吸毒新生儿治疗指南

Due to an explosion in the number of infants born addicted to drugs because of their mother's use while pregnant, pediatricians and hospitals have been given updated guidelines for identifying, monitoring, and treating newborns exposed to painkillers and other drugs in the womb. The American Academy of Pediatrics (AAP) guidelines are a response to what the group calls an alarming increase in addicted newborns.

The National Institute on Drug Abuse states that the number of newborns with neonatal abstinence syndrome or neonatal opioid withdrawal syndrome NAS/NOWS has increased by more than five-fold since 2004. An estimated 32,000 infants with NAS/NOWS were born between 2004 and 2014.

处方药滥用流行

Because prescription drug abuse has increased across the board nationwide, many of those who are addicted to opioid painkillers include pregnant women. Consequently, there has been a corresponding increase in the number of addicted newborns who experience drug withdrawal symptoms.

有些婴儿生来就有毒瘾，因为他们的母亲正在接受药物治疗，使他们对毒品上瘾methadone或丁丙诺啡. 其他的母亲都对海洛因上瘾，可卡因, or other illegal drugs.

The Centers for Disease Control reports that non-medical use of prescription opioids has reached epidemic proportions in the United States in the past five years.

New Guidelines Published

Some infants who were exposed to drugs in the womb experience no withdrawal symptoms at all, the AAP report said; some have only mild clinical signs of withdrawal, but some have much moresevere withdrawals，在极端情况下可能致命。

To make sure these addicted newborns are identified and given appropriate treatment, the AAP published updated guidelines in the journal儿科.指南包括“对需要停用止痛药或镇静剂的住院婴儿的循证管理方法”

婴儿停药症状

婴儿停药症状包括：

• 易怒
• 癫痫发作
• Shrill crying
• Tremors
• 呕吐

Long-term symptoms can include birth defects, impaired growth, and behavior problems.

治疗方案范围

Treatment options suggested by the guidelines range from simply making the infant more comfortable—minimizing exposure to light and sound, or swaddling and rocking—to using medication to reduce moderate to severe withdrawal symptoms.

According to the AAP, doctors have treated drug withdrawal symptoms in newborns with a variety of drug preparations, including opioids (tincture of opium, neonatal morphine solution, methadone, and paregoric), barbiturates (phenobarbital), benzodiazepines (diazepam, lorazepam), clonidine, and phenothiazines (chlorpromazine).

为什么药物治疗并不总是最好的

However, the guidelines caution that pharmacological treatment is not always the best option because it will prolong the baby's drug exposure and lengthen the hospital stay, which could possibly harm maternal-infant bonding.

AAP警告说，使用药物治疗婴儿的戒断症状也可能加强母亲依赖药物治疗婴儿不适或烦人行为的倾向。

扩展指南的主要作者马克·胡达克医学博士说，儿科医生面临的问题是找到合适的药物剂量来缓解婴儿的症状和疼痛，而不给他们太多的药物使他们上瘾。完整的指南以PDF格式在线提供。