PATIENT EDUCATION
NEONATAL ABSTINENCE SYNDROME
What is Neonatal Abstinence Syndrome (NAS)? During pregnancy, your baby can become dependent on drugs (heroin, pain medications etc..) that you take before he/she is born. After birth, when your baby is no longer getting that drug, they may show signs of withdrawal. This is called NAS. Signs usually develop within a few hours to a few days of birth.
How do you know your baby has NAS? Common signs of withdrawal are: excessive crying, tremors, poor feeding/vomiting, unable to settle and sleep properly, sore red skin, loose bowel motions, and fever.
Can you breastfeed if your baby has NAS? Most of the time it is safe to breastfeed, but the drugs can pass through breast milk. Ask your OBGYN when it is time to breastfeed if it is safe.
Can your baby stay with you after birth? Usually your baby can remain with you after birth. Your baby will be checked with a Finnegan Scorecard for NAS signs and if the score is too high, the baby may need to be in a special nursery.
What are the treatments for NAS? Supportive care is important and involves cuddling, swaddling (wrapping up), rocking, and comforting your baby. If you are with your baby as much as possible you will be able to respond to their needs as much as possible. Often they are very hungry and want to feed a lot. If you are breastfeeding, you will be able to breastfeed whenever your baby wants to. If you are formula feeding you will be able to give your baby regular small feeds.
Medication is sometimes needed to help manage your baby’s withdrawal – morphine and/or phenobarbital are prescribed. The amount and frequency of medication depends on the severity of withdrawal. The medication is gradually decreased as the withdrawal subsides.
How long does your baby have to stay in the hospital? This depends on the types of drugs that caused the NAS. For some drugs, it is 3-5 days and for others it can be for a week or longer. Staying in hospital means your baby’s health can be closely monitored and medication can be given if needed. For further information and questions, direct these to your OBGYN.
LONG ACTING REVERSIBLE CONTRACEPTION
Implants and IUDs: Long acting reversible contraception (LARC) includes implants (ie Nexplanon) and intrauterine devices (IUDs), such as Mirena and ParaGard. Methods last between 3-12 years and prevent pregnancy over 99%. They are better at preventing pregnancy long term than oral contraceptives and they have high user satisfaction scores. They are safe for women who have not or have had children. Women are also more likely to achieve 18 months between pregnancy which decreases the risk of preterm birth, low birth weight, and infant mortality. National Addiction Specialists recommends that all women 18-44 years old consider using an implant or an IUD to prevent unwanted pregnancies.
PREVENTION AND TREATMENT OF HEPATITIS C AND HIV
Patients with substance use disorders have much higher rates of HIV and Hepatitis C (Hep C). They are commonly transmitted through shared needles and sex. If you would like to be tested or think you may have one of these, visit your local health department to be tested for free.
HEPATITIS C
General: Acute Hep C develops within 6 months of contracting Hep C and usually progresses to Chronic Hep C, which can lead to liver cirrhosis and liver cancer.
Symptoms of Hep C: none (most common), fever, fatigue, dark urine, abdominal pain, nausea, loss of appetite, joint pain, and yellow skin and eyes.
Prevention of Hep C: 1. Not sharing needles, toothbrushes, and razors. 2. Only using reputable tattoo shops and piercing shops. 3. Using condoms during sex.
Treatment of Hep C: There is no vaccine, but acute and chronic Hep C do have treatments, usually a combination of 2 antiviral medications. Treatment usually lasts 6-24 weeks. People with both HIV and Hep C need individualized treatment as Hep C treatment can interfere with HIV treatment.
HIV
General: HIV is not the same as AIDs. HIV is the virus that causes AIDs. AIDS occurs when HIV destroys your immune system and complications arise. There is no vaccine for HIV and no cure for it, but there are very good treatments to prevent AIDS. It is transmitted through blood, semen, vaginal fluids, and breast milk. HIV can be transmitted from a mother to her fetus and through breast milk. Symptoms: You may not have symptoms for many years. Symptoms are similar to the flu except they last longer and include: tiredness, unexplained fevers, recurring night sweats, enlarged lymph nodes, and weight loss. It can be transmitted even when you have no symptoms.
Prevention: 1. Don’t share needles 2. Use a condom during sex 3. Don’t get intoxicated prior to sex
Treatment: Current treatments are very effective and very safe and can lead to a long healthy life. Treatment doesn’t eliminate the virus, but keeps the amount of the virus low in the blood. This can help prevent AIDS and can help prevent passing it during sex. Treatments are usually 3 drugs called antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART) and involve 1-2 pills per day.
OVERDOSE PREVENTION STRATEGIES AND REVERSAL AGENTS (NALOXONE) STRATEGIES TO PREVENT OVERDOSE
Family Learning: Family should learn how to manage an overdose by learning how to use Naloxone and having it available.
Access To Treatment: Treatment of substance use disorders such as Suboxone with counseling can decrease the risk of overdose.
Access To Naloxone: Ensure ready access to Naloxone.
NALOXONE (NARCAN)
NARCAN (Naloxone) is sprayed into one nostril and has a 2nd dose available if the patient is not responsive afterwards from an OVERDOSE.
Naloxone rapidly reverses opioid overdose and can restore a person who has stopped breathing from an overdose by binding the receptor and blocking the effects of opioids like heroin. Nasal Spray is Narcan.
WE RECOMMEND ALL PATIENTS/FAMILIES SHOULD BUY, HAVE ACCESS TO AND LEARN HOW TO USE NALOXONE (NARCAN) AS IT COULD SAVE YOUR LIFE OR YOUR FAMILY MEMBER’S LIFE.
