The tide may be starting to turn on the number of drug-dependent babies in Tennessee. After an alarming 5-year rise, the number of infants going through withdrawals from opioids is down by more than a quarter from the same point last year.
Tennessee was one of the first states to start weekly monitoring of neonatal abstinence syndrome in 2013. And each year, the total number of cases has been higher than the last, until this year. As of July 1, there have been 125 fewer cases compared to the first half of 2017, a pace that would result in a substantial reduction.
"What we've seen this year appears to be different, so I would say we are cautiously optimistic at this point," says Michael Warren, who oversees population health for Tennessee.
Few other states watch NAS stats so closely, so it's unclear if Tennessee's experience is occuring elsewhere. There's no single explanation at this point, and much has been done in Tennessee to respond to the opioid crisis. Even before new prescribing restrictions were instituted this month, physicians were more careful about prescribing opioids.
And most mothers who have a baby diagnosed with neonatal abstinence syndrome are on at least one prescription opioid, often a type of buprenorphine to help step them down off painkillers or heroin. Still, their babies can end up with NAS, enduring tremors and discomfort as they wean from the opioids their mother was taking.
Warren says women with a history of drug abuse are much more likely to need family planning help, so the state has been offering long-acting birth control implants, sometimes counseling women as they're getting out of jail. Health officials stress that the services are totally voluntary, though at least one judge was reprimanded for reducing sentences based on particpation.
"Certainly, this can have an immediate impact," he says. "So preventing an unintended pregnancy not only can prevent neonatal abstinence syndrome, but if you're trying to get your life back on track, an unintended pregnancy may not be what you need."
Aside from the public health concerns, NAS has also been costing taxpayers millions of dollars a year. NAS often requires a long stay in the hospital, averaging $40,000 per infant. And given that most drug-dependent babies are covered by TennCare, the state's Medicaid program stands to save a considerable amount of money if the positive trend continues.