Neonatal abstinence syndrome: How states can advance the knowledge base for primary prevention and best practices of care

Issues: There has been increasing public health, medical, and political attention on the parallel increase in two trends: prescription opioid abuse and the incidence of neonatal abstinence syndrome (NAS). Although much is known about how to manage opioid dependency in pregnancy and NAS, many research and operational questions remain regarding how to consistently provide good quality of care in an unbiased and compassionate manner.

Description: Neonatal abstinence syndrome has been consistently identified as an emerging priority for health departments. This session will present findings from a literature review and discuss ways in which state health agencies may support better outcomes for mothers and infants affected by opioid dependency.

Lessons Learned: A state-level approach to NAS can address several levels of intervention, including: surveillance for NAS-affected infants and the sources of maternal opiate use; reimbursement for utilizing screening protocols to detect substance abuse early in pregnancy and withdrawal signs in newborns; developing better measures to ensure follow-up of opioid-dependent women and receipt of comprehensive services; collaborative efforts to strengthen clinical standards for identification, management, and follow-up of NAS-affected infants and their families.

Recommendations: Because the points of potential intervention span multiple phases in women and children’s lives, many state agencies, healthcare providers, and community-based services are involved. State health agencies play a key role in linking various resources and providers by tracking substance-exposed infants through screening, assessment, and service delivery.