
“It’s God’s grace and mercy that he didn’t withdraw, and I used the whole time,” McCoy said.
But many babies in Kentucky are not so lucky. Data from the Kentucky Cabinet for Health and Family Services show that last year, 1,200 babies were born with neonatal abstinence syndrome, or NAS, because of opioid drug exposure during pregnancy.
Lori Devlin faces the challenge of treating those babies often in her job as a neonatologist at University of Louisville Physicians practice. She recently helped push through a new law that she said will help her and other physicians better determine if a mother used drugs during pregnancy.
“It’s access to be able to know what the baby has been exposed to,” Devlin said. “Because of all the legal implications, oftentimes we end up not getting the truth, or at least not the whole truth.”
Treating a baby who has the symptoms of NAS isn’t easy; they often suffer from seizures and fever, among other problems. But it’s a little easier if the health provider knows what the baby is detoxing from, or even whether they’re detoxing in the first place. There are many other conditions that have the same symptoms of NAS.
Devlin said there are reasons a pregnant woman would take opioids outside of addiction, including conditions that require pain management, like sickle cell disease, cancer and chronic back issues.
Doctors treating those babies have relied on the mothers to give them that information. But finding out whether someone is using drugs illegally can be tricky.
“It’s a scary situation that if you’re a mom that has just delivered, to say how and when you’ve obtained drugs. You might be thinking clearly or remember, ‘Oh yea, I was on this last month from this doctor,” said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. “Rather than to rely on mom’s corporation, it’s a much better situation to look at the actual documents and know.”
And that data is available via the Kentucky All Schedule Prescription Electronic Reporting, or KASPER. This is a database where health providers legally have to report what controlled substances they prescribe patients.
But until now, access was limited to doctors treating a patient. This didn’t help doctors like Devlin, because her doctor-patient relationship was with the infant. The new law allows Devlin–or any doctor treating a baby they suspect of having NAS–to pull the mother’s report.
Van Ingram said even if a mother doesn’t have a KASPER report, that could be telling, too. And he added the information doctors get from KASPER can’t be used to criminally prosecute a mom.
“Or say it’s a NAS baby but there’s no KASPER report,” Ingram said, “that may be an indicator that mom was using heroin or other drugs off the street.”
Devlin said the opioid epidemic has been a much bigger issue than previous years when other drugs were widely used.
“We had cocaine in the 80s but that didn’t lead to massive withdrawal problems,” Devlin said.
There’s also the question of what the long-term impact will be on babies born with NAS. Researchers know the effect fetal alcohol exposure has on those babies later on in life. But with opioids, it’s a big question mark. Devlin said more research is needed to study the long-term effects.