Identifying and Assessing the Substance-Exposed XXXX .

@entity3347 @entity1 @entity1245 @entity6767
As the rate of opioid prescription grows, so does fetal exposure to opioids during pregnancy. With increasing fetal exposure to both prescription and nonprescription drugs, there has been a concurrent increase in identification of @entity6767 ( @entity6767 ) and adaptation difficulties after birth. In addition, extended use of opioids, barbiturates, and @entity1245 in neonatal intensive care has resulted in iatrogenic @entity3347 . There is a lack of evidence to support the use of any one specific evaluation strategy to identify @entity6767 . Clinicians caring for @entity1 must use a multimethod approach to diagnosis, including interview and toxicology screening. Signs of @entity6767 are widely variable, and reflect dysfunction in autonomic regulation, state control, and sensory and motor functioning. Several assessment tools have been developed for assessing severity of withdrawal in term neonates. These tools assist in determining need and duration of pharmacologic therapy and help in titration of these therapies. Considerable variability exists in the pharmacologic and nonpharmacologic approaches to affected babies across settings. An evidence-based protocol for identification, evaluation, and management of @entity6767 should be in place in every nursery. This article provides an overview of identification and assessment considerations for providers who care for babies at risk for or who are experiencing alterations in state, behavior, and responses after prenatal or iatrogenic exposure to agents associated with the spectrum of withdrawal.
