https://www.washingtonpost.com/national/health-science/hhs-will-aid-infants-and-mothers-affected-by-the-opioid-epidemic/2018/10/23/11a80158-d6db-11e8-aeb7-ddcad4a0a54e_story.html?noredirect=on&utm_term=.cbbc523d2a2d&wpisrc=nl_sb_smartbrief

Comments; The most pitiful victims of all are the babies of addicted mothers.  Neonatal abstinence syndrome is tough.  I really think there should be more studies done with buprenorphine in this population.  Mom’s are given it while pregnant, but my experience has been that the babies are often given methadone in the nursery.  I think bup is such a better choice but the studies haven’t been done yet

“We believe in approaching addiction as a disease, never a moral failing,” Secretary of Health and Human Services Alex Azar said on Oct. 23, 2018. He’s pictured earlier this month. (Alex Wong/Getty Images)

By Lenny Bernstein

October 23 at 3:30 PM

The Trump administration is stepping up aid for infants and mothers caught in the opioid epidemic, promising to help states cope with some of the worst collateral damage of the drug crisis, Health and Human Services Secretary Alex Azar said Tuesday.

Azar said HHS would partner with states to offer a range of services to mothers with substance-use disorders and the skyrocketing number of newborns dependent on drugs. Those infants, who suffer from a condition known as neonatal abstinence syndrome, often endure painful withdrawal symptoms as health-care workers attempt to wean them off drugs during their first weeks of life.

Azar said HHS’s Center for Medicare and Medicaid Innovation would launch its first program “specifically devoted to helping address the effects the opioid crisis is having on mothers and infants.” The effort will include opioid abusers who are pregnant or who recently gave birth, he said.

He did not say what services would be offered or in which states. He also did not specify how much funding would be provided for the effort.

According to a study by Vanderbilt University researchers this year, the incidence of neonatal abstinence syndrome has nearly quintupled as the opioid epidemic has exploded, from 1.19 cases per 1,000 hospital births in 2000, to 5.63 in 2012.

About 72,000 Americans died of drug overdoses in 2017, according to preliminary data released by the Centers for Disease Control and Prevention. About two-thirds of them succumbed to opioids.

Azar cautiously noted a slight drop in the number of overdose deaths in late 2017 and early 2018, expressing hope that the worst drug epidemic in U.S. history may be reaching a plateau.

“Plateauing at such a high level is hardly an opportunity to declare victory. But the concerted efforts of communities across America are beginning to turn the tide,” he said. “We are so far from the end of the epidemic, but we are, perhaps, at the end of the beginning.”

Azar was the lunchtime speaker at a health conference in Washington sponsored by the Milken Institute of Santa Monica, Calif. His remarks came a day before President Trump is scheduled to sign comprehensive anti-drug legislation approved by Congress.

The government has devoted billions of dollars to the crisis, but critics have accused the current administration of doing too little and acting too slowly. Trump declared the crisis a public health emergency last October, and Azar said he recently renewed that declaration. The designation allows the government to bypass some regulations in its effort to speed and expand its efforts.

Azar noted that since Trump took office, there has been a substantial increase in the number of people receiving buprenorphine and naltrexone, two medications offered as treatment for opioid dependence. The number of monthly prescriptions for naloxone, the fast-acting antidote for an opioid overdose, has more than quadrupled, he said.

“We believe in evidence-based treatment, we believe in a public-health approach to this epidemic, and we believe in approaching addiction as a disease, never a moral failing,” Azar said.

He said the National Institutes of Health and the Substance Abuse and Mental Health Services Administration will soon begin an experiment in as many as three hard-hit communities to test an “integrated” approach to controlling the drug crisis. He called the effort “the most ambitious such undertaking in the history of the study of addiction.”

He quoted Sam Quinones, author of “Dreamland,” the groundbreaking book on the drug crisis, who said communities battling the opioid crisis have the most hope of success when “everyone has come together to tackle this challenge: not just healthcare providers and families of those struggling with addiction, but schools, churches, businesses, law enforcement — every element of civil society.”

Dr. Raymond Oenbrink