John Giordano

Suboxone moms graph

Lynndaya will never feel the enchantment of the holidays, nor the warmth of her family’s good cheer or the simple joy of the season. December 10th marks the four-year anniversary of her death. At the time of her passing, Lynndaya was just five-days old. Like so many babies born today, her mother was a Suboxone mom.

It should be no surprise to anyone that with the expansion of prescribing Suboxone in the middle of a growing opioid epidemic, more and more babies are being born across the country addicted to opioids. Current statistics are hard to come by; but what is available paints a very dark future for newborns. The safety net for addicted newborns in this epidemic has always been frail at best. However, it appears as though it is the influx of Suboxone moms that is testing the boundaries and distorting the net beyond its capabilities – thus further endangering newborns.

The rate at which babies are born addicted to opioids surged from 1.2 out of every 1,000 born in 2000, to 7.3 babies out of every 1,000 born in 2013; or a 600% increase over 14 years. This translates into one baby born suffering from opiate withdrawal every 19 minutes. These newborns are more likely than other babies to also have low birth-weight and respiratory complications. Their stay in the hospital averages 16.9 days compared to 2.1 for other newborns. In 2013, the last year records were available, there were over 27,000 babies born addicted to opiates in the United States.

Neonatal Abstinence Syndrome (NAS) is a postnatal drug withdrawal syndrome that occurs primarily among opioid-exposed infants shortly after birth. It’s often manifested by central nervous system irritability, tremors, seizures, autonomic over-reactivity, and gastrointestinal tract dysfunction. Nurses have described NAS symptoms as ear-piercing wails, tremors that shake the entire baby’s body, irritation at the slightest stimulation, sleep problems, tight muscle tone, repetitive sneezing, feeding difficulties, breathing challenges, unstable body temperatures and severe diarrhea. The symptoms can show up any where from the moment of birth to 72 hours after. Many times the symptoms do not reveal themselves until after the baby has left the hospital. Although the symptoms can last for up to six months, the first month is the worst.

Sleep depravity is fairly common among new parents; leaving us to imagine how a mother who uses opioids – prescription and/or illicit – to cope with her own personal issues, can handle life with an addicted newborn screaming non-stop throughout the day and night for days and weeks on end.

Angelica Richardson McKenney was one of those parents. She was 28 when she brought Lynndaya home from the hospital. McKenney had a prescription for Subutex (Suboxone) and used the opioid throughout and after her pregnancy. She also tested positive for benzodiazepines and marijuana at the same time. Her baby Lynndaya tested positive for narcotics at birth. Even with all these red flags, McKenney was allowed to bring her drug-dependent baby home.

The day before her daughter died, McKenney took a Percocet (a semisynthetic opioid synthesized from poppy) and a Xanax (benzodiazepine) – both prescribed to her at the hospital by the physician who delivered her baby – along with her other prescription opioid, Subutex. She woke the next morning to find she was sleeping on top of her baby; Lynndaya suffocated sometime that night.

Clearly, Angelica’s drug problem should have served as a dangerous ‘flashing red light’ warning to the medical professions treating her, but it didn’t. According to Reuters’ News, the doctor – who was aware of McKenney’s drug addiction, yet prescribed the Percocet and Xanax for her – later stated that “just because they’re a drug addict doesn’t mean we’re not going to give them something for their pain,” and did not respond to questions regarding the Xanax.

This statement illustrates just how cavalier many in the medical profession have become in prescribing opioids; a painkiller that was once reserved for end-of-life patients. Doctors should know better than this and they should also know that there is a literal plethora of safe and effective pain medicines available for them to prescribe to addicts that are not opioid based and are non-addictive. Giving Xanax and Percocet to an addict already on Subutex is a prescription for death and the purest definition of insanity there is.

A study (National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012) published on October 31, 2016 in the highly regarded peer-reviewed Journal of the American Medical Association (JAMA) Pediatrics found that pediatric hospitalizations for opioid poisonings increased nearly two-fold from 1997 to 2012. Hospitalization rates were highest
in older adolescents, but the largest percentage increase in hospitalizations over time occurred among the youngest children (toddlers and preschoolers).

One of those toddlers was 2-year-old Londyn Raine Sack who died of a Suboxone overdose. Her mother, Rebekah Robinson, a single mother of four children, didn’t have a prescription for the drug. She acquired it through a trade of Xanax with a friend she had met in rehab. On the morning of Oct. 9, 2014 Emergency Services responded to a 911 call from Robinson’s apartment and found Londyn unresponsive. She was transported to Bristol Hospital and pronounced dead around 9:30 a.m. An autopsy report showed oxycodone and suboxone were found in Londyn’s system. The coroner ruled the cause of death as acute Buprenorphine (Suboxone) Toxicity. On Oct 20th Rebekah Robinson opened a GoFundMe account – Help me bury my baby girl. Robinson is currently in jail awaiting trial on manslaughter charges.

There are federal laws on the books designed to protect children of addicts. In 2003, an older federal law, The Child Abuse Prevention and Treatment Act (CAPTA), was reauthorized and amended by the Keeping Children and Families Safe Act of 2003 (KCFSA of 2003). The amendment is very specific and intended to add a layer of protection for addicted newborns. The federal law requires hospitals and medical professionals in all states to report every drug-dependent newborn case to child protection authorities regardless if the mother is using prescription and/or illicit drugs. Said referrals are not considered evidence of abuse, but merely a red flag meant to protect the baby. In turn, the law requires social services to develop a “plan of safe care” for the child.

The well intended amendment seems to be pretty straight forward and based in common sense. But not all the states viewed it that way. According to Reuters Reporter Duff Wilson, “Today, most states require health officials to report only babies who were exposed to illicit narcotics. That means child protection services may never learn of babies suffering withdrawal from opioids that were legally prescribed to pregnant mothers. Some state policies are so muddled that even child welfare officials are confused about the reporting requirements.”

This was the case with Kentuckian Angelica McKenney and many more like her. Because she had a prescription for Suboxone, state law does not require hospitals or medical professionals to report drug-dependent newborn cases to child protection authorities. These policies guarantee that we’ll never know the full impact MAT drugs
– Suboxone and its cousin Methadone – have on the alarmingly increasing rates at which babies are born addicted to opioids. MAT opioid drugs are being swept under the carpet!

There are a thousand more stories like McKenney’s and Robinson’s. Some may have slightly different slants but they all tell a tale that ends badly. Bringing a child home from the hospital is challenging for even the most well-balanced mother. Anyone who has merely been around an addict can tell you that they are not suited to handle the pressures of parenting any baby – much less an addicted baby – on their own. Keep in mind what the mothers we’re talking about are using; opioids, which clouds their judgment. The endless agonizing shrills of panic so powerful they force the tiny baby’s delicate body to tremble, combined with strains of parenting responsibilities provides the catalyst for the manifestation of massive stress that will drive a sleep-deprived addicted mother into a opioid craving spiral.

Congress has been acutely aware of these problems for quite some time but, in my opinion, they seem to be more concerned with their relationship with PhRMA lobbyists. According to the Associate Press, “The opioid lobby has been doing everything it can to preserve the status quo of aggressive prescribing,” Dr. Andrew Kolodny, a champion of prescription opioid reform, told the AP. “They are reaping enormous profits from aggressive prescribing.” AP and Center for Public Integrity also discovered that makers of prescription painkillers like OxyContin, Vicodin and Fentanyl, spent just shy of a billion dollars on campaign contributions and lobbying initiatives from 2006 through 2015; or an annual average of nearly $100,000,000.00 million dollars per year. That amount of money buys a lot of influence.

In just a couple of weeks it will be 2017; a new year that brings with it realities that even an optimist like me cannot ignore. From every indication I’ve seen to date, there are no signs of this opiate/opioid epidemic easing up. Consequently, more and more people will be taking Suboxone and Methadone. One of the major problems with these opioids and the MAT program in general is that they’re like
the song ‘Hotel California’ in the respect you can check in but never check out – once you’re on Suboxone or Methadone you never get off. There is no plan in place to wean anyone in the Medication-Assisted Treatment (MAT) program off of Suboxone or Methadone – someone could stay addicted to these MAT opioids for the rest of their lives.

With that being said, elementary algebra along with common sense tells us that the number of opiate/opioid addicted mothers including Suboxone moms is only going to increase. As a society we have already recognized our responsibility to protect newborns from the dangers of being born drug-dependent to an addicted mom. This is a huge step but we lack in execution.

Opioid abstinence during pregnancy is the most effective method to protect newborns from NAS, but there are only a handful of doctors that try to get new mothers off opioids and MAT drugs once pregnancy occurs. It seems this modality is too extreme in today’s environment. In fact, much of the literature I’ve read recently recommends Soboxone as a substitute to heroin and other opioids during pregnancy claiming it’s best for the unborn child.

I couldn’t disagree more, but if we are to go down this path it is imperative the appropriate Federal Agencies enforce the KCFSA
of 2003 requiring all hospitals and medical professions to fully and transparently report all cases of neonatal abstinence syndrome
(NAS) to child protection authorities regardless if the mother has a prescription or has obtained the drugs illegally. Moreover, the child protection authorities’ personnel need extensive addiction education to effectively protect newborns and toddlers.

This issue is too big to let slip through the cracks. Unborn defenseless baby’s lives and futures are at stake. Now is the time to call your state and federal representatives and ask what they are doing to protect these babies in danger. If you don’t know who your representatives are, they’re easy to find online. For the sake of these vulnerable babies please make the call.

John Giordano, Doctor of Humane Letters, MAC, CAP, is the President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment check out his website: