Neonatal Abstinence Syndrome Summary

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.

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.

A research design can be understood as the planning of any scientific research from the first to the last step. In this sense it is a program to guide the researcher in collecting, analyzing, and interpreting facts (Bless and Higson-Smith, 1995:63).

Instructions: This is a group activity that you will start in class and complete at home. For each of the following, note, whether the research design used is an experiment, a quasi-experiment, or a correlational approach and why. If a study is an experiment, identify the independent variable and the dependent variable. Please type your answers in complete sentences.

Dr. Perry Kendall’s stated in a report that the mortality rate for people in opioid substitution treatment is about half of what it is for those using street heroin. (“globeandmail”) Another doctor, who has been administering the program as part of his family practice for several years states the rate of success is poor, the nature of the work often frustrating and the paperwork required under new rules is daunting. But the reward is the amazing transformation of those who are helped by methadone, says Dr. Jeff White. (“thetelegram”) Equally, a confident experience is expressed from a recovering addict himself, Jared stated to a Newfoundland based newspaper, The Compass that the methadone program had a super positive impact on his life. Going on to say in a separate interview with The Advertiser, that the first year everything went as well as it could have with him not doing any drugs. (“Advertiser”) This is just a few examples on how the methadone program has continued to play a positive impact on lives when given the

“Every 25 minutes, 1 baby is born suffering from opiate withdrawal. Newborns with neonatal abstinence syndrome (NAS) are more likely than other babies to also have low birth weight and respiratory complications” (Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome, 2015, Paragraph 2). To insure a better life for these babies, people are trying to create an Act called the Plan of Safe Care Improvement or otherwise known as the Infant Plan of Safe Care Improvement. This Act is meant to protect future babies from not only being born drug dependent because of their mothers, but also ensuring them a drug-free environment after birth. It will also “get help for the mothers and any other guardians involved in drug addiction”

This project will focus on using Methadone as a pharmacological treatment strategy as well as the normal non-pharmacological treatment strategies to

Besides preventing withdrawal, methadone treats the mom’s opioid addiction. About 70% of pregnant opioid addicts will relapse back to illicit opioid use (heroin or pain pills not prescribed to them) if they are taken off methadone. We also know that women enrolled in a methadone treatment program are much more likely to get prenatal care, and babies born to moms on methadone have higher birth weights than mothers in active addiction. If the mother is dosed with methadone, the baby is much less likely to be exposed to infectious agents like HIV and hepatitis from shared needle use. The baby also won’t be exposed to adulterants that can cause fetal damage, if heroin is being used.

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).

However, one review article mentioned there is little actually known about the details of opioid abusing mother behavior other than more negative than positive behavior engagement. The lack of detail regarding deficits in parenting among dependent mothers suggests a need for future research in order to tailor and better recruit for interventions and education to mothers and see better results. Additionally, it has not been established that simply treating mothers for their opioid addiction would be sufficient for improving child outcomes, which illuminates the need for parenting education to mothers, especially those who are opioid dependent and have a much higher chance of mental health problems and lack of social support as studies have shown (Peisch et al.,

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.

(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

Mary presented as a 24 year old, single African American female who is self-referred at this time; she was, however, recommended by a friend to attend the assessment. Mary has identified that she has consistently used heroin for the last five years and is afraid that she is approximately 12 weeks pregnant, and unable to stop using. Mary has included that she has consumed four to five beers each night. In order to properly develop an appropriate

A study design is the procedure that guides a researcher on how to collect, analyze and interpret observations. It is a logical model that guides the investigator while he navigates through the various stages of the research. Study types can be classified severally depending on the research strategy employed. A study type can be non-interventional that is ‘observational’ where a researcher just observes and analyses researchable objects or situations without intervening. Non-interventional study designs can be exploratory, descriptive or comparative. A study can also be