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Dr. Radhika V. Kumar
Assistant Professor
Department of Pharmaceutical Sciences
School of Pharmacy
American University of Health Sciences

Neonatal abstinence syndrome or neonatal opioid withdrawal syndrome (NAS/NOWS) is a drug withdrawal syndrome in newborns as a result of opioid use during pregnancy. The manifestation of this syndrome is marked by central nervous system irritability, difficulty feeding, respiratory problems, and seizures. Newborns with NAS/NOWS are more likely than other babies to also have low birthweight and respiratory complications. Nationally, there was a five-fold increase in the incidence of NAS in 2014 compared to 2004. However, in California, there is a two-fold increase in the incidence of NAS from 2009-2012 to 2013-2016. According to the Centers for Disease Control and Prevention (CDC) (2016), contributing factors may include geographic areas, rurality, and availability of care for this particular condition. The cost of hospital stay for a newborn with NAS is nine times that of other newborns and mostly covered by Medicaid, indicating this syndrome to be from lower income communities. According to the CDC, adopted prevention and intervention strategies are prescription drug monitoring programs (PDMPs), education, and proper medical supervision in pregnant women with high relapse rates through collaboration with pediatric care teams, non- pharmacological methods of treatment (rooming-in with mothers after birth, breastfeeding, swaddling, skin-to-skin time and minimizing stimuli in environments), and pharmacological methods through the use of drugs (morphine, methadone, clonidine). Although the efforts are ongoing, social stigma, costs, and legalities are still the barriers that need to be addressed in order to overcome the rising frequency of this syndrome.

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