NAS and Opioid Policy in the News

Opioid use by pregnant women represents a significant public health concern given the association of opioid exposure and adverse maternal and neonatal outcomes, including preterm labor, stillbirth, neonatal abstinence syndrome, and maternal mortality (1,2). State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic (3).

First lady Melania Trump visited Monroe Carell Jr. Children’s Hospital at Vanderbilt Tuesday to learn firsthand about Team Hope, Vanderbilt’s multidisciplinary team focused on helping infants born with neonatal abstinence syndrome (NAS) as well as their families. Trump’s stop in Nashville was part of her Be Best campaign, which launched in May and focuses on children in their individual paths, stressing their social, emotional and physical health. The campaign’s three main pillars focus on well-being, social media use and opioid abuse.

No single approach will end the epidemic of fatal overdoses caused by addiction to opioid painkillers and heroin that is ravaging this country, the U.S. Assistant Secretary for Health, Adm. Brett Giroir, MD, warned Tuesday during a panel discussion in a packed lecture hall at Vanderbilt University Medical Center.

A collaborative program across units at Vanderbilt University Medical Center and Monroe Carell Jr. Children’s Hospital at Vanderbilt is changing the way nurses and doctors care for newborns diagnosed with drug withdrawal symptoms at birth, also known as neonatal abstinence syndrome (NAS).

Infants who are diagnosed with drug withdrawal after birth who are treated with medication as outpatients at home are treated three times longer than infants treated solely as inpatients, according to a new Vanderbilt study. Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that occurs shortly after birth, and can occur when an infant is exposed to an opioid during the pregnancy.

Purdue Pharma, the company that planted the seeds of the opioid epidemic through its aggressive marketing of OxyContin, has long claimed it was unaware of the powerful opioid painkiller’s growing abuse until years after it went on the market. But a copy of a confidential Justice Department report shows that federal prosecutors investigating the company found that Purdue Pharma knew about “significant” abuse of OxyContin in the first years after the drug’s introduction in 1996 and concealed that information.

In 2016, 64,000 Americans died of drug overdose – about two thirds of them linked to opioids. Overdose deaths have risen fivefold since 1999, and the crisis has evolved over the years, with prescription opioids giving way to heroin and illicit fentanyl as the primary drivers of the epidemic.

A lack of resources, higher teen pregnancy rates and the opioid crisis combine with other factors to rob rural children of their childhoods.

I’m a captain in the Commissioned Corps of the U.S. Public Health Service. I hold a position of responsibility at HHS working on the nation’s opioids crisis and serious mental illness initiatives — and I’ve been in recovery from addiction for more than 16 years. It’s not easy to open my life story to the public, but I want to share it in hopes of showing others struggling with addiction that recovery is possible. I want to fight the stigma of addiction that has kept so many hidden and made it difficult for them to seek the help they need.

In the face of an unabating overdose crisis that has already killed more than a half-million people, San Francisco, Philadelphia and Seattle have announced plans to do what was once unthinkable: open centers where people can inject illegal drugs under medical supervision. Many other cities are also debating so-called safe infection facilities (SIFs) — but unfortunately, a common misconception about addiction stands in the way.