#84 Neonatal abstinence syndrome

BrainWaves: A Neurology Podcast

• Episode: #84 Neonatal abstinence syndrome
• Website: BrainWaves: A Neurology Podcast
• Feed URL: http://feeds.soundcloud.com/users/soundcloud:users:214831941/sounds.rss
• Duration: 00:21:20
• Published: 2019-06-06 11:00

The first wave of the opioid crisis began in 1991 when physicians began to overprescribe narcotic analgesics for pain. Eventually, addiction led to abuse and the fatality rates began to climb. In response, the US government cracked down on narcotic prescriptions--leading a surge in the price of medical grade opioids. By 2010, the cost of pharmacologic opiates was unaffordable, and users reverted back to the (now cheaper) alternative, heroin. 2013 marked the third wave of the opioid crisis, whereby synthetic, high-potency opiates like fentanyl and carfentanyl were being infused into other opiate products. With each wave, the world witnessed a spike in the number of opioid-related deaths, and thus far, our solutions have only led to new problems. But there is more to the opioid crisis than the effect of opioids on the voluntary user.

In 2017, we released a show highlighting the clinical consequences and management of opioid dependence on infants born to mothers who had used opioids during their pregnancy. This week, we have remastered the 2017 program and included an update at the end.

Produced by James E. Siegler. Music courtesy of Little Glass Men, Jason Shaw, and Chris Zabriskie. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

1. McQueen K and Murphy-Oikonen J. Neonatal Abstinence Syndrome. The New England journal of medicine. 2016;375:2468-2479.
2. Vlahov D, Des Jarlais DC, Goosby E, Hollinger PC, Lurie PG, Shriver MD and Strathdee SA. Needle exchange programs for the prevention of human immunodeficiency virus infection: epidemiology and policy. American journal of epidemiology. 2001;154:S70-7.
3. Kocherlakota P. Neonatal abstinence syndrome. Pediatrics. 2014;134:e547-61.
4. Hagan H, McGough JP, Thiede H, Weiss NS, Hopkins S and Alexander ER. Syringe exchange and risk of infection with hepatitis B and C viruses. American journal of epidemiology. 1999;149:203-13.
5. Wodak A and Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence. Subst Use Misuse. 2006;41:777-813.
6. Jarlenski M, Barry CL, Gollust S, Graves AJ, Kennedy-Hendricks A and Kozhimannil K. Polysubstance Use Among US Women of Reproductive Age Who Use Opioids for Nonmedical Reasons. Am J Public Health. 2017;107:1308-1310.
7. Hudak ML, Tan RC, Committee On D, Committee On F, Newborn and American Academy of P. Neonatal drug withdrawal. Pediatrics. 2012;129:e540-60.
8. Winkelman TNA, Villapiano N, Kozhimannil KB, Davis MM and Patrick SW. Incidence and Costs of Neonatal Abstinence Syndrome Among Infants With Medicaid: 2004-2014. Pediatrics. 2018;141.
9. MacMillan KDL, Rendon CP, Verma K, Riblet N, Washer DB and Volpe Holmes A. Association of Rooming-in With Outcomes for Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis. JAMA Pediatr. 2018;172:345-351.
10. Gomez-Pomar E and Finnegan LP. The Epidemic of Neonatal Abstinence Syndrome, Historical References of Its' Origins, Assessment, and Management. Front Pediatr. 2018;6:33.