Non-Pharmacologic Interventions for Newborns with Neonatal Abstinence Syndrome Meghan Pasternak 0496981 Dr. Karen McQueen NURS 2030 Lakehead University January 5, 2015 Problematic substance use in pregnancy is prevalent among the Canadian population. The statistics are well documented in the literature. According to a Health Quality Ontario report from 2012, about one in 100 pregnant women giving birth in Ontario hospitals shows substance use. The rate of substance abuse among pregnant women has increased since 2009 by about ten percent. Dow et al. (2012) identify that the management of substance use is particularly problematic in Northern Ontario. Many First Nations communities are in a state of emergency regarding abuse of prescription narcotics (Dow et al., 2012, p. 489). Substance abuse has a profound effect on a woman and her newborn baby whose drug withdrawal manifests itself as neonatal abstinence syndrome or NAS (Dow et al., 2012, p. 488). MacMullen, Dulski & Blobaum (2014) describe NAS as “a group of similar behavioural signs and symptoms in the neonate caused by withdrawal from various pharmacologic agents” (p. 165). Infants who were exposed to opioids such as morphine, methadone, codeine, oxycodone and heroine in utero experience NAS (Dow et al., 2012, p. 489). The way the syndrome presents itself is unpredictable. Neonates will display different symptoms with varying severity over time (Bagley, Wachman, Holland & Brogly, 2014, p.
The Canadian Aboriginal community consists of a strong support system founded on tradition, heritage, and spirituality. However, the history of Natives in Canada is polluted with marginalization, abandonment, and powerlessness. It has been argued that this history is the foundation for the addiction in Canadian indigenous communities, where the rates of substance abuse remain extremely high. Prior to the colonization of North American Natives, addictive substances such as tobacco, and alcohol were available. However, they were used moderately and rarely associated with
The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).
Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.
In 2014, after seeing a significant increase in babies born with neonatal abstinence syndrome (NAS), Tennessee began criminally charging pregnant women who use drugs (Sakuma, 2014). Supporters of the new legislation refer to it as a “velvet hammer” used to convince the pregnant drug users into going into treatment, or doing jail time. However, critics are concerned that this legislation will be just another barrier for a group of women who are already at risk, (Sakuma, 2014).
Through the years, substance misuse in the United States has turned into an industrious issue influencing numerous people. In 2008, it was assessed that 17.8 million Americans beyond 18 years old where substance subordinate. Women who use medications during pregnancy can have an enduring impact on fetal. Medications can have an impact of maternal and child wellbeing, yet there are a lot of different variables, which influence it, poor social environment, nourishment, cleanliness, and sexual abuse. Regenerative interruption connected with heroin utilization has been shown in both and women and even low dosages of opiates can impede ordinary ovarian capacity and ovulation. The harm that goes hand in hand with substance utilization comes either straightforwardly from the impact of the medication itself or from issues identified with development and/or unexpected labor. The entanglements of jumbling components clamorous way of life, poor nourishment, liquor utilization and cigarette smoking influence the appraisal of the impacts of cocaine in pregnancy. In obstetric practice, 100% of pregnant women utilizing cocaine or heroin are cigarette smokers. Cigarette smoking is presumably the most well known manifestation of substance utilizes and is noteworthy corresponding considering ladies who use unlawful medications. Babies whose moms smoked in pregnancy have a tendency to have lower conception weights and diminished length, cranial and thoracic
The use of controlled substances throughout pregnancy is a very prevalent issue among society today. Controlled substances have devastating effects on not only the mothers using the substances, but also infants while they are in utero and after they are born. Many infants born to mothers, who are abusing drugs, suffer from life threatening illnesses and are forever affected through adulthood. Specifically, heroin is a common drug form that is often used during pregnancy and results in the life threatening effects mentioned above.
The data showed that between 2009 and 2010, 16.2 percent of women between the ages of 15-17 years old, 7.4 percent of women between the ages of 18-25 years old, and 1.9 percent of women between the ages of 26-44 years old had used illicit drugs while pregnant. The data also showed substance abuse during pregnancy among different ethnic and racial groups. African Americans had the highest percentage in 2010 at 10.7 percent. The next highest was the White population at 9.1 percent. Hispanics or Latino’s percentage was 8.1 percent and the Asian population had the lowest percentage at 3.5 percent (“Results from”, 2011).
According to Lowe (2017), “…across the United States, a woman presents every 3 minutes to an emergency department for opioid misuse or abuse” (p.657). With the significant increase in the misuse of opioids over the last thirty years in the US, it has become a serious public health concern. With the most dramatic rise in opioid use being of childbearing age women, it is a very important issue in maternal health care (Keough & Fantasia, 2017). It is imperative that nurses are informed and have efficient knowledge of the potential risks, effects, treatment, and prevention of opioid dependence during pregnancy.
The title slide and variables could have been explained in a way to let the reader know that neonatal outcome was being measured after exposure to treatment medication methadone and buprenorphine and not just "opioids."Mariah's presentation followed the grading rubric she did not over-crowd her slides, which made it an easy read. Overall, Mariah's presentation was informative.
The rest of the United States have no specific laws. These laws were made by taking in account the risk of fetuses dying minutes after birth, being born with neonatal abstinence syndrome (NAS), heart defects, weak immune system etc. Additionally, there can also be long-term effects as stated in “March of Dimes”such as learning and behavior problems, sudden infant death syndrome (SIDS), and slower-than-normal growth problems (Street). The first weeks of a drug dependent baby are like an old wooden roller coaster full of trembles and thrills but in this case the thrills are not the pleasant ones. In article published by “Daily Mail,” it shows a disturbing video of a baby’s feet shaking vigorously. This is the kind of heart moving evidence that needs to be shown to society to grasp the depth of this
In today’s society people are talking about babies being born to drugs, and how could a mother do that to their unborn child. Drug addiction is a very serious issue that needs more research. We are still learning the effects of substance abuse. One problem that needs to be looked at is are there enough Rehabilitation Centers, to help the women who are addicted to these different street drugs. Also doctor and nurses should not judge these women but instead give them the best prenatal care that can be provided. We need to see what harm and side affects it has on the mother and baby, so that we can be able to understand better how to treat these women and get them off drugs before they do harm their babies.
Even though there are many studies that highlight the damaging effects of maternal alcohol use on a fetus in utero, there are a multitude of other substances that are used by pregnant mothers that have similar and even, in some cases, more extreme repercussions such as marijuana, heroin, and cocaine. When speaking about pregnancy and drug use, the most common drug that comes to mind is alcohol. During 12 years of schooling, most people are exposed, at one point or another, to the idea of Fetal Alcohol Syndrome and the detrimental effects of alcohol on a fetus in utero. The effects of maternal use of the aforementioned illicit drugs is less studied, partially because they are used less frequently. It is important, however, that as a population, we become more educated about these drugs and the potentially life threatening outcomes for babies in utero.
(n.d.) also conducted a study focused on infants that were exposed to buprenorphine or methadone while in utero. Unlike MacMullen et al. (2014) their focus was on predicting how the symptoms of NAS might manifest in the exposed newborns. Since the 1970s (MacMullen et al., 2014) methadone has been the treatment of choice for mothers with opioid dependence during pregnancy, the use of this drug allows for a decrease in withdrawal symptoms for the child after birth. The main categories of symptoms include central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress and vague autonomic symptoms (MacMullen et al., 2014). Although methadone has been being used for many years buprenorphine has only been used since 2002 in the United States (MacMullen et al., 2014). Their research was consistent with Kaltenbach et al. (n.d.) in that infants born to buprenorphine-exposed mothers had lower scores for NAS than those born to methadone-exposed mothers, but still had varying severities of symptoms and scores across all infants. For at least 10 days after birth, an expert scored the newborns on a modified Finnegan scale every 4 hours. The results showed that high birth weight was often a predictor for high NAS scores, along with lower NAS scores for infants delivered by cesarean section. MacMullen et al. (2014) were unable to find any connection between the use of methadone and buprenorphine to indicators of symptoms of NAS. The main
Many women, including teens, abuse drugs while they are pregnant. This rate is especially high to those who are homeless, underprivileged, or live in a broken home. In order for drug abusers to even have a chance at beating their addiction they have to have support whether it’s family, friends, or boyfriend/spouse. They must also let the abuser now all the consequences to themselves and the unborn child. There are many consequences when using drugs during pregnancy such as miscarriage, health risks to baby, and health risks to the mother. And learning disabilities and brain damage to the fetus.
Alcohol is a substance that should be consumed in moderation, and should be used responsibly. Similar to any substance, there are consequences that come with the irresponsible and abusive use of it. Not only the drinker is affected by alcohol abuse. People around them including family, friends, potential offspring and even Canada’s Health Care System are affected too. Specific to the health care system, there is a burden placed on it in regards to Fetal Alcohol Spectrum disorder (FASD) a variety of disorders grouped together as a result of the abuse of alcohol while pregnant. Alcohol abuse is a factor that contributes to health issues that some women endure from engaging in activities such as the consumption of alcohol while pregnant. Thus, Canada’s health care system has to deal with the outcome associated with alcohol-related health problems, specifically, FASD.