I-Team: Local hospitals detect hundreds of opiate-dependent newborns each year

Posted at 6:00 AM, Aug 31, 2017
and last updated 2017-09-01 14:40:28-04

CINCINNATI -- Amanda Hopkins was overjoyed when she gave birth to her third baby girl in June at a local hospital.

But she was also scared, because her drug screen came back positive for cocaine and the hospital wouldn't release her baby until a confirming test came back negative.

"It was very nerve-wracking for over 48 hours to be told that you can’t leave," Hopkins said.

Hopkins and her daughter were tested as part of a universal drug screening program for newborns. Nearly a dozen hospitals use the program. Since 2013, the program has identified hundreds of opiate-dependent babies.

The voluntary universal testing program began in 2013 as a way to help identify opiate-dependent babies. Newborns who are opiate-dependent usually don't begin showing withdrawal symptoms for the first 24 to 48 hours.

Hopkins' husband Michael and their newborn baby

The program was developed by Dr. Scott Wexelblatt. He's the regional medical director for newborn services at Cincinnati Children's Hospital Medical Center.

"The whole idea from our end is to make sure that the baby goes home safely, into a safe environment," he said. "We want to make sure the baby isn't being discharged too early if it's been exposed to drugs."

Local hospitals took up the testing program in response to the increase in drug-addicted babies born in the area. From 2009 to the beginning of 2013, the number of babies exposed to opioids quadrupled from 10.8 infants per 1,000 births to 46 per 1,000 births, according to data provided by Children's Hospital.

Using universal testing allows the hospitals to avoid any screening practices which would be considered discriminatory, according to Children's Hospital officials. In pilot research for the program, they said as many as 20 percent of the infants exposed to opioids would not have been found under the old system.

In 2016, the program found more than 800 babies who tested positive for opioids, according to Wexelblatt. That's about 3 percent of births in the region.

Children's Hospital provided the following data on the number of babies born and tested for drugs in regional hospitals:


Inconsistencies between hospitals

Wexelblatt told the 9 On Your Side I-Team he has no control over how each hospital runs the program because the hospitals aren't required to use it.

"Different hospitals have different practices," he said.

But some moms are frustrated because of the inconsistencies in how false-positive tests are handled. When Hopkins' doctor came into her hospital room eight hours after giving birth and said her initial drug screen tested positive for cocaine, she thought he was kidding.

But the doctor wasn't kidding, and if the confirming test had also shown that Hopkins had used cocaine, the hospital could have contacted county social workers.

"I was allowed to leave, she was not," Hopkins said. "There was no way I was going to leave without my newborn."

It took two days before the test came back and Hopkins was allowed to bring her baby home, she said.

Confirming tests more accurate

In Hopkins' case, she took the second test right away, but she had to wait two days for the results because the lab at Children's Hospital is the only local lab that runs them, and it's not open on Sunday.

"We're working on seeing how we can get these tests done seven days per week," Wexelblatt said.

The initial test using a urine sample can be done at any hospital, but the results are not as accurate as those from the second test, according to Dr. Kenneth Setchell, the director of clinical mass spectrometry at Children's Hospital. 

The mass spectrometer test done in the lab breaks down samples to double-check results and eliminates human error because it's done with an automated machine, according to Setchell. 

That test is the "gold standard of drug tests," he said. 

False result led to months of scrutiny

Hopkins isn't the only mom to be scrutinized due to a false positive on one of the initial urine tests. The I-Team previously reported on the universal drug testing program after Northern Kentucky mom Holly Schulkers filed a lawsuit against St. Elizabeth Medical Center and the Kentucky Child Welfare Agency.

Schulkers gave birth to her daughter, Allie, at the Edgewood hospital. But she also initially tested positive for opiates. Her experience was different from Hopkins' in one key way: the hospital called state social workers under a mandatory child abuse reporting law before Schulkers was given a confirming drug test.

Records show Schulkers was put on a parenting plan for two months after additional drug tests proved the first test was wrong.

"It was a nightmare," she said.

The I-Team discovered there's no oversight for the pre-natal drug testing program. No one is tracking the number of false-positive results, including Wexelblatt.

"There's nothing else that we would do at that point," he said.

Wexelblatt can't talk about specific cases, but he said hospitals should always do a second drug screen if an initial test comes back positive.

Schulkers said that didn't happen in her case.

"We recommended confirmation of that test if the mother denied use," Wexelblatt said.

For moms who want more oversight for the program, Wexelblatt said the tests are not meant to be punitive, but adding government oversight could make the program punitive.

"The whole idea is to identify babies prior to discharge so they don't withdraw at home," he said. "We want them -- if they are going to withdraw -- to withdraw in the hospital."

Dr. Mike Kalfas, an addiction expert, recommends women ask these questions when they are drug tested before giving birth:
• Who is interpreting the test?
• What will happen with the urine sample?
• Is there confirmatory testing (a second test, if the first test comes back positive)?
• What kind of test is that confirmatory test?
• Who interprets those results?
• Will I have access to the results?