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Panel Discusses Compassionate Care for Neonatal Abstinence Syndrome

by | Apr 07, 2020

During the opioid crisis, the United States experienced a five-fold increase in neonatal abstinence syndrome (NAS), or newborn withdrawal due to in utero opioid exposure.

In response, a panel discussed the need for providing clinical recommendations and developing safe guidelines to improve care for women with opioid use disorders and their neonates during the “Compassionate Care for Neonatal Abstinence Syndrome: Research, Practice, and Public Health.”

The session took place on Friday, April 3rd.

“Our presentations will address ways to appreciate compassionate care and support for women, babies, families and communities impacted by substance use disorder,” said Vania Rudolf, MD, MPH, DFASAM, medical director at Addiction Recovery Services Swedish Medical Center.

Dr. Rudolf and a patient who is a proud woman in recovery focused on myths and truths for moms and babies impacted by opioid use disorder. They highlighted the woman provider and patient perspective and the importance of trauma-informed, compassionate care and “zero separation” for the mother-baby-family triad.

Hendree Jones, PhD, professor and executive director at UNC Chapel Hill, laid the foundation for how NAS is defined and treated. She provided information about its relationship to longer-term outcomes for children.

Mishka Terplan, MD, MPH, FACOG, DFASAM, senior physician research scientist at Friends Research Institute, framed NAS through epidemiological theory and reviewed data on the epidemic of foster care placements driven predominantly by newborn withdrawal to illustrate the disconnect between science, and policy and practice.

Tricia Wright, MD, MS, DFASAM, professor at UCSF, also presented.

“While attempting to mitigate the effects of opioid use disorders in pregnancy and treat NAS, we cannot forget the far more common and more morbid condition of alcohol use in pregnancy,” Dr. Rudolf said. “Tricia will review the epidemiology, pathophysiology, and treatment of AUD in pregnancy in order to help prevent fetal alcohol syndrome (FAS).”

The session helped attendees understand current national data and trends, as well as significant gaps in access to care for neonates and children affected by NAS. Participants were also able to understand practical considerations and benefits of medication stability for pregnant and parenting women, as well as how medication and treatment engagement supports the mother-baby dyad, engagement, parenting and improved NAS outcomes. Recommendations for NAS from ASAM, and the American College of Obstetricians and Gynecologists, were also shared as clinical guidelines.

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