As the problem of prescription drug abuse grows, an increasing number of babies are being born dependent on painkillers, The New York Times reports.

While there are no national figures on how widespread the problem is, the newspaper says its reporting suggests that babies born dependent on opiates is a growing issue, especially in rural areas.

Pregnant women dependent on prescription opiates such as OxyContin may give birth to babies who cry excessively and suffer from stiff limbs, diarrhea and tremors. Many of these babies must be kept in the hospital for weeks so they can be weaned off opiates. Little is known about the long-term effects of opiates on babies’ development, and there is no universally accepted standard of care for babies of opiate-addicted pregnant women, according to the article.

There is no agreement on how to treat pregnant women addicted to prescription drugs. While some pregnant women addicted to opiates are treated with methadone, others are given buprenorphine, which some studies suggest is less likely to cause withdrawal in newborns. But the drug is not universally effective, the article reports. In rural areas, where there are few methadone clinics, buprenorphine is considered a viable alternative because primary care physicians can prescribe it, and the drug can be taken at home.