Health Policy and Advocacy
Protecting Our Infants Act of 2015: Addressing Prenatal Opioid Use and NAS
Vicki Leamy, DNP NNP-BC
Most of us are acutely aware that the incidence of opioid dependence in pregnant women and, as a result, the incidence of neonatal abstinence syndrome (NAS), has climbed steadily in the United States during the past 10 years. Recently published research reports a more than six-fold increase in the percentage of neonatal intensive care unit (NICU) days attributed to NAS from 2004 to 2013 (Tolia et al., 2015), while hospital charges attributed to NAS were $1.5 billion in 2012 (Patrick, Davis, Lehman, & Cooper, 2015). Infants with NAS comprise a larger portion of the NICU census each year; however, no one has a clear picture of the true scope of the problem.
The Protecting Our Infants Act (POIA) is a bipartisan bill that was jointly introduced in the House of Representatives (H.R. 1462) and Senate (S. 799) in March 2015. If passed, the legislation would direct three federal agencies to participate in initiatives designed to quantify the incidence of maternal opioid use and NAS while gathering and disseminating best practices for prevention and treatment of the problem (March of Dimes, 2015). The Agency for Healthcare Research and Quality (AHRQ) would be directed to report on prenatal opioid abuse and NAS. The AHRQ report would include case studies, barriers to treatment for pregnant women, evaluation of treatment options for opioid-dependent women and infants, and recommendations for prevention, identification, and treatment of opioid dependence and NAS. In addition, the U.S. Department of Health and Human Services would be required to address gaps in research and the Centers for Disease Control and Prevention would be required to provide assistance to states to develop a monitoring program (S. 799, 2015; H.R. 1462, 2015).
H.R. 1462 passed the House in September 2015, and the companion bill, S. 799, passed the Senate by unanimous consent on October 22, 2015. The Senate version was passed with an amendment. Thus, it will now go back to the House for consideration because the bill that passes in the House and Senate must be identical prior to going to the president for signature (govtrack.us).
March of Dimes. (2015). Protecting Our Infants Act of 2015 (S. 799/H.R. 1462) [Fact sheet]. Retrieved from www.marchofdimes.org/materials/Protecting-Our-Infants-Act-Fact-Sheet-March2015.pdf.
Patrick, S. W., Davis, M. M., Lehman, C. U., & Cooper, W. O. (2015). Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. Journal of Perinatology, 35, 650–655. http://dx.doi.org/10.1038/jp.2015.36
Protecting Our Infants Act, H.R. 1462, 114th Cong. (2015).
Protecting Our Infants Act, S. 799, 114th Cong. (2015).
Tolia, V. N., Patrick, S. W., Bennett, M. M., Murthy, K., Sousa, J., Smith, P. B., ... Spitzer, A. R. (2015). Increasing incidence of the neonatal abstinence syndrome in the U.S. neonatal ICUs. New England Journal of Medicine, 372, 2118–2126. http://dx.doi.org/10.1056/NEJMsa1500439