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Children and the opioid crisis

Marian Wright Edelman | 11/9/2017, 6:38 p.m.
President Trump’s announcement yesterday reminded us all that the opioid crisis is a public health emergency, but in fact it ...
Marian Wright Edelman

President Trump’s announcement yesterday reminded us all that the opioid crisis is a public health emergency, but in fact it is also a national emergency and we must do so much more. Daily we read articles and see searing reports about the opioid crisis. We’ve learned about the role of some doctors and drug companies in exacerbating it. We heard recently about how Congress was complicit in making it harder for the Drug Enforcement Administration to stop drug companies that were shipping suspicious amounts of opioids. We read about parents whose young adult sons and daughters end up in prison and who are desperate for treatment for loved ones. We keep learning more about the variety of opioids including heroin and extremely potent synthetic opioids like fentanyl coming from China. We read about the toll the continuing crisis and all the deaths are taking on first responders, police, treatment staff, nurses and doctors, families and grandparents being asked to step in to help. But we don’t read enough about its toll on children.

For the last two decades people across our nation have helplessly watched this rapidly escalating epidemic destroy families and entire communities. Most of us know some person or family in our community suffering from the impact of substance abuse disorder. Over 2.5 million Americans were addicted to opioid pain relievers or heroin in 2015. The Centers for Disease Control and Prevention (CDC) reports opioid-related deaths have more than quadrupled since 1999. Prescription and illicit opioids combined have killed more than 300,000 Americans since 2000. Ninety-one Americans die every day from an opioid overdose. This catastrophe of opioid addiction and deaths has fueled a heartbreaking increase of children in crisis.

From the earliest days of pregnancy children whose parents abuse opioids are at high risk. In addition to prenatal drug exposure, parents distracted by drugs and without help may be unable to provide children necessary care to grow and thrive. Children and teens are also susceptible to accidental opioid exposure and misuse. Whether children are born suffering from drug exposure, their parents’ addiction struggle leads to toxic stress or involvement with the child welfare system, or they use or are accidentally exposed to drugs themselves, opioid addiction has a devastating impact. There is much renewed interest in the Adverse Childhood Experiences Study (ACEs) which tracks the impact of stressful and traumatic experiences on children’s later and adult development. Parental substance abuse is one of these ACEs as are emotional and physical abuse and separation from family which put children at risk of lifelong consequences.

Among women who struggle with opioid abuse, 86 percent of pregnancies are unintended, compared with 56 percent of all pregnancies. This means children are more likely to receive insufficient or delayed prenatal care and are at risk of low birthweight and poor mental and physical health.

Between 14 and 22 percent of women nationwide fill an opioid medication prescription during pregnancy. This puts thousands of infants at risk of neonatal abstinence syndrome (NAS), problems stemming from drug withdrawal symptoms which occur in about half of infants with prenatal opioid exposure. In 2012 the maternal opioid use rate in hospitalized births in rural counties was nearly 70 percent higher than that in urban counties.