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Tennessee Department of Health says Putnam County works to reduce Neonatal Abstinence Syndrome

Community Project Designed to Prevent Babies Born Dependent on Drugs

Tennessee Department of HealthCookeville, TN – The Tennessee Department of Health and Putnam County Health Department are optimistic the incidence of Neonatal Abstinence Syndrome, or NAS, may finally be stabilizing, potentially heralding a future decrease in this epidemic that has plagued the state in recent years.

NAS occurs when a baby exposed to certain drugs, primarily narcotics, through the umbilical cord is cut off from that supply at birth and experiences withdrawal symptoms.

TDH made NAS a reportable condition in 2013 and provides weekly surveillance reports on the incidence and causes of NAS. At the end of 2014, the number of NAS cases reported in Tennessee was higher than in 2013.

However, with nearly three-quarters of this year complete, the count in 2015 has consistently been equal to the count from 2014. According to TDH surveillance data on the causes of NAS, 70.5 percent of mothers giving birth to a baby with NAS were using at least one substance prescribed to them by a healthcare provider.

Numerous stakeholders across the state are working to reduce the incidence of NAS in Tennessee with a particular focus on primary prevention—preventing the problem before it ever happens. For NAS, one primary prevention strategy is preventing unintended pregnancy among women of childbearing age who are using substances known to cause NAS such as prescription painkillers.

The Centers for Disease Control and Prevention reports that among all women, approximately half of all pregnancies are unintended. The percentage of unintended pregnancies is far higher (86 percent) among women who are abusing opioid medications, a major contributor to NAS. Preventing unintended pregnancies is a key strategy for reducing the incidence of NAS in Tennessee.

One highlight of the statewide efforts to reduce NAS has been a primary prevention initiative piloted in Sevier and Cocke counties. County health department staff members met with other local officials in 2014 including judges and jail staff members to educate them about NAS and explore how they could collaborate to reduce the problem. Working with these local partners, the group provided health education sessions to inmates in the counties’ jails; these sessions included information on NAS and ways to prevent NAS.

Inmates who chose to participate in the NAS reduction project were transported to the local health department for family planning services, which may include voluntary, reversible, long-acting contraceptives, or VRLACS. Putnam County is launching a similar project this year.

“We’re working to educate people and empower them to make wise choices and take charge of their own health,” said Putnam County Health Department Director Lisa Bumbalough. “Our region has reported nearly 80 NAS cases so far this year, so we know this is a problem in our community. This innovative NAS reduction project is an idea that came out of local community collaborations as a way to address a serious public health issue our partners identified as a problem we want to solve in our communities.”

“The NAS prevention education is offered to all female inmates who are about to be released from the Putnam County Jail,” said Putnam County Sheriff Eddie Farris. “It is a voluntary program, like all of the programs offered at our jail, and those inmates who decide to participate must go through classroom instruction prior to receiving the contraception option that they choose.”

“I think this is an excellent opportunity to educate young women about the dangers of legal and illegal drug use during pregnancy and the devastating effects of NAS,” said Putnam County General Sessions Judge Steve Qualls. “Most of the women we deal with through the courts are good people that are making bad decisions from the cycle of drug use and addiction. I believe this education will give the participants an opportunity to make a responsible decision that may last for years and significantly reduce NAS in our community.”

Results of the pilot project are promising:  Sevier County recorded a 92 percent reduction in babies born with NAS just nine months after implementing a NAS reduction effort.

“In the female population who have been jailed for drug-related causes, more than 80 percent reported using no form of birth control,” said Upper Cumberland Regional Medical Director Don Grisham, MD. “Our goal is to educate both these women and the community at large on behaviors that may have a negative impact on their health and the health of their babies if they get pregnant.”

As of September 2015, Putnam County is one of 24 Tennessee counties and one city participating in similar NAS reduction collaborations, and more counties are developing plans to implement the project in their communities. The East Regional Primary Prevention Initiative Committee has also shared an “NAS Reduction Starter Kit” with neighboring states including Kentucky and West Virginia as a best practice.

Learn more about NAS at http://tn.gov/health/topic/nas

About the Tennessee Department of Health

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. TDH has facilities in all 95 counties and provides direct services for more than one in five Tennesseans annually as well as indirect services for everyone in the state, including emergency response to health threats, licensure of health professionals, regulation of health care facilities and inspection of food service establishments.

Learn more about TDH services and programs at www.tn.gov/health

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