Moderator:

 

Presenters:

Melinda Campopiano, MD, Chief Medical Officer, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration

Susan Ford, MSN, RN, CPNP, State Quality Improvement Coordinator-Ohio Perinatal Quality Collaborative
Stephen Patrick, MD, MPH, MS, Assistant Professor of Pediatrics and Health Policy, Division of Neonatology, Vanderbilt University School of Medicine
Maggie Schroeder, MA, LCADC, Adult Substance Use and Recovery Services Branch Manager, Kentucky Department for Behavioral Health
Ruth Ann Shepherd, MD, FAAP, Former Director of Maternal and Child Health, Kentucky Department for Public Health
Scott Wexelblatt, MD, Regional Medical Director for Newborn Services, Cincinnati Children's Hospital Medical Center

 

Moderator:

Carla S. Saunders, NNP-BC, Advance Practice Coordinator, Pediatrix Medical Group, Neonatal Nurse Practitioner, East Tennessee Children's Hospital and Member, National Rx Drug Abuse & Heroin Summit Advisory Board

 

Neonatal Abstinence Syndrome (NAS) is a constellation of symptoms that can occur in a newborn who is exposed to an opioid while in the mother’s womb. The exposure may be from illicit drug use, misuse of Rx opioids or medication-assisted treatment with methadone or buprenorphine. The National Institute on Drug Abuse reported a five-fold increase from 2000 to 2012 in the proportion of babies born with NAS — equivalent to one baby suffering from opiate withdrawal born every 25 minutes. The immediate and long-term consequences are significant. With an average hospital stay of 16.9 days for NAS newborns, this alone costs hospitals an estimated $1.5 billion a year. An intense effort is underway by clinicians, researchers and social service professionals to develop effective responses. In this workshop, leading experts will examine strategies for management of pregnant women with opioid use and identification and management of the infant at risk for NAS. The use of innovative interdisciplinary collaborative care management teams to improve immediate and long-term outcomes for mothers and babies will be discussed.

 

Dr. Melinda Campopiano and Dr. Stephen Patrick will present recommendations for reducing and treating NAS in infants of mothers with opioid use disorder (OUD), based on a clinical guide being developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) for providers, program directors and policymakers. Effective treatments are available to improve outcomes for the infant, but clinical evidence from randomized controlled trials is limited. To develop recommendations, SAMHSA implemented the RAND/UCLA Appropriateness Method (RAM). Using current scientific evidence and clinical judgment, expert panel members rated the appropriateness of clinical scenarios describing a patient and potential procedure for treatment. The presenters will outline the panel’s conclusions. They also will address using collaborative care techniques to enhance the prenatal and postnatal care for the mother and infant.

 

Dr. Scott Wexelblatt and Ms. Susan Ford will present findings from the Ohio Statewide Quality Collaborative to improve treatment of infants with NAS. They will describe their multisite, interrupted time-series quality improvement (QI) initiative among 54 NICUs over a 21-month intervention period. They will conclude that the statewide QI collaborative showed that standardized training for neonatal nurses in scoring abstinence symptoms, and trauma-informed care, together with standardized non-pharmacologic and pharmacologic bundles, reduced the duration of opiate exposure and hospital stay in a large number of opioid exposed newborns. Other states and institutions treating opioid exposed infants may benefit from the adoption of these practices.

 

Dr. Ruth Ann Shepherd and Ms. Maggie Schroeder will present Kentucky’s multi-disciplinary approach to support infants diagnosed with NAS and their mothers after discharge from the hospital. The federal Child Abuse Prevention and Treatment Act requires states to have policies and procedures to implement and monitor multidisciplinary plans of safe care for infants who were exposed prenatally to alcohol and other drugs. Kentucky is piloting a “Plan of Safe Care” to identify and provide services and supports to the mother and infant, as well as deliniate who is responsible for ensuring that the mother is able to and does access those services and supports. Presenters will detail the plan, which strives to stabilize the mother in the post-partum period, provide ongoing supports for positive parenting and a safe home environment, create opportunities to reduce adverse childhood experiences, thereby improving long-term outcomes, and reduce the risks of repeating the cycle of substance abuse as the infant grows.  

 

 

Title: Gone Viral: Protecting Children in the Opioid Crisis

 

 

Deborah Augustine, National Victim Witness Program Manager, U.S. Drug Enforcement Administration

Paula Beverly, Investigator, Columbiana County (OH) Children’s Services

John Lane, Chief of Police, East Liverpool (OH) Police Department

Josh Lytle, Vice President, Family Care Excellence, Inc.

 

Moderator: Dave Hamby, National Coordinator, National Emerging Threats Initiative

 

In September 2016, the City of East Liverpool, Ohio, released a photo that went viral. It showed a four-year-old boy in the backseat of a car with two adults, who had passed out from heroin overdoses in the front seat. The boy became a face for the thousands of children across America who are endangered by the nation’s opioid crisis. Law enforcement and child protection agents see these faces every day, but the photo attracted the public’s attention to the crisis, including Time magazine publishing a video highlighting the story.

 

This interactive workshop will explore how law enforcement, child protection agencies and other community partners can partner to care for these children. The audience will be invited to comment and work together toward practical solutions.

 

A national expert on drug endangered children will provide the big picture on how the Rx drug abuse and heroin epidemic is impacting children and families and recommend response strategies for law enforcement officers. Her presentation will review current drug trends in relation to the risk to a child resulting from a parent or caregiver’s illicit drug use, manufacturing, distribution or cultivation and non-medical use of Rx drugs. The presenter will raise awareness of key issues, emphasize the importance of collaboration and identify essential tools to safeguard children.

 

Next, the East Liverpool case study will be presented. After viewing the Time video, presenters from East Liverpool will provide more details about the incident. They will discuss the lessons they learned and the challenges they still face. They will describe the collaborative relationship between the police department and children’s services agency, as well as the police department and a faith-based training center. The final presenter’s personal testimony will illustrate that a police interaction can be the turning point away from addiction.