Paper On Neonatal Abstinence Syndrome

The independent variables in this study were buprenorphine and methadone and the dependent variables were the number of neonates requiring treatment for NAS, the peak NAS score, the total amount of morphine needed to treat NAS, the length of the hospital stay for the neonates, and neonatal head circumference.

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).

Tennessee passed a new law that any pregnant women who has been found using narcotics during pregnancy or if the baby is born being addicted to the drug will be arrested. Tennessee is the first state to allow this type of criminal law to go into place. Tennessee law allowed police to arrest women who used drugs when they were pregnant, but this approach never worked (Perez, 2014). Tennesee has a staggering infant mortality rate which ranks among 3rd in the nation (Sakuma, 2013). In 2013, Tennesee lawmakers actually sought to encourage mothers to get treatment under the Safe Harbor Act. The act let mothers get the help they need for the addiction, but they were promised they would not lose custody of their baby so long as they were seeking treatment (Sakuma, 2014). The new law permits moms to avoid prosecution if they can successfully complete their drug rehabilitation program (Sakuma,

(2010) explains that although methadone is used for opioid exposure especially during pregnancy, but also is linked to NAS when a fetus is exposed to methadone. With their focus of the effects of NAS on the central nervous system hyperirritability and autonomic nervous system dysfunction Jones et al. also focused on the different effects of methadone versus those of buprenorphine, which has less substantial research. The points of study included number of newborns requiring treatment for NAS, peak score on a NAS scale, amount of morphine given through out treatment, length of hospital stay and the head circumference. Overall they only found significant differences in outcomes for the total morphine required as well as the length of the neonates hospital stay. When exposed to buprenorphine prenatally the newborns required 89% less morphine during treatment and 43% less time in the hospital than those exposed to methadone (Jones et al.,

The National Health Institute (NIH) explains that addictive drugs such as amphetamines, cocaine, barbiturates, diazepam, and opiates consumed during pregnancy pass from mother to the fetus by crossing the placenta. This causes the baby to become addicted to these drugs along with the mother. Once born, the newborn no longer receives these drugs which then results in NAS (“Neonatal abstinence syndrome”, 2012a).

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).

Opioid abuse in Tennessee is a statewide epidemic affecting both rural and urban cities. One thousand two hundred sixty-three deaths related to opioid overdose occurred in the state of Tennessee in 2014. More people died from opioid overdose than the number of gunshot and motor vehicle accident deaths combined. Known as “Hillbilly Heroin,” the opioid of choice are Hydrocodone, Percocet, Oxycodone IR, and Oxycontin with street values ranging from $5 to $80 dollars per pill. Currently, Tennessee remains the leader in the number of pain pill prescriptions per person (Fletcher, 2015). The misuse and abuse of opioids in Tennessee has resulted in legislative bills proposed and supported by Governor Bill Haslam, as well as local district representatives Senator James R. “Randy” McNally (R-Tenn- Dist. #5) and Representative John Ragan (R-Tenn Dist. #33).

Tennessee is one of the states hit hardest by the nation’s opioid epidemic which began about 20 years ago and had a stark increase since 2009, now reaching unprecedented levels across the county with a 200% increase in the rate of deaths involving opioids (Rudd, Aleshire, Zibbell, & Gladden, 2016; Fletcher, 2016). In Tennessee specifically, it is estimated that about 1 in 6 abuse opioids; the CDC estimates that for every one person who dies from an opioid overdose in Tennessee there are 851 others in the state who are in various stages of their abuse, misuse, and treatment; and the most recent statistics show that opioid overdoses alone make up about 7.7% of deaths in Tennessee, making them responsible for more deaths than car accidents in the state (Botticelli, 2016; Rudd, Aleshire, Zibbell, & Gladden, 2016; Fletcher, 2016; ONDCP, 2016; Thompson, 2016).

Within seventy-two hours after birth, many infants who were exposed prenatally to drugs experience withdrawal symptoms, including tremors and irritability. Their skin may be red and dry; they may have a fever, sweating, diarrhea, excessive vomiting, and even seizures. Such

In 1913, sex education became a topic that was found to be an important education tool. Since then, this form of education has been a hot and debatable topic among many Americans. The original reason for sex education classes was to reduce problems such as sexually transmitted illnesses and prostitution. In recent years, abstinence has become the focus of sex education curriculum. Abstinence means refraining from sex completely. Although, it is the only one-hundred percent way to prevent sexually transmitted diseases and unwanted pregnancies, abstinence-only instruction should not be the only form of sex education taught. Our youth need to know about all aspects of sex. This intails how to protect them if they choose to become sexually

The use of opioids during pregnancy has increased drastically over recent years, causing newborns to fall victim to the opioid crisis. It has now become an epidemic, affecting people in the United States and globally making it a major health concern. A vast percentage leading to the opioid crisis is due to women in their childbearing stages of life. Newborns born to women addicted to opioids suffer through a form of newborn drug withdrawal known as Neonatal abstinence syndrome (NAS), resulting in increased admission rates, prolonged length of stay in the hospital and infants often require medication to recover. NAS is a result of opioid exposure in utero characterized by “central nervous system hyperirritability and autonomic nervous system dysfunction” (Kraft et

It can cause substantial teratogenic effects early in gestation, during the embryonic stage. During the fetal period, abnormal growth and maturation, alterations in neurotransmitters and their receptors, and brain organization are direct effects caused by opioid abuse (Behnke & Smith, 2017). Continuous use of opioids throughout pregnancy increases the risk of prematurity and growth retardation, deficits in attention, cognition, and behavior, neonatal morbidity and mortality, and neonatal abstinence syndrome (NAS) (McQueen, Murphy-Oikonen, & Desaulniers, 2015).

As found in the study executed by the Journal of Rural Health, the highest rate of NAS and additional complications caused by substance abuse occurred in the southeastern part of the state (Stabler et al., 2017, p.11). Even though the southeastern area of the state is troubled, additional regions also undergo harsh conditions due to the drug epidemic. Harrison County hospitals are also encountering staggering increases in the rate of Neonatal Abstinence Syndrome. In the year 2014, approximately fifty percent of babies born in Harrison County required treatment for some type of withdrawal symptoms (Swiger, 2015, p.2). Since that period of time, it is highly likely that piece of data has continued to increase, paralleling the continuous increase of drugs. Discussing the issue, Dr. Alicia Maddix of Premier Pediatric Center in Bridgeport reports, “[This area’s] numbers are approaching, is not surpassing, those in the southern part of the state” (Swiger, 2015, p.2). If a solution is not implemented, the rate of drug use, and consequently Neonatal Abstinence Syndrome, will continue to accelerate, creating a greater issue for the

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.