Substance abuse in pregnancy continues to climb. The American College of Obstetricians and Gynecologists (ACOG) updated their Committee Opinion on alcohol and other substance abuse in pregnancy this June. They encouraged providers to open the discussion on substance abuse and routinely screen all patients. ACOG also highlighted the importance of maintaining a conversation about treatment with patients and advocated development of treatment programs. The major concern for babies with maternal opioid abuse in pregnancy is neonatal abstinence syndrome (NAS). NAS is a treatable opioid withdrawal syndrome affecting unto 94% of neonates exposed to opioids in utero. Between 2000 and 2009, opioid use during pregnancy increased from 1.19 to 5.63 per 1,000 US hospital births. In that same time period, NAS diagnoses increased from 1.20 to 3.39 per 1000 hospital births per year.
Reducing NAS and improving maternal access to substance abuse treatment are major goals the Protecting Our Infants Act (HR 1462/S 799), a bill introduced by Representatives Katherine Clark (D-MA) and Steve Stivers (R-OH), and Senate Majority Leader Mitch McConnell (R-KY) and Senator Bob Casey (D-PA). This legislation has gained momentum and it strives to:
– increase data and surveillance related to NAS
– develop recommendations for preventing and treating prenatal opioid abuse and NAS
– address gaps in treatment for pregnant women with opioid use disorders and treatment and management of infants with NAS
