News and Tribune

October 21, 2013

State task force tackles prescription abuse

Measures could help addicted pregnant mothers

By MAUREEN HAYDEN
newsroom@newsandtribune.com

INDIANAPOLIS — Alarmed by the number of infants in Indiana born addicted to prescription painkillers, a task force of medical and legal experts may push for a new law that would provide some protection for drug-abusing pregnant women who voluntarily seek and stay in treatment for their addiction.

Such a measure is still being considered by the Attorney General’s Prescription Drug Abuse Task Force, which pushed for the new state rules that call for drug-testing of pain-medication patients and closer monitoring of those patients by doctors.

At a meeting Monday, members of the legislative Commission on Mental Health and Addiction heard from task force coordinator Natalie Robinson, who said the incidence of babies born dependent on narcotics may have reached epidemic levels in Indiana.

The condition, known as neonatal abstinence syndrome, or NAS, poses a higher risk of harm and complications for the infant, including premature birth and birth defects. “Even more startling than the higher risks is the pain and suffering that a newborn with NAS endures after birth,” Robinson said.

Currently, the state isn’t required to track the numbers of babies born with neonatal abstinence syndrome. Indiana hospitals say the annual cost of treating babies with NAS has gone from $2 million in 2002 to $28 million in 2010 — with much of that cost picked up by taxpayers through the Medicaid program.

Robinson also said the state’s largest neonatal intensive unit — at Riley Hospital for Children — has gone from seeing about one case a year of a narcotic-addicted infant to one a week over the last decade.

The Prescription Drug Abuse Task Force was formed in 2011, after the state saw a 10 percent increase in the number of prescription drug overdose deaths from the year before. A new report released A new report by the Trust for America’s Health ranks Indiana in the top five states for fastest-growing rate of drug overdose deaths, with prescription drugs accounting for most of the those deaths.

The task force has already pushed for a series of legislative measures aimed at curbing prescription drug abuse in Indiana, including new emergency rules that go into effect Nov. 1 requiring doctors to do much closer monitoring of their pain-medication patients.

The task force plans to push for more legislative remedies in the next session. Among them: requiring all health providers to report cases of neonatal abstinence syndrome to the state health department; and regulating the popular prescription pain-killer, Tramadol, as a schedule IV drug, which would increase the criminal penalties for abusing it or diverting it for someone else’s use.

One measure the task force is still considering: a law like the one passed recently in Tennessee that would give pregnant women some incentives to confess their drug addiction to their doctor and get into drug treatment programs. The Tennessee law, called the Safe Harbor Act, moves a pregnant woman to the front of the line for available spots in drug treatment programs, and guarantees her newborn won’t be taken away by the Department of Children’s Services solely because of the drug use, as long as the woman continues in treatment and the baby is well-cared for.

“We want to encourage these women to do the right thing,” Robinson said. She said drug-abusing pregnant mothers too often avoid getting prenatal care because they fear criminal prosecution and having their infants taken away from them.

The Tennessee legislation was supported by the state medical association, which made prescription drug abuse a priority among its public health issues. The Tennessee law sets out a series of conditions that the pregnant woman must meet in reporting her drug abuse to her doctor and following up with treatment. It doesn’t prevent the state from filing an action to remove the child from the custody of the mother or other caregiver if it’s determined the baby isn’t properly cared for by the mother or caregiver.

One significant obstacle, identified by the Indiana task force, is what Robinson called the “extreme shortage” of drug treatment services in the state and health care providers who will treat pregnant drug abusers.

That concern has been backed up by a series of reports, including a 2010 Indiana University study that found the state spends more on the health care consequences of substance abuse than on its prevention. The study found that for every dollar Indiana spends on services dealing directly and indirectly with substance abuse, 66 cents are used for health care-related consequences while only 1 cent pays for prevention or intervention initiatives.

— Maureen Hayden covers the Statehouse for the CNHI newspapers in Indiana. She can be reached at maureen.hayden@indianmediagroup.com