Neonatal Abstinence Syndrome (NAS) Prevention Toolkit Cynthia Crews Thomas, DO, MPH Northeast Regional Health Office Tennessee Department of Health

Goals of the Toolkit To provide a ready resource for information regarding Neonatal Abstinence Syndrome (NAS) Introductory materials Educational resources Community resources Articles, guidelines and reports

Audience for the Toolkit Health department staff Clinical healthcare providers (primary care and family planning) Home visitors Health educators Healthcare providers Pain management providers Opioid replacement (buprenorphine) prescribers Primary care, pediatric and obstetric providers Community organizations serving women and families Drug and alcohol treatment centers/providers Domestic violence centers Shelters Civic organizations

Contents of THE Toolkit Introductory Materials: NAS FAQs – Tennessee Department of Health Overview of NAS in TN and prevention efforts Example of NAS Surveillance Summary Report and instructions for accessing report Neonatal Abstinence Syndrome and Maternal Substance Abuse in Tennessee, 1999-2011, Tennessee Department of Health Division of Policy, Planning and Assessment, Surveillance, Epidemiology and Evaluation Educational Pamphlets: Neonatal Abstinence Syndrome (providers) Drug Withdrawal in Babies (public) Prescription Medication and Illegal Drug Use During Pregnancy (family planning patients) Common Drugs and Related Problems for Mother and Baby (public) LARC: Long Acting Reversible Contraception (all reproductive aged women, providers who care for them, organizations who deliver services to them) Community Resource Guide: All Northeast Region county health departments Tennessee Department of Mental Health and Substance Abuse Services Prevention Services Provider Directory CHAD, HUGS, CSS, TEIS Frontier Health Comprehensive Community Services Families Free Red Legacy Oxford House Safe Passage Domestic Violence Shelter, CHIPS Family Violence Center, The River Ministry, Family Promise Education Guide for Parents and Caregivers: Niswonger Children’s Hospital, Mountain States Health Alliance Articles, Guidelines, Reports and Reference Materials: Opioid Abuse, Dependence, and Addiction in Pregnancy, Committee Opinion, The American College of Obstetricians and Gynecologists (ACOG) and American Society of Addiction Medicine (ASAM) Neonatal Drug Withdrawal, Clinical Report, American Academy of Pediatrics Hospital-Based Surveillance for Neonatal Abstinence Syndrome in Tennessee, 2013, Tennessee Department of Health, Division of Family Health and Wellness Annual Report 2013, Tennessee Initiative for Perinatal Quality Care (TIPQC) Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care, The Association of State and Territorial Health Officials Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non-Malignant Pain

Contents of the toolkit Introductory Materials: NAS FAQs – Tennessee Department of Health Overview of NAS in the US and TN and state level prevention efforts Example of NAS Surveillance Summary Report and instructions for accessing the report through the archive Neonatal Abstinence Syndrome and Maternal Substance Abuse in Tennessee, 1999-2011, Tennessee Department of Health Division of Policy, Planning and Assessment, Surveillance, Epidemiology and Evaluation Neonatal Abstinence Syndrome in TennCare Enrollees (provisional data, 2012)

Contents of the toolkit Educational Pamphlets: Neonatal Abstinence Syndrome (providers) Drug Withdrawal in Babies (public) Prescription Medication and Illegal Drug Use During Pregnancy (family planning patients) Common Drugs and Related Problems for Mother and Baby (public) LARC: Long Acting Reversible Contraception (all reproductive aged women, providers who care for them, organizations who deliver services to them)

Contents of the toolkit Community Resource Guide: All Northeast Region county health departments Tennessee Department of Mental Health and Substance Abuse Services Prevention Services Provider Directory CHAD, HUGS, CSS, TEIS Frontier Health Comprehensive Community Services Families Free Red Legacy Oxford House Safe Passage Domestic Violence Shelter, CHIPS Family Violence Center, The River Ministry, Family Promise

Contents of the toolkit Education Guide for Parents and Caregivers: Niswonger Children’s Hospital, Mountain States Health Alliance

Contents of the toolkit Articles, Guidelines, Reports and Reference Materials: Opioid Abuse, Dependence, and Addiction in Pregnancy, Committee Opinion, The American College of Obstetricians and Gynecologists (ACOG) and American Society of Addiction Medicine (ASAM) Neonatal Drug Withdrawal, Clinical Report, American Academy of Pediatrics Hospital-Based Surveillance for Neonatal Abstinence Syndrome in Tennessee, 2013, Tennessee Department of Health, Division of Family Health and Wellness Annual Report 2013, Tennessee Initiative for Perinatal Quality Care (TIPQC) Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care, The Association of State and Territorial Health Officials Tennessee Clinical Practice Guidelines for Outpatient Management of Chronic Non-Malignant Pain

Format of the Toolkit Hard Copy Flash Drive

Distribution of the Toolkit Northeast Regional Health Office Regional director, medical director, program directors All county health departments in NER MSHA, Wellmont ETSU Drug and alcohol treatment providers/centers Community organizations

Additional NAS Prevention Activities Letters to Certified Pain Management Clinics and Buprenorphine Prescribers Follow up meetings Distribution of toolkit Direct education to patients NAS Prevention and LARC education for female inmates Pilot in Washington County, expanding to additional counties Presentations to raise awareness and provide information regarding NAS prevention All NER health councils Community forums Community healthcare provider events Annual meetings of home visitors, nutritionists, other health department programs Media campaign WJHL and Niswonger Children’s Hospital Just for Kids programming Live call in show Public service announcement

Additional NAS Prevention Activities Participation in NAS Task Force Participation in ETSU Prescription Drug Abuse and Misuse Working Group Participation in Northeast TN Commission on Children and Youth NAS-specific Primary Prevention Initiatives (PPI) in several NER counties Physicians APNs Health educators Home visitors Clerical

Contact Information Cynthia Crews Thomas, DO MPH Northeast TN Regional Health Office 185 Treasure Lane Johnson City, TN 37604 Phone: 423-979-3200 Ext. 4605 Fax: 423-979-3267 Cynthia.C.Thomas@tn.gov

Questions?