By Tuesday, she was suffering from opiate withdrawal. Exposed to drugs in her mother’s womb, she could not sleep. Inconsolable, her high-pitched cries racked her tiny body.
At 4 days old, a nurse administered the first dose of methadone to ease the infant’s distress. Sedated, the newborn sleeps in a darkened nursery on this drizzly spring day. Electrodes attached to her chest and fingers monitor her heart and respiratory rate.
“She’s had some trouble,” whispered Dr. Gabriel Harpell, medical director of MaineGeneral’s pediatric hospitalist team.
The infant was one of two babies suffering from opiate withdrawal that week at the Augusta hospital.
Maine has one of the highest rates of opiate-affected babies in the country, according to the U.S. Centers for Disease Control. An average of 975 drug-affected babies were born each year in the state — nearly three a day — between 2013 and 2017.
The surge in opiate-addicted pregnant women has challenged Maine’s hospitals, treatment centers and the foster care system, which saw a 45 percent increase in the number of children placed in state custody between 2012 and 2016.
Reasons for the state’s unusually high numbers
Health experts say several factors have contributed to Maine’s high rates of opiate-dependent babies:
— Maine had one of the highest opiate prescription rates in the nation in 2012, with an average of 60 to 65 pills prescribed annually for every man, woman and child. According to a 2012 CDC study, Maine doctors wrote 21.8 opiate prescriptions per 100 residents — more than double the national average of 10.3 prescriptions per 100.
— Treatment for opiate addiction is difficult to access, especially in rural communities where patients often must travel hours to find a doctor that specializes in caring for pregnant women with opiate-use disorders.
— There are 25,000 to 30,000 Maine people, according to the Substance Abuse and Mental Health Administration, who cannot get help for their drug addictions because they do not have insurance.
— Recognized as a mental health illness, Opiate-use disorder is one of the most difficult addictions to treat and cure; highly addictive, opiates make permanent and profound changes in the brain. Women who become pregnant while dependent on opiates often are afraid to seek help, fearing the stigma and shame.
“It is such a powerful disorder at the biological level,” said Edward Bilotti, a South Portland psychiatrist specializing in addiction. “The changes in the brain are so intense that even that maternal instinct, the desire to protect your baby, isn’t enough for most women to make them quit.”
Between 2013 and 2017 in Maine, 4,877 babies were born dependent on opiates or other drugs, according to the state Department of Health and Humans Services. Though the statistics do not differentiate between what substance the mother was using, the escalation of drug-affected babies parallels Maine’s rise in opiate addictions, with 201 infants born exposed to drugs in 2006, compared with 952 in 2017.
“When you have 952 drug-affected babies out of 13,000 births, that’s a horrific number,” said Gordon Smith, executive vice president of the Maine Medical Association. “About 7 percent of our births are from mothers with a substance-abuse disorder.”