Neonatal Abstinence Syndrome (NAS) is extremely prevalent in Tennessee. While there are valiant efforts to help the mothers and children who are affected by NAS, there is little being done to prevent the initial addiction from occurring.
According to the Tennessee Department of Health, 510 cases of NAS have been reported in the state in 2013 (as of week ending September 14). At this rate, the Department of Health predicts that it will exceed 800 cases by the end of 2013, representing a 28 percent increase since 2011.
With support from 43 attorneys general across the country, Food and Drug Administration (FDA) is now requiring warning labels on all opioid analgesics to indicate risk of NAS if taken while pregnant. This could make huge difference in the number of accidental NAS cases where the mother does not know that the drug could be harmful to the infant.
The Tennessee Department of Health has also made these recommendations to prevent these births:
- Provide Training: Physicians should be further educated in the addiction process in order to prevent the prescribing of opioid drugs to pregnant mothers.
- Identify Risk Early: SBIRT (Screening, Brief Intervention and Referral to Treatment) should be included in all ObGyn visits in order to screen for drug and alcohol abuse among women who are pregnant or could become pregnant.
- Tighten Restrictions: TennCare should also put limitations on opioid availability. This includes prior authorization counseling and quantity limitations.
Preventing pregnancy in women using opiate drugs would lower the number of NAS cases. Patient education and access to effective forms of contraception would offer options to women who are addicted to opiates or on long-term opiate pain management therapy.
Identifying reproductive-aged women who may be opioid-addicted through the Controlled Substance Monitoring Database (CSMD) would help to prevent NAS as well. The CSMD allows medical providers to track their patients and counsel them accordingly to prevent an unintended pregnancy and potential NAS birth.
With 42 percent of NAS pregnancies coming from substances prescribed to the mother, we could lower these numbers by collaborating with physicians and other health agencies to help educate the mothers, medical providers and family members on the risks of NAS.