The Impact of Opioid Addiction on

Children and Families

Karen Remley, MD, MBA, MPH, FAAP
CEO\Executive Vice President
American Academy of Pediatrics
THE MISSION OF THE AAP IS TO ATTAIN OPTIMAL PHYSICAL,
MENTAL, AND SOCIAL HEALTH AND WELL-BEING FOR ALL
INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS.
TO ACCOMPLISH THIS MISSION, THE AAP SHALL SUPPORT
THE PROFESSIONAL NEEDS OF ITS MEMBERS.
OPIOID USE DISORDER IN THE PAST YEAR AMONG PEOPLE
AGED 12 OR OLDER, BY AGE GROUP: 2016
 US PREVALENCE OF OPIOID ABUSE OR DEPENDENCE DURING
PREGNANCY, OVERALL AND BY AGE: 1998, 2002, AND 2011
Overall <20 20-34 35-39 40+
5.0
Frequencies per 1,000 deliveries

4.0

3.0

2.0

1.0

0.0
1998 2002 2011

Source: Maeda A, Bateman BT, Clancy CR, et al. Anesthesiology. 2014;121(6):1158-65.

Based on analysis of data from the Healthcare Cost and Utilization Project.
 U.S. NEONATAL ABSTINENCE SYNDROME
DISCHARGE RATES, 1993-2014
12.0

9.8
Rate of discharges per 100,000 persons

10.0

8.0
6.1
6.0

3.8
4.0 3.3
2.7 2.7
2.1 1.8
2.0

0.0
1993 1996 1999 2002 2005 2008 2011 2014

Source: AAP/DOR/DHSR analysis of data from the Agency for Healthcare Research and
Quality (AHRQ), Healthcare Cost and Utilization Project (HCUP) online query system,
National Inpatient Sample (https://hcupnet.ahrq.gov/#setup)
 NEONATAL ABSTINENCE SYNDROME AND MATERNAL OPIOID USE BY
RURAL VS URBAN STATUS, 2004 TO 2013
Rural Urban
9.0

8.0
Frequency per 1,000 hospital births

7.0

6.0

5.0

4.0

3.0

2.0

1.0

0.0
2004/2005 2008/2009 2012/2013 2004/2005 2008/2009 2012/2013
Neonatal Abstinence Syndrome Maternal Opioid Use

Source: Villapiano NLG, Winkelman TNA, Kozhinmannil KB, Davis MM, Patrick SW. Rural
and Urban Differences Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004-2013.
JAMA Pediatr. 2017;171(2):194-196. Based on analysis of data from the Healthcare Cost and Utilization Project .
 NUMBER OF CATEGORIES OF
ADVERSE CHILDHOOD EXPERIENCES

ACE SCORE PREVALENCE

0 36%
1 26%
2 16%
3 9.5%
4 or More 12.5%
 ACES AND RISK of ILLEGAL DRUG USE
40% 37.4%
35%

30% 28.8%
25.6%
Lifetime Risk

25% 22.3%
20%
15.2%
15%
9.4%
10%

5%

0%
0 1 2 3 4 ≥5
ACE Score
Dube, S. R., et al. (2003). "Childhood abuse, neglect, and household
dysfunction and the risk of illicit drug use: the adverse childhood experiences
study." Pediatrics 111(3): 564-572
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