Public Health
Neonatology
Epidemiology & Health Services Pathway
Community Pediatrics
Advocacy Pathway
Adolescent Medicine
Ju Lee Oei, MBBS FRACP MD
Professor
Newborn Care
Royal Hospital for Women
Randwick, New South Wales, Australia
The scope of maternal drug use is staggering. In Western societies, at least 1 in 3 children under the age of 14 are estimated to live with a parent or caregiver using some form of drug of dependency. This accounts for more than 9 million children in the USA alone. Enormous attention has been placed on the consequences of maternal opioid use which can result in the Neonatal Opioid Withdrawal Syndrome (NOWS) or Neonatal Abstinence Syndrome (NAS), one of the fastest growing and costly public health epidemics in the world.
Mothers, however, use many other drugs besides opioids and their newborns can be affected by all of them. These drugs can be illegal (e.g. cocaine, methamphetamines), some are essential for maternal health (e.g. prescription medications), and others are an almost ubiquitous element of society (e.g. alcohol, tobacco, marijuana). The adverse consequences of these drugs are extensive, pervasive, and enduring. Not only is the individual child affected, but the family, society and even subsequent generations can be impacted by maternal drug use. At a societal level, maternal drug use is inextricably intertwined with profound economic, intergenerational, and perpetuating burden and harm. On an individual level, the drug-exposed infant is not only at risk of withdrawal but also of teratogenicity, epigenetic change, neurocognitive impairment, and poor adult outcomes (dependent on both prenatal exposures and postnatal environmental influences).
Efforts to minimize harm from parental drug use requires global, coordinated, and continuing efforts. This is especially true with regard to the impact of the current COVID-19 pandemic on maternal use of addictive substances and its relation to translation of research and practice to policies that have considerable potential to influence individuals, families, and whole communities around the globe. In this session, international clinical, research and policy experts will discuss the latest evidence and knowledge gaps in this area. We will discuss contemporary evidence from randomized controlled studies and observational and cohort studies, particularly focusing on NOWS and other drugs of addiction that may not cause classical signs of abstinence such as cannabis, cocaine and methamphetamines. We will also examine the rationale behind decision-making at clinical and policy levels for the care of children affected by parental drug use in the USA and around the world. We will discuss the long-term and including epigenetic and non-withdrawal implications of prenatal drug exposure and also the legal, societal and health implications of legal drugs of addiction such as alcohol, nicotine and prescription medications.
This session will emphasize the necessity of international collaboration and the consideration of other drugs besides opioids in the quest for improving the lives of children affected by maternal drug use especially in the current crisis of the COVID-19 pandemic
Presenter: Susan McCune, MD – Office of the Commissioner/ FDA
Presenter: Jonathan Davis, MD – Tufts Children's Hospital
Presenter: Stephen Patrick, MD, MPH, MS – Vanderbilt University
Presenter: Elizabeth J. Elliott, MD – University of Sydney
Presenter: Emmalee S. Bandstra, MD – University of Miami Miller School of Medicine
Presenter: Gerri Baer, MD – Food and Drug Administration
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