United States is battling an opioid epidemic, which has resulted in increasing
illicit use and misuse of prescription opioids among pregnant women. Neonatal
abstinence syndrome (NAS), in which infants exhibit postnatal withdrawal
symptoms most commonly due to chronic in utero exposure to opioids, is one unfortunate sequelae of the opioid epidemic. It manifests as a
combination of central nervous system irritability, autonomic nervous system
hyperactivity, respiratory difficulties, and gastrointestinal dysfunction. The majority of pregnant women taking illicit drugs, using prescribed opioids,
or receiving opioid replacement therapy will deliver an infant having
withdrawal symptoms, and many of these infants will develop NAS and require
pharmacologic management. NAS infants are more likely to have a
diagnosis of prematurity, low birth weight, respiratory complications,
seizures, and feeding difficulty. Beyond the neonatal period, they
are at risk for behavioral problems, learning problems, visual disorders, and
psychosocial difficulties (for example, risk for child abuse, foster
Despite awareness of a rising NAS incidence, there is a scarcity of evidence-based management for NAS, lack of improvement in length of inpatient stay, and a rise in health care costs, which highlight the considerable variations in its management by pediatricians and neonatologists. The FPQC hopes to address variability in NAS management.
New in the Tool Box: Provider Education video modules!
Online Tool Box for NAS Hospitals
The Tool Box contains:
This resource is regularly updated throughout the project.
December 4, 2018 - NAS Data Collection: Definitions, Procedures, and Tools
January 15, 2019 - Pharmacologic Management
February 19, 2019 - Eat, Sleep, Console: The Colorado Experience
March 19, 2019 - Connecting to the World Outside
April 16, 2019 - Inter-Rater Reliability
May 2019 - Non-Pharmacologic Management