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As PA Hospitals Adopt Solutions to Address Opioid Crisis, Report Shows Impacts of Neonatal Abstinence Syndrome

March 28, 2018

During 2016, 13 Pennsylvanians died each day from overdoses—a rate four times higher than traffic accident deaths during the same time period. While hospitals across the commonwealth have worked with state and local governments and organizations to coordinate a response to the opioid crisis, Pennsylvania has one of the highest rates of drug overdoses in the country. The crisis touches all populations, even Pennsylvania’s youngest patients: newborns.

The Pennsylvania Health Care Cost Containment Council (PHC4) today released a brief regarding Hospitalizations for Newborns with Neonatal Abstinence Syndrome. Neonatal abstinence syndrome (NAS) is a combination of clinical symptoms exhibited by a newborn as a result of the sudden withdrawal of fetal exposure to a substance, in this case opioids, which was used or abused by the mother.

The brief’s key findings include:

  • During fiscal year (FY) 2017, Pennsylvania hospitals saw more than 1,900 newborn stays related to NAS
     
  • Cases of NAS have spiked 1,000 percent since FY 2000
     
  • Newborns with NAS also experienced longer hospital stays and higher rates of complications including premature birth, low birth weight, difficulty feeding, and respiratory distress
     
  • White, non-Hispanic newborns experienced the highest rates of NAS

Pennsylvania’s hospital community has long held that substance use disorder/opioid use disorder is not a moral failing, but rather a chronic medical condition that requires both physical and behavioral health treatments. Pennsylvania’s hospital community is engaging in a variety of industry-wide and facility-specific initiatives to help address the opioid epidemic, including:

  • Coordinating with county organizations to effectively transition patients from the emergency department to a treatment facility
     
  • Employing prescription guidelines
     
  • Implementing medically assisted treatment protocols

Pennsylvania hospital community is committed to working with families affected by NAS by offering integrated, specialized treatment plans for mother and baby. HAP serves on Pennsylvania’s Multidisciplinary Workgroup on Infant Substance Exposure (MDWISE), which brings together a wide range of community stakeholders, health care and substance use treatment providers, state and county courts, law enforcement, and child protective and social service agencies to work collaboratively to minimize prenatal substance exposure and improve social and health outcomes for infants, children, and families. 

Additionally, numerous Pennsylvania hospitals—particularly those with obstetric units—offer initiatives catered to treating mothers and infants affected by the opioid crisis, including:

  • UPMC Magee-Women’s Hospital provides mothers and babies with services that prioritize mother-infant bonding, individualized care plans, and behavioral health integration.
     
  • Allegheny Health Network’s CenteringPregnancy model provides close monitoring of mothers and infants with NAS. In partnership with the Children’s Institute of Pittsburgh, it sponsors the Fresh Start program to provide three years of services including screenings and therapies to foster crucial early childhood development.
     
  • Crozer-Chester Medical Center, part of Crozer Keystone Health System, serves as Pennsylvania’s first Center of Excellence specifically geared to mothers and infants. Its PEARL program, in partnership with Keystone First, offers expectant mothers and babies integrated physical and behavioral health care, as well as social services, from the perinatal stage until the child’s second birthday.
     
  • Jefferson Health’s Nemours/Alfred I. DuPont Hospital for Children provides a neonatal intensive care unit for babies, and its physicians have developed methods to cut by half the duration of NAS treatment. Jefferson’s Maternal Addiction Treatment Education & Research (MATER) program provides mothers and babies comprehensive treatment in both outpatient and residential settings. MATER’s specialized treatment offerings can include nutrition, counseling, screenings, and art therapy.
     
  • Reading Hospital, part of Tower Health, serves as a Center of Excellence, and its neonatal intensive care unit provides specialized NAS treatment and post-discharge care plans for infants with special needs for the first two years of their lives.

During January, Governor Tom Wolf declared the heroin and opioid crisis a public health crisis. Pennsylvania hospitals applauded this decision and reaffirmed their long-standing commitment to collaborating with state government and community organizations to foster recovery and work to end the crisis.

As outlined in HAP’s news release, HAP continues to call on policymakers to provide funding for appropriate inpatient and outpatient treatment facilities, including telemedicine services and the broadband access that powers them. Additionally, HAP urges Congress to provide the resources needed to help the U.S. Department of Health and Human Services continue its research into the effects of NAS, and implement the resulting recommendations.

For additional information about HAP’s work to address the opioid crisis, contact Michael Consuelos, M.D., senior vice president, clinical integration. For additional information about HAP’s legislative advocacy, contact Scott Bishop, senior vice president, legislative advocacy. For additional information about HAP’s participation in Pennsylvania’s MDWISE, contact Jennifer Jordan, vice president, regulatory advocacy.

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