Presented by DCF SunCoast Region: Kyle Teague, Melissa Worthen, Christina Cuoco, Nina Romeu, Dekesha Seay

Transcription

1 Presented by DCF SunCoast Region: Kyle Teague, Melissa Worthen, Christina Cuoco, Nina Romeu, Dekesha Seay

2 Overview/Learning Objectives What is Addiction Medication Assisted Treatment Discuss facts about Substance Exposed Newborns (SEN) and Neonatal Abstinence Syndrome (NAS) Tips for working with caregivers caring for a substance exposed newborn Discuss skills utilized and challenges experienced by the Sarasota County SEN unit Panel Discussion

3 What is Addiction The disease of addiction is a chronic and life long brain disease that leads to compulsion to use even though there are negative effects. It takes over decision making, judgement, behavioral control, learning, and memory. 1. Biological/genetic factors 2. Environmental factors Stress and what was modeled to us play a huge factor in how we cope.

4 Why do we use Medication Assisted Treatment (MAT) with pregnant woman From what the research provides it allows for better outcomes with lower relapse with Opioid Use Disorder (OUD) and less stress on the fetus. Relapse it part of the cycle of addiction and MAT allows for a safe monitored multi-faceted approach to treatment. Negative affects of withdrawal are minimized, cravings lowered, and thus drug seeking behaviors are mitigated.

5 Check with Providers It is important to obtain records and know service providers. Talk to all doctors concerning what they are prescribing. Most individuals who are suffering from addiction also have a mental health diagnosis and may be on multiple medications. Minimization, avoidance, defensiveness are all symptoms with the individual suffering from addiction and thus leads to being a poor historian at times.

6 Every 15 minutes a baby is born with Neonatal Abstinence Syndrome (NAS) according to a new study published in the journal Pediatrics Doctors use urine or Meconium (first feces of the newborn) to confirm the types of drug(s) in the baby and mom s system. Sarasota Memorial Hospital uses the Finnigan score to determine if the baby is presenting with NAS along with severity and how to follow protocol for treatment with medication. Three scores of 8 or greater, then medication may be administered and more monitoring is required. NAS symptoms may appear as soon as 24 hours or as long as 10 days. Some factors are the frequency in which the Mom used drugs, the types of drug(s) and her last use of the drug(s) prior to delivery

7

8 How do babies get Neonatal Abstinence Syndrome (NAS)? NAS occurs when the baby is born and the discontinuation of the opioid drug then takes place. Symptoms include: Tremors (Disturbed and Undisturbed) Irritability (excessive crying) Sleep Problems High Pitched Crying Tight Muscle tone (stiffness) Hyperactive reflexes Seizures Yawning, stuffy nose, and sneezing Poor feeding and sucking Vomiting Diarrhea Dehydration Sweating Fever or unstable temperature

9

10

11 With the right services for the entire family we can make a difference and see successes big and small

12 How it all started Critical Incident Rapid Response Team (CIRRT) Creation of the unit in Sarasota County How QA is involved SEN maltreatment

13 Stats As of 8/8/18 (18 months into the process) 722 total investigations received region-wide 210 total investigations in Sarasota/DeSoto (29%) 146 newborns tested positive 177 mothers tested positive 125 mothers tested positive or admitted to using substances during pregnancy (59.5%) 62 mothers have previously given birth to another child born positive for substances (29.5%) 51 mothers had a previous services case 17 mothers were open to services at time of delivery 53 mothers had children previously removed from their care (51 of them due to substance abuse) 61 investigations identified present danger (29%)

14 Total Positive Results 160 Substance Exposed Newborns - Newborn Drug Screen Results 98.8% 96.0% 90.8% 100.0% 90.0% % 80.0% 75.1% % % 60.0% % % 40.0% 30.0% % % 0.0% Substance

15 Total Positive Substance Exposed Newborns - Mother Drug Screen Results 98.7% 100.0% % 93.1% 90.0% 78.4% 80.0% % 70.0% 56.3% 60.0% 50.0% % 40.0% 30.0% % % 0.0% Substance

16 Panel Discussion

17 10 Tips for CPI s Working SEN Cases Do a thorough pre-commencement of the case Don t be scared to ask as many questions as possible Always get as many collaterals as possible Know the history of the case and any prior drug use of the parents Have a natural conversation with the client Make sure that you ask about any treatment that the client has and get the proper releases signed Request all medical records within the first 48 hours Take your Behavioral Health Consultant (BHC) out at the onset of the case to assess for mental health and on-going substance issues Use your supervisor as needed to assess for the appropriate risk of the child Learn to work around the frustrations of the client to make an appropriate assessment

18

19