A new government report finds a dramatic increase in the proportion of babies born dependent on opioid drugs, such as heroin or prescription pain relievers. Between 2000 and 2009 the number of infants born to women who had used opioids increased nearly fivefold annually–from 1.19 to 5.63 per 1,000 hospital births.

The report also found that an annual average of about 21,000 pregnant women ages 15 to 44 misused opioids in the past month, according to HealthDay.

“It is critical that pregnant women of all ages have access to prevention, treatment, and recovery services that meet their specialized needs,” Deputy Assistant Secretary for Mental Health and Substance Use Kana Enomoto said in a news release. “Programs that provide pregnant women with access to opioid use disorder treatment and reproductive health services can help ensure that these future mothers and their children live healthier, happier and more productive lives.”