I was going to comment on the first point. You had brought up the issue that I had talked about earlier, which is the “syndemic”. We don't compartmentalize many of these things, but we have to look at them as a whole.
In Oregon, we've seen sharp increases in syphilis in general. Much of that is among men who have sex with men, but many of them also have sex with women. We're starting to see an overlap of those congenital syphilis cases. When we talk to those folks, many of them are also using opioids, meth or other drugs as well. Again, it's very difficult to say the issue is syphilis because the issue is not only syphilis. It's also these other drugs and disinhibited behaviours that people have. That's in general.
When you're talking about the infants, you're absolutely right, infants born addicted to drugs is a real problem. The neonatal abstinence syndrome that we're seeing takes a huge amount of health care dollars. These babies need to be monitored very closely for withdrawal, and even after that, they have a lifetime of problems, so it is part of a larger issue.
We can't just focus on individuals. We really need to think about the larger context that is causing them to both use drugs in the first place and/or have this disinhibited, if you will, sexual behaviour that's leading to this increase in syphilis.