Skip to main content
SpringerLink
Log in

Opioid exposure in newborns: lessons learned from fetal alcohol spectrum disorder

  • Viewpoint
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

Abstract

The increasing incidence of opioid-exposed pregnancies in the United States is a concerning public health challenge. Analysis of the public health responses to prenatal alcohol exposure may inform future prevention and treatment strategies. Behavioral interventions, improved screening, and prenatal education may be effective measures to reduce prenatal exposure to opioids. Medicaid coverage should be expanded to cover substance misuse treatments for pregnant women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haight S, Ko J, Tong V, Bohm M, Callaghan W. Opioid use disorder documented at delivery hospitalization—United States, 1999–2014. MMWR Morb Mortal Wkly Rep. 2018;67(31):845–9.

    Article  Google Scholar 

  2. Kocherlakota P. Neonatal abstinence syndrome. Pediatrics. 2014;134(2):e547–61.

    Article  Google Scholar 

  3. Desai R, Hernandez-Diaz S, Bateman B, Huybrechts K. Increase in prescription opioid use during pregnancy among medicaid-enrolled women. Obstet Gynecol. 2014;123(5):997–1002.

    Article  Google Scholar 

  4. Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of neonatal abstinence syndrome—28 States, 1999–2013. MMWR Morb Mortal Wkly Rep. 2016;65:799–802. https://doi.org/10.15585/mmwr.mm6531a2.

    Article  Google Scholar 

  5. Teater D. Prescription drug report download | National Safety Council [Internet]. Safety.nsc.org. 2020. https://safety.nsc.org/painmedevidence.

  6. Boscarino J, Rukstalis M, Hoffman S, Han J, Erlich P, Gerhard G, et al. Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system. Addiction. 2010;105(10):1776–82.

    Article  Google Scholar 

  7. Wolff K, Perez-Montejano R. Opioid neonatal abstinence syndrome: controversies and implications for practice. Curr Drug Abuse Rev. 2014;7(1):44–58.

    Article  Google Scholar 

  8. Epstein R, Bobo W, Martin P, Morrow J, Wang W, Chandrasekhar R, et al. Increasing pregnancy-related use of prescribed opioid analgesics. Ann Epidemiol. 2013;23(8):498–503.

    Article  Google Scholar 

  9. Patrick S, Schumacher R, Benneyworth B, Krans E, McAllister J, Davis M. Neonatal abstinence syndrome and associated health care expenditures. JAMA. 2012;307(18):1934–40.

    Article  Google Scholar 

  10. Public Policy Office. Substance use during pregnancy. Guttmacher Institute. 2020. https://www.guttmacher.org/state-policy/explore/substance-use-during-pregnancy.

  11. Winkelman T, Villapiano N, Kozhimannil K, Davis M, Patrick S. Incidence and costs of neonatal abstinence syndrome among infants with medicaid: 2004–2014. Pediatrics. 2018;141(4):e20173520.

    Article  Google Scholar 

  12. Young N, Gardner S, Otero C, Dennis K, Chang R, Earle K et al. Substance-exposed infants: state responses to the problem. U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Administration for Children and Families, Atlanta. 2009.

  13. May PA, Chambers CD, Kalberg WO, Zellner J, Feldman H, Buckley D, et al. Prevalence of fetal alcohol spectrum disorders in 4 US Communities. JAMA. 2018;319(5):474–82. https://doi.org/10.1001/jama.2017.21896.

    Article  Google Scholar 

  14. Hackler C. Ethical, legal and policy issues in management of fetal alcohol spectrum disorder. J Arkansas Med Soc. 2011;108(6):123–4.

    Google Scholar 

  15. Floyd R, Decouflé P, Hungerford D. Alcohol use prior to pregnancy recognition11. Am J Preven Med. 1999;17(2):101–7.

    Article  Google Scholar 

  16. Popova S, Lange S, Probst C, Parunashvili N, Rehm J. Prevalence of alcohol consumption during pregnancy and fetal alcohol spectrum disorders among the general and aboriginal populations in Canada and the United States. Eur J Med Genetics. 2017;60(1):32–48. https://doi.org/10.1016/j.ejmg.2016.09.010.

    Article  Google Scholar 

  17. CDC. Fetal Alcohol Spectrum Disorders (FASDs) [Internet]. Centers for Disease Control and Prevention. 2020. https://www.cdc.gov/ncbddd/fasd/index.html.

  18. Subbaraman M, Thomas S, Treffers R, Delucchi K, Kerr W, Martinez P, et al. Associations between state-level policies regarding alcohol use among pregnant women, adverse birth outcomes, and prenatal care utilization: results from 1972 to 2013 vital statistics. Alcoholism. 2018;42(8):1511–7.

    Article  Google Scholar 

  19. Roberts S, Berglas N, Subbaraman M, Mericle A, Thomas S, Kerr W. Racial differences in the relationship between alcohol/pregnancy policies and birth outcomes and prenatal care utilization: a legal epidemiology study. Drug Alcohol Depend. 2019;201:244–52.

    Article  Google Scholar 

  20. Roberts S, Zahnd E, Sufrin C, Armstrong M. Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study. J Perinatol. 2014;35(2):146–50.

    Article  Google Scholar 

  21. Heberlein A, Leggio L, Stichtenoth D, Hillemacher T. The treatment of alcohol and opioid dependence in pregnant women. Curr Opin Psychiatry. 2012;25(6):559–64.

    Article  Google Scholar 

  22. Akbar M, Egli M, Cho Y, Song B, Noronha A. Medications for alcohol use disorders: an overview. Pharmacol Ther. 2018;185:64–85.

    Article  Google Scholar 

  23. Choate P, Badry D, MacLaurin B, Ariyo K, Sobhani D. Fetal alcohol spectrum disorder: what does public awareness tell us about prevention programming? Int J Environ Res Public Health. 2019;16(21):4229.

    Article  Google Scholar 

  24. Cil G. Effects of posted point-of-sale warnings on alcohol consumption during pregnancy and on birth outcomes. J Health Econom. 2017;53:131–55.

    Article  Google Scholar 

  25. Roberts S, Mericle A, Subbaraman M, Thomas S, Kerr W, Berglas N. Variations by education status in relationships between alcohol/pregnancy policies and birth outcomes and prenatal care utilization. J Public Health Manag Pract. 2020;26:S71–83.

    Article  Google Scholar 

  26. Roberts S, Pies C. Complex calculations: how drug use during pregnancy becomes a barrier to prenatal care. Matern Child Health J. 2011;15(3):333–41.

    Article  Google Scholar 

  27. Mangat A, Schmölzer G, Kraft W. Pharmacological and non-pharmacological treatments for the neonatal abstinence syndrome (NAS). Semin Fetal Neonatal Med. 2019;24(2):133–41.

    Article  Google Scholar 

  28. Ernst K, Makkar A. The opioid-exposed neonate: a review of the Oklahoma experience. J Okla State Med Assoc. 2019;111(8):768–74.

    Google Scholar 

  29. Kaltenbach K, O’Grady K, Heil S, Salisbury A, Coyle M, Fischer G, et al. Prenatal exposure to methadone or buprenorphine: early childhood developmental outcomes. Drug Alcohol Depend. 2018;185:40–9.

    Article  Google Scholar 

  30. House Bill No. 3104. Ownbey of the house and Griffin and Pittman of the Senate; State of Oklahoma. 2018.

  31. Drakulich A. A worldwide take on opioid prescribing and access [Internet]. Practical Pain Management. 2020. https://www.practicalpainmanagement.com/meeting-summary/worldwide-take-opioid-prescribing-access. Accessed 4 July 2020.

  32. World Health Organization. Guidelines for identification and management of substance use and substance use disorders in pregnancy [Internet]. Who.int. 2020. https://www.who.int/publications/i/item/9789241548731. Accessed 4 July 2020.

Download references

Author information

Authors and Affiliations

  1. Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW, Washington, DC, 20052, USA

    Forest Ogunyankin

Authors
  1. Forest Ogunyankin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Forest Ogunyankin.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ogunyankin, F. Opioid exposure in newborns: lessons learned from fetal alcohol spectrum disorder. J Public Health Pol 41, 529–534 (2020). https://doi.org/10.1057/s41271-020-00239-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/s41271-020-00239-w

Keywords

Search

Navigation