Associate Editor Dr. Phyllis Dennery offers a preview of a State-of-the-Art Review being early released this week from our August issue.
|Photo by ceejayoz via Wikimedia Commons|
The State of the Art review by Dr. Kocherlakota (doi: 10.1542/peds.2013-3524) artfully reminds us of the significant changes that have occurred around the problem of neonatal abstinence syndrome.
What was thought to be an urban problem of female heroin users or users in methadone programs is now a much bigger and growing problem. In many instances, the abused drug is one that was prescribed or obtained through unscrupulous providers or “pill mills”, and the problem is expanding into rural as well as suburban communities with easy access to such drugs. This makes it difficult for practitioners to appropriately treat the infant because it is often not clear if drugs are used in combinations that may modify symptoms and therapeutic approaches.
In addition, lengths of stay are getting longer because we fear the consequences of rapid weaning. It will be important to adopt management guidelines that allow for judicious use of resources so as to arrive at best outcomes. Perhaps, in the vein of personalized medicine, we will also need to tailor our approaches to the drug(s) abused.