O pioids , Suboxone And Newborn Abstinence Syndrome: The Link

Neonatal Abstinence Syndrome is a common illness that develops when a baby becomes accustomed to opioids while in the mother's body during pregnancy.

12/27/20224 min read

Neonatal Abstinence Syndrome (NAS) is a condition that affects newborns.

Neonatal Abstinence Syndrome is a common illness that develops when a baby becomes accustomed to opioids while in the mother's body during pregnancy. Irritability, trouble feeding, reflux or vomiting, diarrhea, sneezing, stuffy nose, or yawning will occur a few days (2-4 days) after the baby is delivered and outside of mom's body, similar to symptoms adults experience when withdrawing from opiates. This is frequent, with 30-80% of newborns exposed to opioids during pregnancy experiencing it. This can happen if the mother uses opioids on a regular basis, including illegal drugs, prescription pharmaceuticals, and/or opioid addiction treatment treatments. The following is a list of these opioids.

Opiates, both prescription and illicit
  • Heroin

  • Fentanyl

  • Oxycodone/Percocet

  • Hydrocodone/Vicodin

  • Codeine

  • Morphine

  • Dilaudid

  • Ultram/Tramadol

Treatments for opioid addiction that are based on scientific evidence (MAT)
  • Naloxone/buprenorphine (Suboxone)

  • Methadone

NAS is regarded as EXPECTED, RARE, and TREATABLE.

What is the treatment for NAS?

The nursery staff will keep a watchful eye on your infant. For monitoring purposes, your baby will need to stay in the hospital for at least 5-7 days following birth. Various monitoring tools are used by different nurseries. The Eat Sleep Console (ESC) tool and the Finnegan NAS tool are two examples.

Treatment with NAS

When your baby begins to retreat, there are several things that mom can do to help her child. Supportive care includes things like:

  • Breastfeeding is a method of nourishing a child (as long as no contraindications like HIV)

  • Skin-to-skin contact is when two people come into contact with each other.

  • Creating a low-stimulation, dark, and quiet environment

  • Swaddling

  • To decrease tension, provide frequent feedings.

When newborns experience more severe symptoms, medicines like morphine or methadone may be utilized. These will make your baby feel more at ease and will be gradually weaned off. **NAS symptoms may be exacerbated if mom additionally uses/takes nicotine, SSRIs (antidepressants), or benzodiazepines (medications like Klonopin, Xanax, Valium, and Ativan).

Should I use buprenorphine/naloxone (Suboxone) or methadone during pregnancy because they can trigger NAS?

Yes! For pregnant individuals with opioid addiction, medications for addiction therapy (MAT), such as buprenorphine/naloxone (Suboxone) and methadone, are considered first-line treatment and standard of care. Patients should assess the risks and benefits of each option before making a decision. There is a small yet possible risk of birth abnormalities when using MAT. The risk of not using MAT and continuing to use or relapse on illicit opioids, on the other hand, can destabilize mom and lead to dreadful outcomes such as overdose/death, spontaneous miscarriage, and intrauterine growth retardation (IUGR) in the baby. The American College of Obstetricians and Gynecologists (ACOG), a professional organisation that promotes evidence-based medicine, recommends treatment with buprenorphine/naloxone (Suboxone) and methadone for optimal health for both mom and baby.

The following are some recommendations for patients who are addicted to opioids:
  • It is suggested that people using buprenorphine/naloxone (Suboxone) or methadone maintain their MAT treatment during pregnancy.

  • It is suggested that individuals who are not currently on buprenorphine/naloxone (Suboxone) or methadone begin MAT during pregnancy.

In conclusion:
  • Buprenorphine/naloxone (Suboxone) or methadone are far safer for your newborn than heroin, fentanyl, or other non-prescribed opioids.

  • For optimal maternal and fetal health, MAT IS RECOMMENDED!

    Which treatment option is best for me if I have an opiate addiction? Should I take methadone or buprenorphine/naloxone (Suboxone) when pregnant?

This is unquestionably a personal choice that should be left to Mom. Both drugs are considered evidence-based, first-line, and standard-of-care treatments for opioid addiction and dependence while pregnant. According to new research, taking buprenorphine/naloxone (Suboxone) during pregnancy can result in shorter hospital stays and less drugs used to treat babies with neonatal abstinence syndrome (NAS).

While buprenorphine/naloxone (Suboxone) is typically provided in an outpatient setting with weekly to monthly prescriptions, moms who attend a methadone treatment may benefit from the extra structure and regularity. Pregnancy can be a particularly difficult time in a woman's life, regardless of which medicine she takes, and it will be critical for mom to look after her physical and mental health. Mom should seek out a complete program that includes therapy and drugs to support her mood symptoms (such as anxiety and depression), as well as access to other resources and programs, such as parenting and birthing classes, to help her gain confidence and best prepare her.

I've heard that if I use buprenorphine/naloxone (Suboxone) or methadone while pregnant, I'll be reported to the local child protection agency. Is that correct?

Yes, despite the benefits of being on MAT during pregnancy, health care practitioners are required to disclose being on this drug to child welfare groups since the infant is deemed "substance exposed." This means that the organization will be active in ensuring that mom stays in treatment and that her kid is raised in a safe and loving environment.

Other useful hints:
Consult your health care provider if you are pregnant or planning to get pregnant:
  • Tell your doctor about any medications or medicines you're using, including opioids.

  • Do not stop taking opioids without first consulting your doctor.

  • Ask your doctor about drugs for addiction therapy (MAT), such as buprenorphine/naloxone (Suboxone) and methadone, if you're taking opioids.

  • If you don't want to get pregnant, talk to your doctor about birth control options.

Summary and Messages to Take Home:

Neonatal abstinence syndrome (NAS) is a type of opioid withdrawal that occurs when newborns are born to mothers who are addicted to opioids (including opioid-abusing drugs such as buprenorphine/naloxone/Suboxone and methadone). In the nursery, babies with NAS symptoms are evaluated and treated with supportive care and, in some cases, drugs. For OPTIMAL results for both mom and baby, it is recommended that moms with opioid addiction get on or continue on MAT such as buprenorphine/naloxone (Suboxone) or methadone. Before, during, and after pregnancy, moms should seek comprehensive support that allows them to address their physical and emotional health care needs.