Drs. Young and Devlin: Opportunities to ACT NOW for Infants with Neonatal Opioid Withdrawal Syndrome

Key Takeaways: 

• The opioid crisis has increased the number of infants who are exposed to opioids during pregnancy. Opioid-exposed newborns may develop symptoms of neonatal opioid withdrawal syndrome (NOWS), which includes tremors, excessive crying and irritability, and problems with sleeping and feeding.

• The care provided to infants with NOWS varies across hospitals, which is due in part to a lack of evidence to support a standard approach to care. A recent clinical trial provides evidence to support the use of the Eat, Sleep, Console (ESC) care approach, which provides a function-based assessment of withdrawal severity centered around how well an infant can eat, sleep, and be consoled. ESC prioritizes and emphasizes non-pharmacologic care, including increased family presence, holding, swaddling, and rocking in low-stimulus environments, as first-line treatment.

• Newborns cared for with ESC were medically ready for discharge approximately 6.7 days earlier on average, and they were 63% less likely to receive medication as part of their treatment when compared to newborns given the usual care.

This research was made possible because the NIH Helping to End Addiction Long-term^® Initiative brought together two existing networks of many institutions that specialize in pediatric research:

• ECHO’s Institutional Development Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN)
• The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network

Speakers:

Leslie W. Young, MD
University of Vermont
Larner College of Medicine

Speaker Bio: 

Leslie Young, MD is a practicing neonatologist at the University of Vermont Children’s Hospital and an associate professor of pediatrics in the Division of Neonatal-Perinatal Medicine at the Larner College of Medicine at the University of Vermont. Dr. Young’s research is currently focused on optimizing the care provided to infants following in-utero opioid exposure and on improving long-term outcomes for these infants and their families. She is involved in NIH HEAL Initiative^®-sponsored research programs including the Advancing Clinical Trials in Neonatal Opioid Withdrawal Collaborative, a collaboration between ECHO ISPCTN and the NICHD Neonatal Research Network. Dr. Young is a principal investigator for Improving Pediatric Access to Clinical Trials in Vermont, Vermont’s ISPCTN site, where she works to increase the representation of rural and underserved populations in clinical trials. Dr. Young completed her undergraduate studies in psychology at Creighton University before receiving her medical degree at the Larner College of Medicine at the University of Vermont.

Lori Devlin, DO, MHA, MS
University of Louisville School of Medicine

Speaker Bio: 

Dr. Lori Devlin is a practicing neonatologist with the Norton Children’s Medical Group and Professor of Pediatrics at the University of Louisville School of Medicine. Her research is focused on NOWS, and she is currently a lead study investigator for two NIH HEAL Initiative^®-supported multicenter randomized controlled trials. She is a Multiple Principal Investigator at the Kentucky ECHO IDeA States Pediatrics Clinical Trial Network site and at the HEAL Evaluation of Limited Pharmacotherapies for Neonatal Opioid Withdrawal Syndrome Consortium.

Date: Wednesday, September 13th, 1 to 2pm ET
Join Zoom Meeting- https://duke.zoom.us/j/91562266720?pwd=T1hUK0tPUkNvNFJHdGdaWTVpOVh5Zz09

Drs. Young and Devlin’s Slides