Challenges of foster parents who care for infants with neonatal abstinence syndrome all health care providers are required by law to make a referral to the department of childrens. Opioid use during pregnancy is on the rise in the united states. Born drug free tennessee a babys life shouldnt begin with. Neonatal abstinence syndrome nas occurs when a baby is born dependent on drugs used by the mother during her pregnancy. Substance use by pregnant women is also accompanied by medical, legal, and economic consequences for the mother. From 2009 to 2015, the average nas rate per 1,000 hospital births across eight states rose from about six to more than 25. When he is born, he is still dependent on the drug. Neonatal abstinence syndrome tennessees epidemic and the. Objectives between 2003 and 20, the rate of neonatal abstinence syndrome nasa postnatal drug withdrawal syndrome in tennessee increased approximately 10fold. In 2012, 35% of pregnant women admitted to statefunded treatment services listed prescription opioids as their primary substance of abuse. Neonatal abstinence syndrome surveillance may 2019. Neonatal abstinence syndrome nas is a postnatal drug withdrawal syndrome that occurs primarily among opioidexposed infants shortly after birth, often manifested by central nervous system. Hospitalbased surveillance for neonatal abstinence.
What is the optimal management of an infant with nas. The term neonatal abstinence syndrome nas refers to a group of signs and. Our objectives for this study were to validate the diagnostic codes for nas and to develop an algorithm to optimize identification. A baby with neonatal abstinence syndrome costs 6 times more to care for than a baby without nas. Neonatal abstinence syndrome nas is a withdrawal syndrome that can occur in newborns exposed to certain substances, including opioids, during pregnancy. Reducing neonatal abstinence syndrome in tennessee november 2015 rising prescription painkiller abuse and the simultaneous increase in heroin dependence have led to an alarming growth in the number of infants born with neonatal abstinence syndrome nas since 2000. In 20, about onethird of tennessee babies with nas were born in the east region. Born drug free tennessee a babys life shouldnt begin.
The number of babies born to mothers addicted to opioids or antianxiety medication in tennessee is soaring, according to the associated press. Maternal use of opioids and other substances, the primary cause of neonatal abstinence syndrome nas, is a leading cause of medical and developmental problems in the newborn. From 199920, the overall incidence of neonatal abstinence syndrome tripled. This is due to many factors, including longer hospital stays, higher monitoring costs, medications, health problems that continue after discharge, etc. Adverse neurobehavioral outcomes have been documented in infants with nas. Pdf treating infants with neonatal abstinence syndrome. Implementation of a statewide surveillance system for. Recommendations to the indian health service on neonatal. The tennessee department of childrens services would like to sincerely thank the east tennessee childrens hospital for their expertise, shared knowledge, and dedication to neonatal abstinence syndrome education and treatment. Feb, 2015 nationally, tennessee ranks second in the rate of prescriptions written for opioid pain relievers, with 1. The prevalence of neonatal abstinence syndrome nas is increasing, as is the need for evidencebased interventions to treat it.
Effects of breast milk on the severity and outcomes of neonatal abstinence syndrome among infants of drug dependent mothers. Miller, phd 1, julie traylor, mph 1, audrey bauer, dvm 1, stephen w. Reducing neonatal abstinence childrens safety network. Neonatal abstinence syndrome is epidemic in the eastern tennessee area of appalachia, with unique maternal and infant characteristics that have important implications for primary. Neonatal abstinence syndrome a tennessee perspective on vimeo. References w 475 rates of nas3 neonatal abstinence syndrome. Request pdf implications of tennessee s opioid legislation for neonatal abstinence syndrome opioid use during pregnancy is on the rise in the united states. Neonatal abstinence syndrome nas neonatal abstinence syndrome nas is a treatable condition that newborns experience after chronic exposure to certain substances, primarily opioids, while in utero opioid use is the most common source of nas symptoms include. These babies suffer the effects of neonatal abstinence syndrome, such as tremors, abdominal pain, incessant crying and rapid breathing. Not surprisingly, tennessee has seen a dramatic rise in the number of neonatal abstinence syndrome nas cases. The terminology neonatal opioid withdrawal syndrome nows will be used to describe the clinical condition addressed herein by this document and replaces neonatal abstinence syndrome nas used in previous indian health service ihs guidelines.
Tennessee law to prevent neonatal abstinence syndrome fails. Newborns exposed to opioids before birth can experience withdrawal symptoms known as neonatal abstinence syndrome nas. Nas happens when babies are in contact with medications or illegal drugs in the womb. References w 475 rates of nas3 neonatal abstinence.
Challenges of foster parents who care for infants with. Born drugfree in tennessee the howard baker center for. Neonatal abstinence syndrome nas, also known as newborn drug withdrawal. Neonatal abstinence syndrome nas, also known as newborn drug withdrawal, is a public health epidemic. Neonatal abstinence syndrome tennessees epidemic and. Between 2004 and 2014, tennessee experienced a fivefold increase in nas hospitalizations, from 1.
Article information, pdf download for implications of tennessees. The law was meant to discourage pregnant women from using drugs in an effort to prevent something called neonatal abstinence syndrome, which is a collection of health problems experienced by. We analyzed tennessee data to understand the need for special. The rising prevalence of opioid pain reliever use and misuse in tennessee led to an increase in adverse outcomes in the state, including neonatal abstinence syndrome nas. Within two days of delivery, that worstcase scenario also. Jul 29, 2015 neonatal abstinence syndrome nas was first described in the 1970s, identified among neonates whose mothers most commonly used heroin or were on methadone maintenance.
Implementation of a statewide surveillance system for neonatal abstinence syndrome tennessee, 20. After birth, they experience withdrawal just like adults. From 2002 to 20, tennessees rate of neonatal abstinence syndrome increased 1,000%. Nas occurs when a baby in the womb withdraws from a substance that they have been exposed to through the placenta, after becoming dependent on those drugs through a mothers use.
Last week, tennessee legislature opted out of the fetal assault law which penalized the mothers of babies who are born testing positive for drugs. Newsroom tackling neonatal abstinence syndrome in tennessee. Numerator is number of inpatient hospitalizations with age less than one and any diagnosis of neonatal abstinence syndrome icd9cm 779. Neonatal abstinence syndrome nas neonatal abstinence syndrome happens when babies are in contact with medications or illegal drugs in the womb. Neonatal abstinence syndrome nas refers to a group of signs and symptoms that may occur in infants withdrawing from drug dependency following inutero drug exposure the most common substances causing nas are the opiate class of drugs. Tennessees epidemic and the states response michael d. Health briefs offer quick but comprehensive information about some of the biggest health challenges tennessee is facing. Implications of tennessee s opioid legislation for neonatal abstinence syndrome jennifer n. Positive predictive value of administrative data for.
Request pdf implications of tennessees opioid legislation for neonatal abstinence syndrome opioid use during pregnancy is on the rise in the united states. Neonatal abstinence syndrome nas was first described in the 1970s, identified among neonates whose mothers most commonly used heroin or were on methadone maintenance. Neonatal abstinence syndrome nas is a group of problems that occur in a newborn who was exposed to addictive illegal or prescription drugs while in the mothers womb. Surveillance, epidemiology, and estimated burden of. This condition is also known as neonatal abstinence syndrome nas. Neonatal abstinence syndrome east tennessee state university. Featured stories, opioid epidemic, tennessee opioid crisis tagged with. Nas is associated with poor fetal growth and preterm birth, and can cause symptoms such as seizures, excessive irritability, poor feeding, and dehydration. We analyzed tennessee data to understand the need for special educational services among infants who are born with nas. These babies form a physical dependence on the drug used by their mother during pregnancy. Jail outreach program prevents neonatal abstinence. Neonatal abstinence syndrome nas ashley brantley oct. Number of babies born with neonatal abstinence syndrome in. Reducing neonatal abstinence syndrome in tennessee nihcm.
Dreyzehner specifically addressed the issue of nas in his presentation. After these babies are born, they can suffer from drug withdrawal symptoms. Tennessee having the highest number of opioid prescrip. Some babies born to opioid using pregnant women may experience neonatal abstinence syndrome nas. Educational disabilities among children born with neonatal. Characteristics and risk factors among mothers and infants in one area of appalachia. Clinical policy neonatal abstinence syndrome guidelines page 2 of 8 48 hours and all of the discharge criteria in section i. Hospital administrative data are commonly used for research and surveillance but have not been validated for nas. Neonatal abstinence syndrome nas develops when a baby is no longer exposed to a drug his mother used during pregnancy.
Federal and state controlled substance laws and guidelines. The baby is affected by the drug while he is in the womb and becomes dependent on it. Neonatal abstinence syndrome archives tennessee baby doe. The neonatal abstinence syndrome refers to a postnatal opioid withdrawal syndrome that can occur in 55 to 94% of newborns whose mothers were addicted to or treated with opioids while pregnant. Mar 28, 2016 tennessee law to prevent neonatal abstinence syndrome fails. Objectives between 2003 and 20, the rate of neonatal abstinence syndrome nasa postnatal drug withdrawal syndromein tennessee increased approximately 10fold. Neonatal abstinence syndrome aap pointofcaresolutions. Numerator is number of inpatient hospita lizations with age less than one and any diagnos is of neonatal abstinence syndrome icd 9cm 779. Neonatal abstinence syndrome is a growing problem in tennessee. Neonatal abstinence syndrome nas is a condition in which a baby is exposed to certain substances during pregnancy. Neonatal abstinence syndrome nas description of illness.
Positive predictive value of administrative data for neonatal. The rising prevalence of opioid pain reliever use and misuse in tennessee led to an increase in adverse outcomes in the state, including neonatal abstinence syndrome. The home environment, caregiver, and support team must be taken into consideration. Tennessee law to prevent neonatal abstinence syndrome. Four views of the trends in n eonatal abstinence syndrome nas births in the united states are provided. Presented by the tennessee department of childrens services. They have a screechlike cry, claw their faces and squirm. Objectives define the etiology, diagnosis, and management of neonatal abstinence syndrome nas outline the scope of nas in tennessee describe tennessee interventions to reduce the. Maternal treatment with opioid analgesics and risk for birth defects. Implications of tennessees opioid legislation for neonatal.
Neonatal abstinence syndrome nas is a postnatal drug withdrawal syndrome that can occur. Between 2003 and 20, the rate of neonatal abstinence syndrome nasa postnatal drug withdrawal syndromein tennessee increased approximately 10fold. Using a neonatal abstinence syndrome scoring system allows clinicians to diagnose the severity of each case of nas and develop appropriate treatment plans for each infant. Clinics can also provide information and referral for substance abuse treatment or other available nas services in your area. The baby becomes dependent while in the womb and then suffers from withdrawals after birth. To describe the epidemiology of neonatal abstinence syndrome nas in a. Goal of treatment during neonatal withdrawal is to alleviate shortterm. We analyzed tennessee data to understand the need for special educational services. Neonatal abstinence syndrome nas describes withdrawal symptoms experienced by newborns exposed to opioids while in utero. Neonatal abstinence syndrome nas is a postnatal withdrawal syndrome experienced by some infants with opioid exposure. East tennessee state university appalachian research network. More than 1,000 infants in tennessee are born dependent on drugs each year. Over the last decade, rates of opioid pain reliever prescribing grew substantially in the united states, affecting many segments of the. Tennessee s struggle with addicted mothers and their babies.
Hospital discharge data system hdds and birth stat istical system. Many times, the baby is exposed when the mother uses substances such as medications or illicit drugs during pregnancy, and after the baby is born and separated from the mothers body, the baby goes through. What are key strategies for changing provider knowledge and behavior. To describe the epidemiology of neonatal abstinence syndrome nas in a 16county appalachian area of eastern tennessee.
Many times, the baby is exposed when the mother uses substances such as medications or illicit drugs during pregnancy, and after the baby is born and separated from the mothers body, the baby goes through withdrawal because it is no longer receiving the substances. These drugs can include amphetamines, barbiturates, benzodiazepines, cocaine, marijuana and opiatesnarcotics. By using tennessee medicaid and birth certificate data, infants who were born in. A new cdc article looked at laws enacted in six states that make health departments or hospitals report all babies born with nas for public health monitoring. Neonatal abstinence syndrome what you need to know. Neonatal abstinence syndrome nas care east tennessee. Neonatal abstinence syndrome nas, also known as newborn drug. Surveillance, epidemiology, and estimated burden of neonatal.
Treatment depends on the drug involved, the infants overall health and if the baby was born full term or premature. Describe the characteristics of infants with nas and determine if treatment outcomes varied. Neonatal abstinence syndrome nas is a drug withdrawal syndrome that occurs among opioidexposed infants shortly after birth. Tennessee principles to initiating opioids prescribing of opioids by another provider is not, in and of itself, a reason to continue reasonable nonopioid treatments should be tried before opioids are initiated ask about pregnancy and discuss birth control plan for patients of childbearing age. Mapping neonatal abstinence syndrome nas in davidson county.
Between 2003 and 20, the rate of neonatal abstinence syndrome nasa postnatal drug withdrawal syndrome in tennessee increased approximately 10fold. An infant suffering from nas is born every 25 minutes in the us. Populations of women who may give birth to infants with nas include women who use heroin, women who use or misuse prescription opioids e. Trusted answers from the american academy of pediatrics. A guide for professionals programs in agriculture and natural resources, 4h youth development, family and consumer sciences, and resource development. Neonatal abstinence syndrome is a condition in which a baby has withdrawal symptoms after being exposed to certain substances.
The most widely used standardized scoring tool of nas is the finnegan neonatal abstinence scoring system. Neonatal abstinence syndrome and maternal substance abuse. Neonatal abstinence syndrome nas is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. The tennessee department of childrens services would also like to thank dr. Tennessee efforts to prevent neonatal abstinence syndrome. Neonatal abstinence syndrome nas is a withdrawal syndrome exhibited by infants shortly after birth. Also, a special thank you to appalachia hidta and united way of greater knoxville for providing the funding and support of this campaign.
Tennessee will not uphold law that criminalizes giving. Hospital discharge data system hdds and birth statistical system. Scroll down to read all about neonatal abstinence syndrome in our state or jump to a specific section. Nationally, tennessee ranks second in the rate of prescriptions written for opioid pain relievers, with 1. Vanderbilt university school of nursing east tennessee childrens hospital neonatal abstinence syndrome management trends in tennessee pdf. Babies with neonatal abstinence syndrome nas are born addicted to illegal or prescription drugs that their mothers took while pregnant with them. The syndrome most commonly occurs after inutero exposure to opioids like heroin, methadone or hydrocodone. The east tennessee neonatal abstinence syndrome nas task force would like to express special thank you to born drugfree florida for the development and design of these campaign materials. Reducing neonatal abstinence syndrome in tennessee.
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