Nonpharmacologic interventions are available to help NAS infants. “Systematic implementation of policies that support rooming-in, breastfeeding, swaddling, on-demand feeding schedules, and minimization of sleep disruption may reduce symptoms of NAS and reduce the duration of, or even eliminate the need for, pharmacologic treatment of NAS,” the researchers said. “Pharmacologic treatment with buprenorphine, for example, has been shown to reduce hospital length of stay by 35%.”
Another intervention is medication-assisted treatment during pregnancy, which studies have shown “improves outcomes and reduces costs associated with NAS, compared with attempted abstinence,” Dr. Winkelman and his associates said. It does not necessarily reduce NAS incidence, but “it may prevent prolonged hospital stays due to preterm birth, reduce NICU [neonatal intensive care unit] admissions, decrease the severity of NAS symptoms, and improve birth outcomes for some infants.”
The researchers also endorsed screening, referral, and treatment for substance abuse and mental health disorders among reproductive age women, including adolescents, because these are risk factors for opioid abuse.
One author was supported by an award from the National Institute on Drug Abuse. None of the other authors had relevant financial disclosures.
SOURCE: Winkelman TNA et al. Pediatrics. 2018;141(4):e20173520.