scholarly journals Opioid Use in Pregnant Women and Neonatal Abstinence Syndrome—A Review of the Literature

Toxics ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 9 ◽  
Author(s):  
Fábio Martins ◽  
David Oppolzer ◽  
Catarina Santos ◽  
Mário Barroso ◽  
Eugenia Gallardo
Keyword(s):  
Scientific Community ◽  
Neonatal Abstinence Syndrome ◽  
Health Concern ◽  
Abstinence Syndrome ◽  
Review Of The Literature ◽  
Opioid Use ◽  
Research Directions ◽  
Developmental Problems ◽  
Future Goals ◽  
Opiate Use

Opiate use during pregnancy has been an increasing problem over the last two decades, making it an important social and health concern. The use of such substances may have serious negative outcomes in the newborn, and clinical and cognitive conditions have been reported, including neonatal abstinence syndrome, developmental problems, and lower cognitive performance. These conditions are common when opiates are used during pregnancy, making the prescription of these kinds of drugs problematic. Moreover, the mother may develop opiate addiction, thus, increasing the likelihood of the infant being born with any of those conditions. This paper reviews the use of opiates during pregnancy and focuses mainly on the neonatal abstinence syndrome. First, the commonly prescribed opiates will be identified, namely those usually involved in cases of addiction and/or neonatal abstinence syndrome. Second, published approaches to deal with those problems will be presented and discussed, including the treatment of both the mother and the infant. Finally, we will outline the treatments that are safest and most efficient, and will define future goals, approaches, and research directions for the scientific community regarding this problem.

Factors associated with the prevalence of neonatal abstinence syndrome in West Virginia

2018 ◽  
Vol 14 (6) ◽  
pp. 445-452 ◽  
Author(s):  
Taylor Rogerson, BSc ◽  
Anthony Houston II, BA ◽  
Garrett Lyman, BS ◽  
Jenna Ogden, BS ◽  
Kevin Paschall, BS ◽  
...  
Keyword(s):  
West Virginia ◽  
Neonatal Abstinence Syndrome ◽  
Future Research ◽  
Abstinence Syndrome ◽  
Factors Associated ◽  
Opiate Use ◽  
Two Factors ◽  
Treatment Facilities ◽  
Geographic Regions ◽  
Regional Treatment

Neonatal abstinence syndrome (NAS) is a group of problems associated with withdrawal symptoms of a newborn who was exposed to maternal opiate use while in the womb. West Virginia (WV) is of utmost concern as this state exhibits among the highest rates of opioid abuse and consequently, NAS. In this manuscript, we review factors associated with the prevalence of NAS in WV. We provide evidence suggesting that states exhibiting high Medicaid participation demonstrate a high NAS rate, further associating these two factors. Although a similar trend was observed in the substate geographic regions of WV, the presence of regional treatment facilities was negatively associated with NAS prevalence in WV, possibly suggesting that the establishment and utilization of more of these facilities may reduce NAS. Future research

scholarly journals Methadone for Treatment of Pregnant Opiate Addicted Women: Is There a Safer Alternative? A Review of Literature

2008 ◽  
Author(s):  
Holly Tichelkamp ◽  
Thomas Parish
Keyword(s):  
Neonatal Intensive Care ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Review Of Literature ◽  
Methadone Dose ◽  
Intrauterine Growth ◽  
Opiate Use ◽  
Hospital Stays ◽  
Opiate Addicts ◽  
Alternative Medications

Methadone is commonly used for the treatment of pregnant opiate-addicts. But, it can have severe effects on the neonate including Neonatal Abstinence Syndrome, increased length of stay in the neonatal intensive care unit, and intrauterine growth retardation. Neonatal Abstinence Syndrome includes neurological excitability, gastrointestinal dysfunction, and autonomic signs. Because of these adverse effects, studies have been conducted to determine what can help reduce the severe complications caused by methadone. Varied dosages of methadone and alternative medications, such as buprenorphine, slow-release morphine, and others have been studied. Most of the alternative medications, especially buprenorphine, are gaining popularity in Europe where there is a growing problem of opiate use during pregnancy. In the studies comparing methadone and buprenorphine, a slight decline in symptoms of Neonatal Abstinence Syndrome as well as shorter hospital stays for the neonates exposed to buprenorphine was noted. Studies of different dosages of methadone were conducted to determine the lowest methadone dose that is both effective for the mother and safe for the neonate. All of the studies have provided information that is helping in the search for the safest and most effective treatment for opiate addiction. What is known is that helping the mother overcome the addiction is very important. So far, the data collected are not strong enough to make a conclusion on the best choice for treatment. Further research is indicated for methadone itself and also for all its possible alternatives.

Clinical Opinion Letters Regarding Breastfeeding and Neonatal Abstinence Syndrome for Child Apprehension Family Court Proceedings

2018 ◽  
Vol 35 (2) ◽  
pp. 349-353
Author(s):  
Martha Jane Paynter
Keyword(s):  
Replacement Therapy ◽  
Child Protection ◽  
Best Interests ◽  
Family Court ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Opioid Use ◽  
Best Interest ◽  
Rights Of The Child ◽  
Opioid Replacement Therapy

The accelerating reach of opioid use disorder in North America includes increasing prevalence among pregnant people. In Canada, the rate of Neonatal Abstinence Syndrome (NAS) rose 27% between 2012–2013 and 2016–2017, and it is estimated that 0.51% of all infants now experience NAS after delivery. Pregnant people are a priority population for access to opioid replacement therapy programs. Participation in such programs demonstrates significant commitment to self-care among pregnant people and concern for fetal and infant wellbeing. Participation in opioid replacement therapy often results in family surveillance by Child Protection Services and infant apprehension. Children of Indigenous descent are held in foster care at high and disproportionate rates.The Convention on the Rights of the Child principle of Best Interests of the Child governs family law and child access decisions. The value of breastfeeding for all children and in particular for children recovering from NAS can be a consideration in the Best Interest of the Child. Clinicians with expertise in lactation may support the breastfeeding dyad to remain together by preparing Clinical Opinion Letters for the court. This Insights into Policy presents a how-to description of the content of clinical opinion letters in such cases, including context and process considerations, client background, breastfeeding science, and factors specific to neonatal abstinence syndrome.

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