The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

doi:10.1136/archdischild-2015-310045

Review

. 2017 Mar;102(2):F183-F187.

doi: 10.1136/archdischild-2015-310045. Epub 2017 Jan 10.

The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

Jason R Pryor^{1

2}, Faouzi I Maalouf^{1

2}, Elizabeth E Krans³, Robert E Schumacher⁴, William O Cooper^{1

5

6}, Stephen W Patrick^{1

2

5

6}

Affiliations

¹ Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.
² Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA.
³ Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women's Research Institute University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁴ Department of Pediatrics, University of Michigan Health Systems, Ann Arbor, Michigan, USA.
⁵ Vanderbilt Center for Health Services Research, Nashville, Tennessee, USA.
⁶ Department of Health Policy, Vanderbilt University, Nashville, Tennessee, USA.

PMID: 28073819
PMCID: PMC5730450
DOI: 10.1136/archdischild-2015-310045

Review

The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

Jason R Pryor et al. Arch Dis Child Fetal Neonatal Ed. 2017 Mar.

. 2017 Mar;102(2):F183-F187.

doi: 10.1136/archdischild-2015-310045. Epub 2017 Jan 10.

Authors

Jason R Pryor^{1

2}, Faouzi I Maalouf^{1

2}, Elizabeth E Krans³, Robert E Schumacher⁴, William O Cooper^{1

5

6}, Stephen W Patrick^{1

2

5

6}

Affiliations

¹ Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.
² Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA.
³ Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women's Research Institute University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁴ Department of Pediatrics, University of Michigan Health Systems, Ann Arbor, Michigan, USA.
⁵ Vanderbilt Center for Health Services Research, Nashville, Tennessee, USA.
⁶ Department of Health Policy, Vanderbilt University, Nashville, Tennessee, USA.

PMID: 28073819
PMCID: PMC5730450
DOI: 10.1136/archdischild-2015-310045

Abstract

As the prescription opioid epidemic grew in the USA, its impact extended to pregnant women and their infants. This review summarises how increasing rates of neonatal abstinence syndrome resulted in a need to improve care to pregnant women and opioid-exposed infants. We discuss the variations in care delivery with particular emphasis on screening at-risk mothers, scoring systems for neonatal drug withdrawal, type and duration of pharmacotherapy, and discharge safety.

Keywords: Drug Withdrawal; Neonatology.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PubMed Disclaimer

Conflict of interest statement

Competing interests None declared.

Figures

**Figure 1**
US incidence of neonatal abstinence syndrome (NAS), 2000–2012.

See this image and copyright information in PMC

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References

1. Plante GE, VanItallie TB. Opioids for cancer pain: the challenge of optimizing treatment. Metabolism. 2010;59(Suppl 1):S47–52. - PubMed
1. Sullivan MD, Edlund MJ, Fan MY, et al. Trends in use of opioids for non-cancer pain conditions 2000–2005 in commercial and Medicaid insurance plans: the TROUP study. Pain. 2008;138:440–9. - PMC - PubMed
1. Bateman BT, Hernandez-Diaz S, Rathmell JP, et al. Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 2014;120:1216. - PMC - PubMed
1. Davies H, Gilbert R, Johnson K, et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia, and Ontario, Canada. BMJ. 2016;101:F26–30. - PubMed
1. Hudak ML, Tan RC Committee on Drugs, Committee on Fetus and Newborn, American Academy of Pediatrics. Neonatal drug withdrawal. Pediatrics. 2012;129:e540–60. - PubMed

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[1] Plante GE, VanItallie TB. Opioids for cancer pain: the challenge of optimizing treatment. Metabolism. 2010;59(Suppl 1):S47–52. - PubMed

[2] Plante GE, VanItallie TB. Opioids for cancer pain: the challenge of optimizing treatment. Metabolism. 2010;59(Suppl 1):S47–52. - PubMed

[3] Sullivan MD, Edlund MJ, Fan MY, et al. Trends in use of opioids for non-cancer pain conditions 2000–2005 in commercial and Medicaid insurance plans: the TROUP study. Pain. 2008;138:440–9. - PMC - PubMed

[4] Sullivan MD, Edlund MJ, Fan MY, et al. Trends in use of opioids for non-cancer pain conditions 2000–2005 in commercial and Medicaid insurance plans: the TROUP study. Pain. 2008;138:440–9. - PMC - PubMed

[5] Bateman BT, Hernandez-Diaz S, Rathmell JP, et al. Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 2014;120:1216. - PMC - PubMed

[6] Bateman BT, Hernandez-Diaz S, Rathmell JP, et al. Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 2014;120:1216. - PMC - PubMed

[7] Davies H, Gilbert R, Johnson K, et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia, and Ontario, Canada. BMJ. 2016;101:F26–30. - PubMed

[8] Davies H, Gilbert R, Johnson K, et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia, and Ontario, Canada. BMJ. 2016;101:F26–30. - PubMed

[9] Hudak ML, Tan RC Committee on Drugs, Committee on Fetus and Newborn, American Academy of Pediatrics. Neonatal drug withdrawal. Pediatrics. 2012;129:e540–60. - PubMed

[10] Hudak ML, Tan RC Committee on Drugs, Committee on Fetus and Newborn, American Academy of Pediatrics. Neonatal drug withdrawal. Pediatrics. 2012;129:e540–60. - PubMed

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The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

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The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

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