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The addiction crisis has seeped into nearly every aspect of U.S. life. Among the most vulnerable victims are tens of thousands of babies born every year to mothers who took opioids. The image of these trembling, crying babies in hospital nurseries is often invoked by lawyers suing the opioid companies. But as WPLN's Blake Farmer reports, some worry that when those lawsuits end, there won't be any money left for those babies as they grow.
BLAKE FARMER, BYLINE: Neonatal abstinence syndrome - or NAS, as it's known - was only recently something doctors even looked for. The numbers quadrupled over a decade. The condition can result in tremors, seizures and even breathing trouble in the first days of life. Robbie Nicholson of Eagleville, Tenn., knows what it's like to watch your baby withdrawing from drugs you were taking.
ROBBIE NICHOLSON: The whole experience was just traumatizing, really.
FARMER: Nicholson's ordeal goes back to her first pregnancy. Afterwards, she was prescribed a pile of Percocets by her doctor. That was the norm.
NICHOLSON: Back then, it was like I was on them for, like, a full month. And then he was like, OK, you're done. And I was like, oh, my God. I've got a newborn - first-time mom, no energy, no sleep. Like, that was getting me through. And so it just built - build and build and build off that.
FARMER: After developing a full-blown addiction to painkillers, she eventually found her way into recovery, taking medication to keep her opioid cravings at bay. And then another pregnancy. The trouble is medication-assisted drug treatment, which involves taking a special kind of opioid, can still result in withdrawals for the newborn. Hospitals have gotten pretty good at weaning them, but not much is known about the long-term effects.
NICHOLSON: And I wanted her to be perfect. And she is absolutely perfect. But just that in the back of my mind is always going to be there.
(SOUNDBITE OF TODDLER BABBLING)
NICHOLSON: That's daddy.
(SOUNDBITE OF TODDLER BABBLING)
FARMER: That's Nicholson's youngest, now a toddler. She's happy and healthy, if a bit strong-willed, Nicholson says. There are thousands of children like her entering the education system. And neonatologist Stephen Patrick says this is where money is so desperately needed.
STEPHEN PATRICK: So you hear teachers talking about infants with a developmental delay. I mean, I just got an email this morning from somebody.
FARMER: Patrick says no one's shown a direct link between NAS and behavior problems in kids, but that's where more research is headed. As states, cities counties and even hospitals are going after drug companies in court, Patrick fears the kids will be left out. He leads the Center for Child Health Policy at Vanderbilt University.
PATRICK: It's somewhere where we need to be in the mix right now in schools, understanding how we can support teachers, how we can support students as they try to learn, even as we work out, was there cause and effect of opioid use and developmental delays or issues in school?
FARMER: But it's a nuanced problem with no consensus on where money's most needed, even among those who've been working on the problem for years. Justin Lanning started 180 Health Partners, which works with mothers at risk of delivering a drug-dependent baby. He sees a need to fund government insurance for new mothers since, in some states, coverage goes away after just two months. He says that often derails the mother's own drug treatment funded by Medicaid.
JUSTIN LANNING: This consistency of care is so key to their recovery, to their productivity, to their thriving.
FARMER: Lanning's company hires mothers who've been there to act as mentors. Robbie Nicholson is one of them. In working directly with these pregnant women struggling with addiction, she says their biggest need is a stable place to live and reliable transportation.
NICHOLSON: It's just I feel kind of hopeless because I'm like, oh, my God, I don't know what to tell these women.
FARMER: There are many needs, Nicholson says, but no simple fix. Those who work with mothers in recovery fear any opioid settlement money may be spread so thin that it doesn't benefit their children, the next generation of the crisis.
For NPR News, I'm Blake Farmer in Nashville.
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