scholarly journals Neonatal Abstinence Syndrome in West Virginia: Trends, risks, and effectiveness of in utero exposure detection

2015 ◽  
Author(s):  
Meagan E. Stabler
2018 ◽  
Vol 218 (1) ◽  
pp. S141 ◽  
Author(s):  
Carol C. Coulson ◽  
Erin Lorencz ◽  
Melinda A. Ramage ◽  
Marie Gannon ◽  
Shelley Galvin

2017 ◽  
Vol 9 (1) ◽  
pp. 37
Author(s):  
Jacinta Louise Calabro

Abstract Neonatal Abstinence Syndrome (NAS) occurs after significant in-utero exposure to opiates, such as methadone and heroin.  Infants with NAS are often hospitalized for 4-6 weeks in a special care nursery, which is both expensive and detrimental to the parent-child bonding process. This study trialled the effectiveness of recorded sedative music (RSM) and multimodal stimulation (MMS) for infants with NAS.  The infants were recruited by the hospitals alcohol drug and pregnancy team (ADAPT) and randomly allocated into one of 4 groups. The study hypothesised that infants in the treatment groups would experience a shorter hospital stay, higher weight gain, more parent visits, more days until medication began and less medication than control infants.  The study also hypothesised that the treatment infants would have lower NAS scores compared to control infants. Due to a small and skewed sample the hypotheses were not supported.  There were no significant results for any measure, although slight trends were noted for reduced crying and regular respiration for infants in the treatment groups.  These findings support previous research into alternative treatment interventions for infants with NAS.  It is suggested that RSM and MMS interventions can still be potentially useful interventions with this population. KeywordsNeonatal abstinence syndrome (NAS), music therapy, multimodal stimulation, recorded sedative music.


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 ◽  
...  

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


2014 ◽  
Vol 19 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Melissa R. Johnson ◽  
David R. Nash ◽  
Mary R. Laird ◽  
Robert C. Kiley ◽  
Michael A. Martinez

OBJECTIVES: To compare the length of wean and abstinence severity in neonatal and pediatric patients with neonatal abstinence syndrome or iatrogenic opioid dependence treated with a pharmacist-managed, methadone-based protocol compared with physician-managed patients treated with either methadone or dilute tincture of opium (DTO). METHODS: This was a prospective, single-centered, interventional evaluation of 54 pharmacist-managed patients versus 53 retrospective, physician-managed patients. Wean duration and severity of neonatal abstinence syndrome were compared between groups using the Student t test. RESULTS: Significantly shorter wean duration in in utero-exposed pharmacist-managed patients compared with patients on physician-managed DTO (11.7 days vs 24.2 days, p < 0.001), but not compared with patients on physician-managed methadone (11.7 days vs 47 days, p = 0.101). No statistically significant difference was seen in wean duration in iatrogenic-exposed pharmacist-managed patients compared with patients on either physician-managed DTO or methadone (8.69 days vs 14 days, p = 0.096) and (8.69 days vs 9.82 days, p = 0.34), respectively. There were significantly fewer abstinence scores >12 in pharmacist-managed patients versus physician-managed DTO, but not physician-managed methadone (2.05 vs 17.3, p = 0.008 and 2.05 vs 74.3, p = 0.119, respectively). Significantly fewer abstinence scores ≥8 × 3 consecutively were seen in pharmacist-managed patients compared with patients on either physician-managed DTO or methadone (2.89 vs 11.9, p = 0.01 and 2.89 vs 24, p < 0.001, respectively). CONCLUSIONS: Use of a pharmacist-managed, methadone-based weaning protocol standardizes patient care and has the potential to decrease abstinence severity and shorten duration of wean versus physician-managed patients exposed to opioids in utero. Additionally, a methadone wean of 10% to 20% per day was well tolerated in both neonatal and pediatric patients.


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