Essay Example: Substance Abuse Effects on Neonate

Pregnant women who abuse some types of medications or drugs could cause severe and detrimental impacts on the neonate and the fetus. In a survey carried out by the National Institute on Drug Abuse (NIDA) in 2010, most of the pregnant women have at one point abused drugs. Cases of pregnant women abusing drugs have increased due to the prescriptions given to them to reduce chronic or acute pains. Due to these cases, most of the infants get addicted to drugs, and these cases are on the rise. The increase in drug abuse by pregnant women is a primary health concern which has posed tremendous risks to neonates, fetus and the child that is developing. This paper aims at describing how the fetus exposed to drugs is affected and the treatment methods.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

Nursing Diagnosis

Screening regularly for all pregnant women for the presence of any drugs is essential. This screening is best recommended during first-time visits for antenatal care clinics. The screening tools include the use of questionnaires. Drug testing is another way of diagnosing the presence of drugs in pregnant women. This will help determine any chances of the infant suffering from placental abruption. Immunoassays have also been recommended widely to be used in the drug screening, whereby the techniques used are gas and liquid chromatography (Bailey & Diaz-Barbosa 2018). Lastly, using the neonate's hair to test for the usage of any drugs is one of the toxicological screening methods.

Findings

Several effects occur on the neonate as a result of substance abuse by their mothers. Structural abnormalities are one of the effects of exposing a neonate to drugs. However, its effects are determined by the timing during which the neonate was exposed. One significant impact associated with drug abuse during pregnancy, especially the first week is a miscarriage. This scenario is, however, hard to establish the cause since determining the conception date is challenging as well as the exclusion of other factors which would cause the miscarriage. Almost all drugs abused are known to cause preterm birth (Bailey & Diaz-Barbosa, 2018). Organs develop during the first two months of pregnancy, and this is the period when the use of drugs can cause structural abnormalities during cell division or cause interference in the development of the fetus. Structural abnormalities associated with alcohol include fetal alcohol syndrome, and it can also create a restriction in the growth of the fetus.

Another impact brought by substance abuse on a fetus is that the central nervous system (CNS) is greatly affected. Drugs that affect the development of the central nervous system include cocaine, marijuana, opioids, and methamphetamine. Antiepileptic drugs have also been associated with changing the behavioral and cognitive functions of a child during childhood, causing impairments (Bailey & Diaz-Barbosa 2018). However, people are aware of these effects by pregnant women cannot stop taking the drugs immediately. This is because some of the mothers use medications for medical purposes. Some use methadone medication during pregnancy as prevention of drug relapses. For drug discontinuation, the mother's safety, as well as the fetus safety, should be an essential consideration. All drugs that a pregnant woman can take have the potential to be harmful and pose a risk to the fetus and should, therefore, be analyzed before use.

Assessment

As a nurse, there are various ways of treating and taking care of the patient. To treat the neonate, the mother should be addressed first. Women who are pregnant and those that are within the age bracket of childbearing should all receive counseling on the potentially harmful impacts of medications during pregnancy. They should also be equipped with resources and support to help them discontinue medication as soon as possible. For example, for women who are pregnant and use opioids, counseling them to stop the medicines may not be possible. The best prescription should be agonist therapy for stabilization of withdrawal symptoms, raise prenatal clinic attendance, reduction of heroin cravings and develop positive behaviors in maternal health from both the mother and the fetus (Bailey & Diaz-Barbosa 2018). Administration of methadone helps reduce the period of stay in the hospital for the newborn, reduces neonatal abstinence syndrome treatment durations, and also reduces withdrawal symptoms. Neonatal abstinence syndrome develops on neonates whose mothers abused and are addicts to drugs.

Nonpharmacological care is the treatment considered for neonatal abstinence syndrome. The therapy includes comfort, swaddling, and providing an environment that is spacious and quiet for the neonate with less overstimulation. Failure of the neonate to respond to the nonpharmacological treatment, a combination of pharmacological therapy and one of any of the regimens are administered: tincture of opium that has been diluted, morphine without or with phenobarbital, sublingual buprenorphine and lastly methadone without or with clonidine. According to Buddy (2019), usage of pharmacological treatment poses a risk of increasing the length of the infant's stay in the hospital. It is, therefore, essential to follow standardized protocol when using pharmacological treatment to treat neonatal abstinence syndrome.

Breastfeeding for babies born by women addicted to drugs should be encouraged. This is mainly those women who use regimens for maintaining stability, for example, suboxone and methadone. Breastfeeding helps to increase the bond between the infant and the mother as well as the participation of the mother in the care of the infant (Shukla & Pomar2018). Breastfeeding aids in the reduction of the need to treat infants suffering from opioid exposure according to recent studies. However, women who had used illicit drugs before delivery did not attend prenatal care clinics and had conditions such as HIV should be discouraged from breastfeeding their infants.

Various scoring systems, for example, Finnegan Neonatal Abstinence and Lipsitz tool scoring systems have been applied to aid in titration, weaning, and initiation of opioid therapy. The scoring systems usage depends on the severity and presence of the clinical signs. The scoring systems also require monitoring the infant for any withdrawal signs from birth and assessments of three or four hour's intervals during hospitalization (Shukla and Pomar 2018). Finnegan is the most commonly used scoring system, among others. After complete weaning of the infant from pharmacotherapy and has attained stability for about 24 hours, they can, therefore, be discharged. Other hospitals discharge infants after weaning off the opioid medications.

In conclusion, the issue of women abusing drugs when pregnant has become a considerable problem and issues in the society which has both neonatal and prenatal effects. Diagnostic methods of the presence of drugs in the maternal blood or that of the fetus include use of hair, immunoassays, drug testing, and screening. Legal and illegal drugs, when used during pregnancy, have adverse effects on the neonate. Some of the effects of abuse of the drugs by pregnant women cause structural abnormalities during cell division to the neonate hence lack of some organs or underdevelopment of some of them. Substance abuse could also cause problems in the central nervous system leading to impairments in terms of behavioral and cognitive functioning. However, there are several ways of treating a neonate affected by the results of substance abuse by their mothers. Pharmacological treatments, nonpharmacological treatments, breastfeeding, and scoring systems are some of the ways of treating neonate suffering from neonatal abstinence syndrome and withdrawal signs.

References

Bailey, N. A., & Diaz-Barbosa, M. (2018). Effect of Maternal Substance Abuse on the Fetus, Neonate, and Child. Pediatrics in review, 39(11), 550-559.

Buddy, T. (2019). Guidelines for treating drug-addicted newborns. Retrieved from https:// https://www.verywellmind.com/guidelines-updated-for-treating-drug-addicted-newborns-67819

National Institute on Drug Abuse. (2010). What are the effects of maternal cocaine use? Retrieved from: https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-effects-maternal-cocaine-use. Accessed July 2017

Shukla, S., & Pomar, E. G. (2018). Perinatal drug abuse and neonatal drug withdrawal. In Stat Pearls [Internet]. Stat Pearls Publishing.