Annotated Bibliography

Annotated Bibliography Doctors are prescribing fewer drugs – how is this affecting the opioid epidemic? (2018). MedMark. Retrieved from https://medmark.com/doctors-are-prescribing-fewer-drugs-how-is-this-affecting-the-opioi d-epidemic/ In order to answer the question of how can NAS be prevented, it must first be determined how the dangerously increasing opioid epidemic can be stopped. This article discusses doctor's over-prescription of opioids to patients and its role in sparking and continuing this epidemic. This article not only identifies the root of the problem but also proposes solutions as to how doctors can prescribe less medication in order to decrease the diversion of drugs by following the CDC opioid prescription guidelines. This article and articles like it that identity how the opioid epidemic has surfaced and how it can be prevented are crucial to determining how NAS can be prevented, because the only way to stop NAS is to stop drug addiction in mothers. This research will be used in conjunction with research on prenatal medication and therapies in order to develop an answer for how NAS can be stopped in its tracks.

Egan, J. (2018). Children of the epidemic. The New York Times. Retrieved from http://go.galegroup.com/ps/i.do?p=GPS&sw=w&u=henrico&v=2.1&it=r&id=GALE%7 CA538324743&sid=classroomWidget&asid=236b9f3f This article tells the stories of multiple women addicted to opioids, focusing on the origins of their addiction, and their pregnancy/postpartum experience. In doing so, this article brings the opioid epidemic and NAS to life in a more understandable and relatable form, as told through the stories of feel people. Relating this research to real people will allow for the understanding of the humanity, emotion, and guilt behind the mothers of babies with NAS. This article is also unique in that is discusses the debate of whether addiction should be treated as a mental illness or as a criminal offense punishable by law. This article sparks curiosity as to how mothers who give birth to babies with NAS should be addressed legally.

Harris, S. (2018). Nursing interventions for neonatal abstinence syndrome. Scholars Week, 15. Retrieved from https://digitalcommons.murraystate.edu/cgi/viewcontent.cgi?referer=https://www.google. com/&httpsredir=1&article=1755&context=scholarsweek

This article was chosen in hopes to further understand what nurses can do to enhance the treatment and care of babies with NAS and their mothers. This article is interesting as it explains the importance of three different methods of intervention for NAS including breastfeeding, kangaroo care, and rooming-in. These three methods have been shown to improve patient outcomes as they foster a nonjudgmental environment that allows mothers and their babies to bond and heal together. These interventions break the stigma surrounding addicted mothers by recognizing the importance of mother-child bonding for infant development. This article is an abundant resource that will give valuable advice backed with research on how to exude compassion without judgement in regards to the mothers in order to make sure that the babies are recovering as quickly as possible.

Kocherlakota, P. (2014). Neonatal abstinence syndrome. Pediatrics, 134(2). Retrieved from https://pediatrics.aappublications.org/content/134/2/e547 One positive thing about this article is that it gives a comprehensive history of the opioid epidemic and how we have gotten to the position we are in now, as well as the change in treatments for NAS overtime. It is important to understand how neonatal medicine has evolved in order in order to continue to reach new heights in research and treatment. A controversial idea among Obstetricians, this article discusses the importance of breastfeeding among opioid addicted mothers and its benefits on a baby with NAS. Furthermore, the article reports follow-up procedures following a baby’s discharge to ensure the proper growth and support of the child, including neurodevelopmental and family support assessments. With the variety of angles and issues this article covers in regards to NAS, it will be an abundant resource for this research.

McQueen, K., & Murphy-Oikonen, J. (2016). Neonatal abstinence syndrome. The New England Journal of Medicine, 375, 2468-2479. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMra1600879 This article discusses the importance of not only treating those who are currently affected by NAS, but how to prevent opioid use in women of childbearing age and prevent the subsequent development of the neonatal abstinence syndrome. This can be through programs that monitor opioid-drug prescribing practices or the establishment of opioid dosage thresholds. One thing the article touches on is how to identity children at risk through maternal disclosure which requires a nonjudgmental and open-ended approach to interviewing all pregnant women. This will certainly contribute to the question about how to care for guilt stricken mothers and establish empathetic relationships with patients in order for the child and mother to receive trusted care. The bulk of the article discusses treatment options including pharmacologic treatment and the management of long-term symptoms. This will help to investigate the optimal care to ensure that babies with NAS are nursed back to health quickly and permanently.

Murphy-Oikonen, J., Brownlee, K., Montelpare,W., & Gerlach, K. The experiences of NICU nurses in caring for infants with neonatal abstinence syndrome. Neonatal Network, 29(5) 307-313. Retrieved from http://academyofneonatalnursing.org/NAS/ExperiencesNICU.pdf This article is very different from the others found thus far in that it focuses on the experiences of NICU nurses in caring for infants with neonatal abstinence syndrome. By seeking out the responses from fourteen different NICU nurses, the article reflects on the challenges faced by nurses when caring for infants with NAS, elaborated on themes of frustration and burnout, increased awareness of drug use in the community and at home, and challenges surrounding interactions with the mothers. This research will be used to thoroughly understand the challenges faced by NICU nurses and how they can be addressed through education of patience, knowledge, and commitment. While it is important to understand treatment methods and pharmacology, this research brings the emotion behind NAS to life, providing insight to the heart behind the treatment: nurses.

Summers, J. & Forman, J. (2018). Brief for amici curiae, the drug policy alliance, families for sensible drug policy. Drug policy. Retrieved from http://www.drugpolicy.org/sites/default/files/2018-05-03_dpabrieffinal_0.pdf Throughout the research thus far, there have been a few articles that briefly mention the stigma of mothers with addiction as well as legal punishments, but none of these article have given an in depth perspective behind whether pregnant woman with opioid addictions should be punished by law. This source was intriguing as it is an amicus curiae that provides an argument as to why pregnant women should NOT be punished for addiction but rather receive rehabilitation. The argument presents valid information on the stigma of drug-abuse that deters pregnant woman from seeking out prenatal care and being honest with their physicians, thus compromising the neonates’ health. In addition, the authors argue that punishments reinforce this stigma and no not deter nor rehabilitate individuals with substance abuse, thus prolonging the issue at hand. This source will be further investigated in order to learn of their alternate solution for preventing NAS and dealing with the mothers. While this article is not directly related to nursing, it will aid understanding of the dangerous effects that judgement and stigma have on these mothers from a health care perspective.

Summey, J., Chen, J., Mayo, R., Charron, E., Hudson, J., Sherrill, W., & Dickes, L. (2018). Early treatment innovation for opioid-dependent newborns: a retrospective comparison of

outcomes, utilization, quality, and safety. The Joint Commission Journal on Quality and Patient Safety, 44(6), 312–320. Retrieved from https://www.jointcommissionjournal.com/article/S1553-7250(17)30299-4/fulltext This article is based on a study that analyzes a treatment program called MAiN that provides multidisciplinary, coordinated, community based care for infants at high risk for opioid withdrawal. In doing so, the article compares MAiN infants to NAS infants that were eligible for MAiN but received traditional care, in order to determine the effectiveness of the program. This article will be beneficial for this research as it provides in depth analysis of one particular treatment program that may hold the answers to caring for and preventing NAS in the future. Additionally, this article includes a plethora of diagrams that provide illustrative inside into the data and ideas put forth by this study that will help to visualize the numbers as well as eventually aid the presentation visually. White, R. (2017). For babies born addicted to opioids, the after-effects show up at school. Center for Health Journalism. Retrieved from https://www.centerforhealthjournalism.org/2017/01/19/babies-born-addicted-opioids-afte r-effects-show-school This article focuses on the long-term effects of Neonatal Abstinence syndrome on children in schools which is very beneficial to this research in order to answer the question: how are those with NAS affected in the long run? The article discusses a study done on Australian children has found that children born with NAS performed significantly worse at school than their peers. This suggests that as the number of children with NAS continues to grow, we will need to enhance support for children who are failing behind in school. This article also questions the source of poor academic achievement as it could be attributed to impaired brain development from drug exposure OR the role of being born into families chained to addiction and poverty leading to missed school days and neglect. After reading this article, a segment of this paper will likely include the environmental effects of being a child of an addict, beyond the mental effects of NAS.

WTHR. (2017, Feb 2). Born Addicted [Video File]. Retrieved https://www.youtube.com/watch?v=7fqsgBrZNAI This video puts a face to NAS by telling the stories of baby Amber and baby Giovanni, who were born with Neonatal Abstinence Syndrome. This video explores what it is like to be a nurse caring for these babies but interviewing a few nurses and volunteers that spend their days tending to the shrinking cries of babies with NAS. They also explore the alarming rise in NAS that is leading to a shortage of staff to care for the babies in many rural areas. This source is

appealing as it gives a personal perspective of NAS by telling to story of two mothers who never meant to cause their children harm but simply could not stop using no matter how hard they tried. It is very important to visually feel the guilt of these mothers and the pain of these babies in order to understand the humanity behind the research so that the numbers don’t reinforce the stigma.