On “‘Choose Physical Therapy’ for Neonatal Abstinence Syndrome: Clinical Management for Infants Affected by the Opioid Crisis.” McCarty DB, Peat JR, O'Donnell S, Graham E, Malcolm WF. Phys Ther. 2019; 99;771–785

2020 ◽  
Vol 100 (6) ◽  
pp. 1040-1040
Author(s):  
Priti Kharel ◽  
Joshua Robert Zadro ◽  
Stephanie Mathieson ◽  
Christopher Maher
2019 ◽  
Vol 99 (6) ◽  
pp. 771-785 ◽  
Author(s):  
Dana B McCarty ◽  
Jennifer R Peat ◽  
Shannon O'Donnell ◽  
Elisabeth Graham ◽  
William F Malcolm

Abstract In response to the opioid crisis, the American Physical Therapy Association has strongly advocated for physical therapy as a safe alternative to pharmacological pain management through the “#ChoosePT” campaign and the dedication of a PTJ special issue to the nonpharmacological management of pain. Physical therapists not only play an important role in the rehabilitation of the nearly 2 million adolescents and adults addicted to prescription opioids but also provide care to infants born to mothers with various drug addictions. This Perspective article explores the incidence, pathophysiology, and risk factors for neonatal abstinence syndrome and describes the clinical presentations of withdrawal and neurotoxicity in infants. Discipline-specific recommendations for the physical therapist examination and plan of care, including pharmacological management considerations, are outlined. Nonpharmacological management, including supportive care, feeding, parent education, social aspects of care, and follow-up services, are discussed from a physical therapy perspective. Finally, this article reviews developmental outcomes in infants with neonatal abstinence syndrome and reflects on challenges and future directions of research in this area.


Author(s):  
Stephanie Nagy

The Government of Canada in 2016 officially declared the opioid crisis as a national public health emergency. 1As the opioid crisis continues to prevail, the number of expecting mother’s using opioids during their pregnancy is increasing, as well as complications associated with the infant’s health. Neonatal abstinence syndrome (NAS) occurs when the infant experiences withdrawal symptoms, such as hyperirritability, excessive crying and tremors after birth due to the in-utero drug exposure.  These withdrawal symptoms often interfere with infant’s ability to engage in oral feeds, and thus they receive their nutrients via tube feedings. 2 However, infants who are in the NICU must have achieve independent oral feeds before being discharged from the hospital. The concept of NAS infants having longer feeding times compared to other NICU infants has been a common assumption, but no research has sought out to quantitively prove this. This study will be conducted by a retrospective chart review and the participants will be infants with NAS who are in the NICU and require pharmacological interventions. This study group will be matched with a control group of infants, with respiratory distress syndrome, for birth age (1-week difference) and birth weight (≤500 g difference). Independent group t-tests will be conducted to determine if there is a statistically significant difference between the two groups in time to reach independent oral feeds and a Chi square test will be used to compare baseline demographics. References University of Wisconsin. (2015). Canada: Opioid consumption in morphine equivalence (ME), mg per person. Retrieved from http://www.painpolicy.wisc.edu/sites/www.painpolicy.wisc.edu/files/country_file s/morphine_equivalence/canada_me_methadone.pdf Velez, M., & Jansson, L.M. (2008). The opioid dependent mother and newborn dyad: non-pharmacologic care. Journal of Addiction Medicine, 2(3), 113-120. DOI: 10.1097/ADM.0b013e31817e6105


2019 ◽  
Vol 109 (9) ◽  
pp. 1193-1197 ◽  
Author(s):  
Katelyn V. Chiang ◽  
Ekwutosi M. Okoroh ◽  
Laurin J. Kasehagen ◽  
Luigi F. Garcia-Saavedra ◽  
Jean Y. Ko

2017 ◽  
Vol 22 (3) ◽  
pp. 148-152 ◽  
Author(s):  
Katie Murphy ◽  
Helen Coo ◽  
Ruth Warre ◽  
Vibhuti Shah ◽  
Kimberly Dow

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 197A-197A
Author(s):  
Katherine M. Somers ◽  
Ashley R. Taylor ◽  
Andrew Jung ◽  
Alfred Wicks ◽  
Andre A. Muelenaer

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