Commentary: Your Baby’s Life Shouldn’t Begin with Detox

When I took office in 2011, Florida was in the midst of a public safety crisis of epic proportions – prescription drug abuse. Because of weak regulatory oversight of pain management practices, limited oversight of physician dispensing habits, and no statewide Prescription Drug Monitoring Program (PDMP), drug dealers in white coats were running rogue pain management clinics or “pill mills.” They were carelessly doling out highly addictive pain killers on street corners and in strip malls throughout Florida. In 2010, 98 of the top 100 dispensing physicians of oxycodone nationwide resided in Florida, and more than seven Floridians a day were dying from prescription drug abuse. Sadly, this problem was not just affecting adults. The prescription drug abuse epidemic was affecting increasing numbers of pregnant women throughout the state, which fueled an explosion in cases of neonatal abstinence syndrome (NAS), babies being born exposed to prescription drugs.

Babies born suffering from NAS experience symptoms such as tremors, abdominal pain, incessant crying, rapid breathing, and in extreme cases, they also experience seizures. In 2011, there were nearly 1,600 newborns diagnosed with drug exposure in Florida, a three-fold increase since 2007 – and this issue is still believed to be a widely unreported problem. It was evident that the prescription drug abuse epidemic was having a heartbreaking and destructive impact on our state, and I made it a top priority to stop this deadly problem.

I worked with the Florida Legislature during the 2011 legislative session on laws that provided a comprehensive plan to close “pill mills” and arrest unscrupulous doctors who over-prescribe prescription narcotics. The legislation enhanced criminal and administrative penalties against doctors and clinics engaged in prescription drug trafficking; established standards of care for doctors prescribing narcotics; required registration with the Florida Department of Health; and banned doctors from dispensing the most-abused narcotics. The legislation also toughened oversight of pharmacies and wholesale distributors and strengthened Florida’s PDMP by speeding up the time data must be entered from 15 days to seven days. We worked with law enforcement throughout Florida to prosecute “pill mill” doctors, and these new tools greatly assist in protecting Floridians. Because of these comprehensive efforts, Florida’s prescription drug-related deaths are down by nearly 30 percent, and none of the top 100 dispensing physicians of oxycodone now reside in Florida.

Additionally, I worked with the Legislature to create the Statewide Task Force on Prescription Drug Abuse and Newborns to address the growing problem of NAS. I chaired the 15-member task force which examined the scope of the problem; the costs associated with caring for babies with neonatal withdrawal syndrome; the long-term effects of the syndrome; and strategies for preventing prescription drug abuse by expectant mothers.

In less than one year of establishing the Statewide Task Force on Prescription Drug Abuse and Newborns, we are already implementing strategies for preventing babies from being born exposed to prescription drugs. Last month, we worked with the Department of Children and Families and the Department of Health, both are task force members, to launch an educational website and a helpline as part of a statewide initiative to raise awareness about babies being born exposed to prescription drugs. and the helpline at 1-877-233-5656 are intended to educate expectant mothers about the importance of discussing prescription drug use with their doctors, as well as to offer assistance to the women. The first of many billboards with the website and helpline is now up, and it reads “Your baby’s life shouldn’t begin with detox.”

Prescription drug abuse is a national problem, and I encourage everyone to do their part in ending this crisis. Awareness is a key component in stopping this abuse and saving lives. I urge everyone to educate themselves on the dangers of prescription drug abuse. There are multiple ways to get involved. National Drug Take-Back Days are an excellent way to participate in stopping this epidemic. The Medicine Abuse Project is doing outstanding work in raising awareness and preventing medicine abuse in teens. I encourage those who haven’t taken the first step in protecting teens from medicine abuse to sign the pledge at today. Additionally, pregnant mothers, talk to your doctors about NAS and the dangers of taking opiates while pregnant. With everyone’s involvement, we will save lives.

We have made great strides in stopping the prescription drug abuse epidemic, but we aren’t finished. I promise to remain dedicated to ending this public safety crisis, and I encourage you all to join me.

Florida Attorney General Pam Bondi- Join Together at the Partnership for Drug-Free Kidsg

  Pam Bondi
  Florida Attorney General

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    Sandy B. RN,BS,RAS

    May 16, 2013 at 9:50 AM

    Ms Bondi you must realize you nor anyone else will stop drug abuse or end this crisis. The best we can do as health providers is offer treatment to ALL who need it,and make it affordable. I treat many pregnant women who are stable on methadone and off of all illicit opiates. We work with their OB MDs together up to and after birth. Our women are knowledgeble about NAS before they go into the hospital, and have spoken with the staff at the hospital prior to delivery. We want to make sure our patients and their babies get the best care, and yes their babies do detox while in the hospital, but when done per protocol, the babies bond, breastfeed, and live long happy lives. So please don’t say “end the crisis” and “stop abuse”, because it will never end. It can only be managed by abuse professionals, the patients, and their primary MDs. S.B. RN,BS,RAS

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    Alan Wartenberg MD

    May 15, 2013 at 1:17 PM

    Agree completely with Drs. Newman and Shore. For women who are using street drugs – whether heroin or illicit prescription opioids – the use of methadone or buprenorphine vastly improves not only their lives, but the health and futures of their babies. Neonatal withdrawal, when properly recognized and treated, should have babies who are healthy and feeding well, interacting with their mothers, while being gradually tapered from opioids. With buprenorphine, the syndrome appears to be less frequent, less severe and shorter.

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    robert newman, md, mph

    May 15, 2013 at 11:57 AM

    Dr. Shore is 100% right. It is disappointing that AG Bondi clearly construes NAS to ALWAYS be something one must avoid. In fact, the federal govt has for years distributed the message to pregnant, opiate-dependent women that “methadone can save your baby’s life.” Furthermore, to the extent babies with NAS undergo the suffering Ms. Bondi describes it generally reflects inappropriate and/or inadequate neonatal care. Robert Newman, MD

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    Michael Shore MD

    May 14, 2013 at 1:33 PM

    I commend Ms.Pam Bondi, but she must realize there WILL be pregnant patients on opiates, including Heroin which is becoming more common now that prescription opiate use is down. Safe and effective management can include Methadone or Suboxone, and this type of treament provides for vastly improved outcomes for mothers and neonates. Dr. Shore

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