[et_pb_section fb_built=”1″ admin_label=”Header” _builder_version=”4.24.0″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” background_color=”#2a3282″ background_enable_image=”off” background_size=”stretch” custom_padding=”4vw||129px||false|false” locked=”off” global_colors_info=”{}” background_color_gradient_start__hover=”#2b87da” background_color_gradient_start__hover_enabled=”#2b87da” background_color_gradient_end__hover=”#29c4a9″ background_color_gradient_end__hover_enabled=”#29c4a9″ use_background_color_gradient__hover=”off” use_background_color_gradient__hover_enabled=”off” background_color_gradient_type__hover=”linear” background_color_gradient_type__hover_enabled=”linear” background_color_gradient_direction__hover=”180deg” background_color_gradient_direction__hover_enabled=”180deg” background_color_gradient_direction_radial__hover=”center” background_color_gradient_direction_radial__hover_enabled=”center” background_color_gradient_start_position__hover=”0%” background_color_gradient_start_position__hover_enabled=”0%” background_color_gradient_end_position__hover=”100%” background_color_gradient_end_position__hover_enabled=”100%” background_color_gradient_overlays_image__hover=”off” background_color_gradient_overlays_image__hover_enabled=”off” background_color_gradient_stops__hover=”#2b87da 0%|#29c4a9 100%”][et_pb_row _builder_version=”4.16″ _module_preset=”default” max_width=”80%” use_custom_width=”on” width_unit=”off” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.24.0″ _module_preset=”default” header_font=”||||||||” header_2_font=”Noto Serif||||||||” header_2_font_size=”40px” header_2_line_height=”1.4em” custom_margin=”||-2px|||” header_2_font_size_tablet=”30px” header_2_font_size_phone=”24px” header_2_font_size_last_edited=”on|phone” locked=”off” global_colors_info=”{}”]<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Blog” _builder_version=”4.16″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” custom_padding=”74px||0px|3px||” global_colors_info=”{}”][et_pb_row column_structure=”1_3,1_3,1_3″ _builder_version=”4.24.0″ _module_preset=”default” background_color=”#7f89e2″ border_radii=”off|25px|25px||” global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”#php” button_text=” Public Health Practitioners” button_alignment=”center” _builder_version=”4.24.0″ _module_preset=”default” custom_button=”on” button_text_size=”16px” button_text_color=”#FFFFFF” button_bg_color=”#7f89e2″ button_border_width=”0px” button_border_radius=”66px” button_letter_spacing=”1px” button_font=”|700||on|||||” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”#cp” button_text=”Clinical Providers” button_alignment=”center” _builder_version=”4.24.0″ _module_preset=”default” custom_button=”on” button_text_size=”16px” button_text_color=”#FFFFFF” button_bg_color=”#7f89e2″ button_border_width=”0px” button_border_radius=”66px” button_letter_spacing=”1px” button_font=”|700||on|||||” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”#cer” button_text=”Community Education Resources” button_alignment=”center” _builder_version=”4.24.0″ _module_preset=”default” custom_button=”on” button_text_size=”16px” button_text_color=”#FFFFFF” button_bg_color=”#7f89e2″ button_border_width=”0px” button_border_radius=”66px” button_letter_spacing=”1px” button_font=”|700||on|||||” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.24.0″ _module_preset=”default” background_color=”#7f89e2″ border_radii=”off|||25px|25px” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”#pr” button_text=”Policy Resources” button_alignment=”center” _builder_version=”4.24.0″ _module_preset=”default” custom_button=”on” button_text_size=”16px” button_text_color=”#FFFFFF” button_bg_color=”#7f89e2″ button_border_width=”0px” button_border_radius=”66px” button_letter_spacing=”1px” button_font=”|700||on|||||” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”#pub” button_text=”Publications” button_alignment=”center” _builder_version=”4.24.0″ _module_preset=”default” custom_button=”on” button_text_size=”16px” button_text_color=”#FFFFFF” button_bg_color=”#7f89e2″ button_border_width=”0px” button_border_radius=”66px” button_letter_spacing=”1px” button_font=”|700||on|||||” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ _module_preset=”default” custom_padding=”||0px|||” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text module_id=”php” _builder_version=”4.24.0″ _module_preset=”default” text_font=”Poppins||||||||” text_font_size=”23px” text_line_height=”1.8em” header_font=”||||||||” header_font_size=”42px” header_2_font=”Noto Serif||||||||” header_2_font_size=”40px” header_2_line_height=”1.4em” custom_margin=”||4px|||” custom_padding=”||0px|||” animation_style=”fade” header_2_font_size_tablet=”30px” header_2_font_size_phone=”24px” header_2_font_size_last_edited=”on|phone” locked=”off” inline_fonts=”Poppins” global_colors_info=”{}”]<\/p>\n
<\/span><\/p>\n<\/div>\n<\/div>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_accordion open_toggle_text_color=”#2a3282″ open_toggle_background_color=”rgba(0,0,0,0)” closed_toggle_text_color=”#2a3282″ toggle_icon=”||fa||900″ icon_color=”#2a3282″ _builder_version=”4.24.0″ _module_preset=”406cfb42-b874-40c7-8445-70ada1219600″ toggle_text_color=”#FFFFFF” toggle_font=”Poppins|700|||||||” toggle_font_size=”20px” body_font=”Poppins||||||||” body_text_color=”#2a3282″ text_orientation=”center” custom_margin=”18px|||||” hover_enabled=”0″ border_width_all=”2px” border_color_all=”#2a3282″ locked=”off” global_colors_info=”{%22gcid-86031d5b-0170-405c-b57e-166734aa8a67%22:%91%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22%93}” sticky_enabled=”0″][et_pb_accordion_item title=”NAS Verses NOWS” open=”on” _builder_version=”4.24.0″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n NAS verses NOWS:<\/a> The CSTE position statements 19-MCH-01 and 23-MCH-01 define a standardized surveillance case definition for neonatal abstinence syndrome (NAS). Also frequently referred to in literature, and defined in the linked HHS clinical case definition, is neonatal opioid withdrawal syndrome (NOWS). NAS is defined as a constellation of signs of withdrawal in a neonate due to in utero substance exposure, and NOWS is specific to neonatal withdrawal from opioids. NOWS is considered a subset of NAS, and the HHS clinical case definition treats these syndromes as separate but related.<\/span><\/p>\n <\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Public Health Ethics on Substance Use During Pregnancy” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n Substance use during pregnancy and neonatal abstinence syndrome are important public health concerns and also surrounded by stigma and potential legal ramifications. Public health reporting, surveillance, and linkage with services for these families can present ethical concerns that necessitate careful consideration. Clark County, Washington has made the framework and resources used by their Public Health Ethics Review Committee available publicly<\/a>, built on the 2002 Principles of the Ethical Practice of Public Health<\/a>. In 2019 APHA released an updated Public Health Code of Ethics<\/a>.<\/p>\n <\/p>\n \n [\/et_pb_accordion_item][et_pb_accordion_item title=”NAS Surveillance Funding Opportunity” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n Some jurisdictions currently conducting NAS surveillance have received funding through CDC as a part of the Notice of Funding Opportunity for Pregnant People\u2013Infant Linked Longitudinal Surveillance<\/a>, which closed in April 2023. A summary of this NOFO can be found within the informational call slides<\/a> and notes<\/a>.<\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Surveillance System Evaluation” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n Resources are available that outline a process for evaluating surveillance systems<\/a> as well as behavioral health surveillance systems<\/a>. Conducting a surveillance system evaluation can help a jurisdiction currently conducting surveillance for NAS identify the strengths and weaknesses of their processes, or using these evaluation tools as guides for consideration while setting up a new surveillance system can help ensure quality in implementation.<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Healthcare Cost and Utilization Project ” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/ncsacw.acf.hhs.gov\/files\/Collaborative_Approach_508.pdf” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n Healthcare Cost and Utilization Project<\/a>(HCUP): HCUP includes the largest collection of longitudinal hospital care data in the United States and is created by the Agency for Healthcare Research and Quality. As a part of their \u201cSpecial Emphasis\u201d Fast Stats Data Tool, HCUP provides data from 2009-2020 on the rate of NAS diagnoses per 1,000 newborn hospitalization by state.<\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”SAMHSA & ACF A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorder” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n <\/a>This extensive resource prepared by the Substance Abuse and Mental Health Services Administration and the Administration for Children and Families provides Practice and Policy Considerations for Child Welfare, Collaborating Medical and Service Providers. This includes a review of existing guidelines and policies as well as an overview of the Substance-Exposed Infants Framework.<\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Kansas Perinatal Quality Collaborative (KPQC) NAS Resources” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/kansaspqc.org\/resources\/nas-resources\/#toggle-id-4″ link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n <\/a>KQPC conducted a two-year initiative to partner with birthing centers across Kansas to improve health outcomes for infants born at risk for NAS. A description of this initiative and their monthly outcome measures are available here<\/a>. KQPC has assembled resources on breastfeeding and medication\/substance use, caring for the infant at risk for NAS, and caring for birthing parents\/family with substance use.<\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”CDC\u2019s Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET)” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.cdc.gov\/ncbddd\/set-net\/what-is-set-net.html” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n <\/a> SET-NET builds upon the US Zika Pregnancy and Infant Registry to collect health information on pregnant people and their infants to identify the impact of emerging health threats. Currently SET-NET collects information on COVID-19, hepatitis C, syphilis, Zika, and congenital cytomegalovirus (CMV). Jurisdictions participating in SET-NET may already have valuable knowledge and partnerships in place to support surveillance for NAS and subsequent referral of families to services.<\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Bexar County Mommies Toolkit” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/wp.uthscsa.edu\/nas-symposium\/introduction-to-the-mommies-toolkit\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n <\/a> Bexar County (San Antonio), Texas developed a Mommies Program to support families impacted by NAS. As part of the toolkit four online courses are available, including a free \u201cMommies Program Overview\u201d course that includes details about program design so that it can be replicated in other communities. Courses on substance use disorders, NAS, and integrated treatment programs are also available.\u00a0<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Illinois Perinatal Quality Collaborative Toolkit” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/ilpqc.org\/mothers-and-newborns-affected-by-opioids-neonatal-initiative\/#quick-start” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n <\/a> The ILPQC developed a toolkit based on their work to implement system-wide protocols and clinical culture changes to improve outcomes for opioid-exposed newborns.\u00a0<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Florida NAS Toolkit” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/health.usf.edu\/publichealth\/chiles\/fpqc\/nas\/~\/media\/E2C3217B2EB1416AAD0891069DAE5E38.ashx” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n <\/a>As a quality improvement initiative, Florida developed a collection of resources that may be adapted by local institutions in order to develop standardized protocols and processes for addressing NAS.<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Minnesota Perinatal Quality Collaborative Initiative Guide” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/minnesotaperinatal.org\/wp-content\/uploads\/2023\/05\/MOSTaRE-Program-Guide.pdf” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n A guide for birthing facilities partnering with the MNPQC on their initiative to increase the identification and treatment of substance use disorders (SUDs) in pregnant people and substance exposure in infants by 50% or more in order to improve pregnancy and postpartum outcomes, increase the use of non-pharmacologic methods for treating infants exposed to opioids and reduce the average length of stay for these infants.<\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Perinatal Substance Use Disorder Learning Collaborative” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.wsha.org\/perinatal-substance-use-disorder-learning-collaborative\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The Washington State Hospital Association and the Washington Department of Health collaborated to create a roadmap of suggested actions for hospitals to improve care for people who are pregnant or postpartum and have substance use disorder.<\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Project SCOPE ” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.uwyo.edu\/wind\/scope\/programs.html” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n Project SCOPE was a collaboration between the Wyoming Institute for Disabilities (WIND), University of Cincinnati Center for Excellence in Developmental Disabilities (UCCEDD), and The Ohio State – Nisonger Center. The purpose of this national initiative is to train interdisciplinary teams in targeted states on emerging knowledge and evidence-based practices in screening, monitoring and interdisciplinary care for children impacted by neonatal abstinence syndrome (NAS), trauma, or related exposure. This program ran from 2019-2022, but information on the model they utilized and outcomes are available on their website.<\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][\/et_pb_accordion][et_pb_divider color=”#2a3282″ divider_style=”dotted” divider_weight=”7px” _builder_version=”4.24.0″ _module_preset=”default” width=”69%” module_alignment=”center” custom_margin=”26px|||||” global_colors_info=”{}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ prev_background_color=”#ffffff” admin_label=”Events” _builder_version=”4.24.0″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” background_color=”#151f33″ min_height=”775.2px” custom_margin=”100px|||||” custom_padding=”0px||0|0px|false|false” top_divider_style=”wave” custom_width_px__hover=”1080px” custom_width_px__hover_enabled=”1080px” custom_width_percent__hover=”80%” custom_width_percent__hover_enabled=”80%” global_colors_info=”{}” gutter_width__hover=”3″ 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header_2_font_size_last_edited=”on|phone” locked=”off” inline_fonts=”Poppins” global_colors_info=”{}”]<\/p>\n <\/span><\/p>\n<\/div>\n<\/div>\n [\/et_pb_text][et_pb_accordion open_toggle_background_color=”rgba(0,0,0,0)” toggle_icon=”||fa||900″ icon_color=”#ffb856″ _builder_version=”4.24.0″ _module_preset=”406cfb42-b874-40c7-8445-70ada1219600″ toggle_text_color=”#FFFFFF” toggle_font=”Poppins|700|||||||” toggle_font_size=”20px” body_font=”Poppins||||||||” body_text_color=”#FFFFFF” text_orientation=”center” border_width_all=”2px” border_color_all=”#ffb856″ locked=”off” global_colors_info=”{%22gcid-86031d5b-0170-405c-b57e-166734aa8a67%22:%91%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22%93}”][et_pb_accordion_item title=”Standardizing the Clinical Definition of Opioid Withdrawal in the Neonate” open=”on” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.jpeds.com\/article\/S0022-3476(21)01227-0\/fulltext” link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n The U.S. Department of Health and Human Services worked collaboratively with clinicians and researchers to develop a standardized clinical case definition for neonatal opioid withdrawal syndrome (NOWS). This definition is for clinical practice and distinct from the CSTE standardized surveillance case definition for neonatal abstinence syndrome surveillance.<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”CDC Clinical Practice Guideline for Prescribing Opioids for Pain” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/rr\/rr7103a1.htm” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n This CDC guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged \u226518 years. Additional CDC resources for applying this guideline<\/a> are available.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”SAMHSA Shared Decision-Making Tool” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.samhsa.gov\/brss-tacs\/recovery-support-tools\/shared-decision-making” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The Substance Abuse and Mental Health Services Administration (SAMHSA) has a shared decision-making tool for Medication-Assisted Treatment (MAT) and Opioid Use Disorder.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”AAP NOWS Recovery-friendly Family-centered Pediatrics” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.aap.org\/en\/patient-care\/opioids\/maternal-infant-health-and-opioid-use-program\/recovery-friendly-pediatric-care\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The American Academy of Pediatrics has extensive resources for pediatricians on caring for the parent-infant dyad, including opioid use during pregnancy, planning for birthing parent and infant discharge, and community care coordination.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”AAP Recovery-Friendly Care for Families Affected by Opioid Use Disorder” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.aap.org\/Recovery-Friendly-Care-for-Families-Affected-by-Opioid-Use-Disorder” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n An American Academy of Pediatrics has a free online course.\u00a0 Pediatricians working with young children and families affected by opioid use often encounter challenges when initiating successful and sustainable practices in coordinating care for postpartum people with opioid use disorder (OUD), and infants diagnosed with neonatal opioid withdrawal syndrome (NOWS). This course aims to support community pediatricians and their teams in implementing recovery-friendly approaches and environments within the patient- and family-centered medical home framework.<\/em><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”ASAM E-Learning” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/elearning.asam.org\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The American Society of Addiction Medicine has an extensive online education platform with over 300 hours of accredited education. Courses are available that address the stigma affecting pregnant people with substance use disorder (SUD). Some courses relevant to substance use during pregnancy include:<\/p>\n This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses opioid use disorder treatment during pregnancy and in the post-pregnancy period.<\/em><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”AIM Patient Safety Bundles” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/saferbirth.org\/patient-safety-bundles\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The Alliance for Innovation on Maternal Health (AIM) has developed patient safety bundles for specific clinical conditions to support best practices that make birth safer. Patient safety bundles are collections of evidence-informed best practices, developed by multidisciplinary experts, which address clinically specific conditions in pregnant and postpartum people. Bundles encompass a variety of conditions, including one on the Care for Pregnant and Postpartum People with Substance Use Disorder<\/a>.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”AAP NOWS Resources and Infographics for Pediatricians” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.aap.org\/en\/patient-care\/opioids\/maternal-infant-health-and-opioid-use-program\/share-your-knowledge-neonatal-opioid-withdrawal-syndrome-nows\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n The American Academy of Pediatrics has developed communication tools and infographics centering on provider education, including infographics for pediatrician FAQs on the Plan of Safe Care and partnering with birthing parents to support their recovery.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Kansas Perinatal Quality Collaborative (KPQC) NAS Resources” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/kansaspqc.org\/resources\/nas-resources\/#toggle-id-4″ link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n KQPC has assembled resources on breastfeeding and medication\/substance use, caring for the infant at risk for NAS, and caring for birthing parents\/family with substance use. There are resources to describe best practices for identifying infants at risk for NAS, evaluating those infants for NAS, best practices for treatment of the dyad, and standardizing safe discharge and follow up.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Minnesota Hospital Association (MHA) Perinatal Substance Use” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/minnesotaperinatal.org\/wp-content\/uploads\/2022\/05\/MHA-Perinatal_Substance_Use_road_map.pdf” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n MHA has created a roadmap to provide hospitals and health systems with evidence-based recommendations and standards for the development of perinatal substance use prevention and quality improvement programs.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”AAP Pediatrics on Call Podcast, Acknowledging Stigma and Embracing Empathy When Treating Neonatal Opioid Withdrawal Syndrome” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.aap.org\/en\/pages\/podcast\/acknowledging-stigma-and-embracing-empathy-when-treating-neonatal-opioid-withdrawal-syndrome\/” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n In this episode Kenneth Zoucha, MD, FAAP, a recognized leader in addiction medicine for the state of Nebraska, talks about the stigmas around substance use disorder and neonatal opioid withdrawal syndrome. Hosts David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, also talk to Tamela Milan-Alexander, MPPA, about her history with opioid use disorder, which led to a high-risk pregnancy, and her subsequent advocacy for mothers and their babies.<\/em><\/p>\n [\/et_pb_accordion_item][\/et_pb_accordion][et_pb_divider color=”#FFFFFF” divider_style=”dotted” divider_weight=”7px” _builder_version=”4.24.0″ _module_preset=”default” width=”69%” module_alignment=”center” custom_margin=”26px|||||” global_colors_info=”{}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Blog” _builder_version=”4.16″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” custom_padding=”||0px|3px||” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text module_id=”cer” _builder_version=”4.24.0″ _module_preset=”default” text_font=”Poppins||||||||” text_font_size=”23px” text_line_height=”1.8em” header_font=”||||||||” header_font_size=”42px” header_2_font=”Noto Serif||||||||” header_2_font_size=”40px” header_2_line_height=”1.4em” custom_margin=”||4px|||” animation_style=”fade” header_2_font_size_tablet=”30px” header_2_font_size_phone=”24px” header_2_font_size_last_edited=”on|phone” locked=”off” inline_fonts=”Poppins” global_colors_info=”{}”]<\/p>\n Many organizations and jurisdictions have developed resources for education and outreach for families affected by NAS, pregnant people, and healthcare professionals providing care for pregnant people with substance use disorder. Below are some examples of different types of resources used across the country. If you have resources you\u2019d like to share with the surveillance community on this page.<\/span><\/p>\n <\/span><\/p>\n<\/div>\n<\/div>\n [\/et_pb_text][et_pb_accordion open_toggle_text_color=”#2a3282″ open_toggle_background_color=”rgba(0,0,0,0)” closed_toggle_text_color=”#2a3282″ toggle_icon=”||fa||900″ icon_color=”#2a3282″ _builder_version=”4.24.0″ _module_preset=”406cfb42-b874-40c7-8445-70ada1219600″ toggle_text_color=”#FFFFFF” toggle_font=”Poppins|700|||||||” toggle_font_size=”20px” body_font=”Poppins||||||||” body_text_color=”#2a3282″ text_orientation=”center” border_width_all=”2px” border_color_all=”#2a3282″ locked=”off” 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title=”Example Family Guides” open=”on” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}”]<\/p>\n Ohio Perinatal Quality Collaborative NOWS Family Guide<\/a><\/p>\n Pennsylvania Department of Health NAS Family Guide<\/a><\/p>\n <\/p>\n \n [\/et_pb_accordion_item][et_pb_accordion_item title=”Example Patient Handouts” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n Rhode Island Department of Health Palm Card<\/a><\/p>\n Rhode Island Department of Health Tri-Fold Brochure<\/a><\/p>\n Maryland Department of Human Services Tri-Fold Brochure<\/a><\/p>\n California Department of Public Health Tri-Fold Brochure<\/a><\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Example Posters” _builder_version=”4.24.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n Substance Abuse and Mental Health Services Administration Poster<\/a><\/p>\n AAP NOWS Stigma & Language Infographic<\/a><\/p>\n AAP NOWS Family-Centered Care Infographic<\/a><\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Example Provider Handouts” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/ncsacw.acf.hhs.gov\/files\/Collaborative_Approach_508.pdf” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n Rhode Island Department of Health Provider Handout<\/a><\/p>\n ASTHO Supporting Pregnant and Postpartum Women with Opioid Use Disorder: An Infographic Series<\/a><\/p>\n <\/p>\n <\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ prev_background_color=”#ffffff” admin_label=”Events” _builder_version=”4.24.0″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” background_color=”#151f33″ min_height=”775.2px” custom_margin=”-242px|||||” custom_padding=”0px||0|0px|false|false” top_divider_style=”wave” 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header_font_size=”42px” header_2_font=”Noto Serif||||||||” header_2_font_size=”40px” header_2_line_height=”1.4em” custom_margin=”||4px|||” custom_padding=”1px|||||” animation_style=”fade” header_2_font_size_tablet=”30px” header_2_font_size_phone=”24px” header_2_font_size_last_edited=”on|phone” locked=”off” inline_fonts=”Poppins” global_colors_info=”{}”]<\/p>\n <\/span><\/p>\n<\/div>\n<\/div>\n [\/et_pb_text][et_pb_accordion open_toggle_background_color=”rgba(0,0,0,0)” toggle_icon=”||fa||900″ icon_color=”#ffb856″ _builder_version=”4.24.0″ _module_preset=”406cfb42-b874-40c7-8445-70ada1219600″ toggle_text_color=”#FFFFFF” toggle_font=”Poppins|700|||||||” toggle_font_size=”20px” body_font=”Poppins||||||||” body_text_color=”#FFFFFF” text_orientation=”center” border_width_all=”2px” border_color_all=”#ffb856″ locked=”off” global_colors_info=”{%22gcid-86031d5b-0170-405c-b57e-166734aa8a67%22:%91%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22,%22toggle_text_color%22%93}”][et_pb_accordion_item title=”CAPTA, CARA, and Surveillance” open=”on” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.cwla.org\/hhs-issues-guidance-on-capta-safe-care\/” link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n The Child Abuse Prevention and Treatment Act (CAPTA) was originally enacted in 1974 and is the key source of federal funding and guidance to states in support of prevention, assessment, investigation, prosecution, and treatment activities relating to child abuse and neglect. One of the most recent amendments to CAPTA was the Comprehensive Addiction and Recovery Act (CARA). CARA was the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic in a coordinated response\u2014prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. These recent amendments are intended to promote better health practices for people with OUD and substance use disorders and their children, including, timely access and engagement in treatment, prenatal care, consistent and non-biased drug screening, and supportive plans of safe care (are housing and supports available, medication for treatment of OUD, adequate pain medication, etc.) for birthing parents and newborns. Additional policy considerations are outlined by SAMHSA in their publication \u201cA Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders<\/a>\u201d. Epidemiologists should be aware that definitions of substance use may differ from the standardized surveillance definitions in this position statement and ICD-10-CM diagnosis codes and could result in conflicting reports of NAS incidence.<\/p>\n Epidemiologists should be aware of their state regulations stemming from the CARA amendments to CAPTA that set forth the state procedures for these interventions. Although substance dependence is a chronic disease, stigma and bias among healthcare providers can result in both under-reporting of substance use and insufficient medication dosing, which often leads to delayed or ineffective treatment. In addition, at least 18 states classify maternal drug use as child abuse, and 3 other states consider it as reason for involuntary hospitalization<\/a>, disincentivizing pregnant people from seeking treatment. Birthing parents who are allowed to stay with their children<\/a> during treatment are more likely to start treatment and maintain abstinence<\/a>.<\/p>\n <\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”Neonatal Abstinence Syndrome: A Critical Role for Medicaid in the Care of Infants” _builder_version=”4.24.0″ _module_preset=”default” link_option_url=”https:\/\/www.medicaid.gov\/sites\/default\/files\/federal-policy-guidance\/downloads\/cib060818.pdf” link_option_url_new_window=”on” global_colors_info=”{}” open=”off”]<\/p>\n Coverage for newborns and Medicaid-eligible birthing parents of newborns with NAS is described in this informational bulletin. Some pregnant people and newborns may have private insurance coverage that covers all of their care and others may be underinsured and have the benefit of dual coverage. In the event the birthing parent of a newborn with NAS is not Medicaid-eligible, the newborn and, in some cases, the birthing parent of the newborn, may be eligible for certain services under the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. As of 2020, CMS coverage policies ensure some form of MAT<\/a> across all CMS programs.<\/p>\n [\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Blog” _builder_version=”4.16″ _module_preset=”2f9ba0d6-901e-4fe6-bc73-dd2b0141f7ba” custom_padding=”||0px|3px||” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text module_id=”pub” _builder_version=”4.24.0″ _module_preset=”default” text_font=”Poppins||||||||” text_font_size=”23px” text_line_height=”1.8em” header_font=”||||||||” header_font_size=”42px” header_2_font=”Noto Serif||||||||” header_2_font_size=”40px” header_2_line_height=”1.4em” custom_margin=”||4px|||” animation_style=”fade” header_2_font_size_tablet=”30px” header_2_font_size_phone=”24px” header_2_font_size_last_edited=”on|phone” locked=”off” inline_fonts=”Poppins” global_colors_info=”{}”]<\/p>\n Brennan J, Wiedeman C, Dunn JR, Schaffner W, Jones TF. Surveillance, Epidemiology, and Estimated Burden of Neonatal Abstinence Syndrome, Tennessee, 2013-2016. Public Health Reports. 2019;134(5):537-541. doi:<\/span>10.1177\/0033354919867718<\/a><\/p>\n Chiang KV, Okoroh EM, Kasehagen LJ, Garcia-Saavedra LF, Ko JY. Standardization of State Definitions for Neonatal Abstinence Syndrome Surveillance and the Opioid Crisis. Am J Public Health. 2019;109(9):1193-1197. doi:<\/span>10.2105\/AJPH.2019.305170<\/a><\/p>\n Doherty KM, Scott TA, Morad A, et al. Evaluating Definitions for Neonatal Abstinence Syndrome. Pediatrics. 2021;147(1):e2020007393. doi:<\/span>10.1542\/peds.2020-007393<\/a><\/p>\n Elmore AL, Tanner JP, Lowry J, et al. Diagnosis Codes and Case Definitions for Neonatal Abstinence Syndrome. Pediatrics. 2020;146(3):e20200567. doi:<\/span>10.1542\/peds.2020-0567<\/a><\/p>\n Goyal S, Saunders KC, Moore CS, et al. Identification of Substance-Exposed Newborns and Neonatal Abstinence Syndrome Using ICD-10-CM – 15 Hospitals, Massachusetts, 2017. MMWR Morb Mortal Wkly Rep. 2020;69(29):951-955. Published 2020 Jul 24. doi:<\/span>10.15585\/mmwr.mm6929a2<\/a><\/p>\n Jilani SM, Frey MT, Pepin D, et al. Evaluation of State-Mandated Reporting of Neonatal Abstinence Syndrome \u2014 Six States, 2013\u20132017. MMWR Morb Mortal Wkly Rep 2019;68:6\u201310. doi:<\/span>http:\/\/dx.doi.org\/10.15585\/mmwr.mm6801a2<\/a><\/p>\n Jilani, S.M., Jordan, C.J., Jansson, L.M. et al. Definitions of neonatal abstinence syndrome in clinical studies of mothers and infants: an expert literature review. J Perinatol 2021;41:1364\u20131371. doi:<\/span>https:\/\/doi.org\/10.1038\/s41372-020-00893-8<\/a><\/p>\n Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of Neonatal Abstinence Syndrome \u2014 28 States, 1999\u20132013. MMWR Morb Mortal Wkly Rep 2016;65:799\u2013802. doi:<\/span>http:\/\/dx.doi.org\/10.15585\/mmwr.mm6531a2<\/a><\/p>\n Ko JY, Wolicki S, Barfield WD, et al. CDC Grand Rounds: Public Health Strategies to Prevent Neonatal Abstinence Syndrome. MMWR Morb Mortal Wkly Rep 2017;66:242\u2013245. doi:<\/span>http:\/\/dx.doi.org\/10.15585\/mmwr.mm6609a2<\/a><\/p>\n Krause KH, Gruber JF, Ailes EC, et al. Assessment of Neonatal Abstinence Syndrome Surveillance – Pennsylvania, 2019. MMWR Morb Mortal Wkly Rep. 2021;70(2):40-45. Published 2021 Jan 15. doi:<\/span>10.15585\/mmwr.mm7002a3<\/a><\/p>\n Lind JN, Ailes EC, Alter CC, et al. Leveraging Existing Birth Defects Surveillance Infrastructure to Build Neonatal Abstinence Syndrome Surveillance Systems – Illinois, New Mexico, and Vermont, 2015-2016. MMWR Morb Mortal Wkly Rep. 2019;68(7):177-180. Published 2019 Feb 22. doi:<\/span>10.15585\/mmwr.mm6807a3<\/a><\/p>\nFor Clinical Providers<\/span><\/h2>\n
\n
<\/a>This 8-hour on-demand workshop is designed for providers relatively new to the field of addiction medicine, such as primary care physicians, clinicians, nurse practitioners, physician assistants, and behavioral health specialists, who see patients at risk for or with addiction.<\/em><\/li>\n
<\/a>This 8-hour, online course provides the education that is essential for providers to identify, assess, diagnose, and manage pregnant and postpartum patients with opioid use disorder (OUD).<\/em><\/li>\n
<\/a>Moving Beyond the Barriers of Treating Opioid Use Disorder provides a deep dive into implementing office-based treatment for opioid use disorder. This case-based, interactive, on-demand course addresses moving beyond common barriers that prevent qualified clinicians from successfully treating patients with OUD.<\/em><\/li>\n
<\/a>This 30-minute, on-demand session from the ASAM 2023 Review Course discusses substance-related treatment for pregnant or post-partum patients and newborns.<\/em><\/li>\n\n
<\/a>This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses the new Supportive Pregnancy Care Model COMPASSION and opportunities for providers to be a champion for the health of parents with SUD and their babies.<\/em><\/li>\n
<\/a>This one hour on-demand journal article examines about stigma towards substance use in pregnancy.<\/em><\/li>\n
<\/a>This 75-minute on-demand session from the ASAM 54th Annual Conference addresses how the medical system interacts with the child welfare system.<\/em><\/li>\n
<\/a>This 1-hour on-demand session from ASAM Virtual 2021 addresses patient’s reproductive health as there are an increasing number of reproductive age patients with SUDs who are having higher rates of unintended pregnancy and lower rates of contraception use.<\/em><\/li>\n
<\/a>This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses care and outcomes in pregnant and postpartum individuals using methamphetamines in pregnancy.<\/em><\/li>\n
<\/a>This 1-hour, on-demand session from the ASAM 53rd Annual Conference provides a person-centered perspective on the current evidence and evidence gaps about cannabis use in pregnancy.<\/em><\/li>\n
<\/a>This 45-minute, on-demand session from the ASAM 2022 Review Course provides an overview of complex ethical and legal issues when treating substance use disorder and other co-occurring disorders as well as issues surrounding criminal justice, impaired professionals, minors, and pregnant women.<\/em><\/li>\n<\/ul>\nCommunity Education Resources<\/span><\/h2>\n
Policy Resources<\/span><\/h2>\n
Publications<\/span><\/h2>\n