Agenda for 2015 Symposium

Pregnant Women, Drug Use, and NAS: Experts Share Science & Strategies that Help Women, Babies, and Families 

The objective of this symposium was to identify, evaluate, and learn from programs, approaches, and policies addressing pregnant women, drug use, and Neonatal Abstinence Syndrome (NAS). This symposium brought together evidence-based research, renowned medical experts, professionals working in a variety of fields, and people directly affected by policies addressing pregnancy, parenting, and drug use, with specific attention to opioids and NAS. The presenters distinguished myth from fact, scientific information from media hype, and provided meaningful tools for improved care, treatment, and advocacy to advance the health and wellbeing of women and their families.

FRIDAY


8:00 – 8:30 Welcome: Setting the Stage 

Dr. Jessica Young, MD, Assistant Professor, Obstetrics & Gynecology, Vanderbilt University School of Medicine 


8:30 – 10:00 What is Neonatal Abstinence Syndrome? History, Definition, Diagnosis, and Practice

This panel will lay the foundation for how medical providers, policymakers, media, and the public understand NAS by clarifying what we know and don’t know about NAS. How was NAS identified and named? Historically, what has NAS—and medical responses to monitoring and treating NAS—looked like? To what extent can we predict NAS? And what, if anything, do we know about the pre-birth practices that affect the duration and severity of NAS? To what extent is a diagnosis of NAS objective or subjective? How do we define NAS to medical professionals? And how do we define NAS to media? And to policymakers? Is there a difference? Lynn Paltrow, JD, Executive Director of National Advocates for
  • Moderator: Lynn Paltrow, JD, Executive Director of National Advocates for Pregnant Women          
  • Karen DApolito, PhD., NNP-BC, FAAN, Professor & Program Director, NNP Program, Vanderbilt School of Nursing
  • Loretta Finnegan MD, President of Finnegan Consulting      
  • Hendrée Jones, PhD, Director of UNC Horizons and Professor in the UNC Department of Obstetrics and Gynecology
       

10:15 – 11:45 Developing, Implementing, and Improving Guidelines and Protocols 

Three recent national surveys assessing the management of NAS highlight the inconsistency of policies that determine the presence of and treatment for NAS. Those same studies show that only half of approximately all hospitals and NICUs have written guidelines for the management of NAS. How do policies come into being? How can we tell if existing policies are evidence-based? How do state laws and regulations influence and interact with hospital policies? What mechanisms have been and can be used to update, improve, existing policies or create new ones? How do we resolve competing models of care?
  • Moderator: Davida Schiff, MD, Boston Children’s Hospital
  • Joelle Puccio, BSN, RN, Director of Women’s Services in Seattle, WA
  • Mishka Terplan, MD, MPH, FACOG, Assistant Professor of Obstetrics, Gynecology & Reproductive Sciences, and Epidemiology & Public Health at the University of Maryland School of Medicine
  • Mary Hepburn, MD, MRCGP, FRCOG, Senior Lecturer in Women’s Health at the University of Glasgow
 

11:45 – 1:00 Lunchtime Lecture by Carl Hart, PhD and Author of High Price 

 

1:00 – 2:30 Evidence-Based Research and Practices That Work

From encouraging breastfeeding to facilitating bonding between mother and child to providing trauma-informed care, there are numerous methods to better support moms and babies. This panel will discuss several of those methods and the burgeoning evidence-based research on NAS and approaches that in general can improve birth outcomes. How can we better understand the bio/psycho/social impacts of trauma? How can health care providers better integrate gender responsive treatment into our daily practices? What have we known and what can we still learn about minimizing and treating the symptoms of NAS? How can we support women and their families not just during prenatal care and delivery, but also ensure that they continue receiving support after birth and when they go home? 

  • Moderator: Katie Clark, MSPH, CSAC
  • Ron Abrahams, MD, Medical Director of perinatal addictions at the BC Women's  Hospital and Health Centre in Vancouver
  • Mona Liza Hamlin, RN, IBCLC, NPA Board Member
  • Bernadette Hoppe, JD, MA, MPH, Attorney and Counselor at Law, The Littell House     
 
 

2:45 – 4:00 Hearing and Responding to Pregnant Women’s Needs

Efforts to determine effective protocols and guidelines often proceed without including the women to whom those guidelines are directed. So what really does work for pregnant women who use drugs? What would we learn if we asked them? What actually happens when women are reported to the child welfare system? Why should we care about or support self-directed medical care? This panel will include experts working in the field who bring both personal and professional experience to development of the most effective policies and practices.      
  • Moderator: Heather Howard, Ph.D., MSW, LICSW, Perinatal Clinical Social Worker, Women & Infants' Hospital
  • Jenn McCrindle, Streetworks, HER Pregnancy Program, Edmonton, Canada
  • Kimberly Byrnes, CAN, Mentoring Mom at the Center for Early Relationship Support at Jewish Family & Children’s Service of Greater Boston
  • Shannon Casteel, Family Advocate
          

4:155:30 Stigma, Coercion, Funding, and Other Barriers to Treatment

This panel will discuss the available treatments for pregnant women who are struggling with opioid addiction, who are opioid-dependent, or who are managing chronic pain. It will also discuss the myriad barriers to those treatments, including federal regulations, funding, housing, transportation, and stigma, among others. How do people confront these barriers? What short and long-term solutions are people using and/or considering? What are the differences between voluntary and mandated treatment, and who pays for mandated and coerced treatment? What happens in drug courts and other courts and agencies with the ability to mandate drug treatment? 
  • Moderator: Cherisse Scott, Founder & CEO, SisterReach, TN
  • Robert Roose, MD, MPH, Chief Medical Officer of Addiction Services of the Sisters of Providence Health System in Holyoke, MA
  • Zac Talbott, MS, CMA, Certified MAT patient advocate, Director of the
  • Southeastern chapter of the National Alliance for Medication Assisted Recovery, and Administrator for the SAMHSA-funded MARS Peer Recovery Network 
  • Tia Smith, Streetworks, HER Pregnancy Program, Edmonton, Canada

SATURDAY


9:00 – 10:15 Legal and Ethical Responses to Pregnant Women and Drug Use: Best Approaches

PART 1: Numerous civil and criminal laws at both the federal and state levels have been passed to address issues of pregnant women and drug use. This panel will provide an overview of those laws and public health policy positions regarding best practices and use of federal, state, and local governments. The panel will discuss these measures as a matter of ethics, and best medical practice. 
  • Moderator: Ellen Clayton, MD, JD, Professor of Pediatrics, Vanderbilt University School of Medicine, Director of the Center for Biomedical Ethics and Society
  • Lynn Paltrow, JD, Executive Director of National Advocates for Pregnant Women
  • Mary Faith Marshall, Director, Program in Bioethics at the Center for Biomedical Ethics   and Humanities School of Medicine, University of Virginia
  • Susan Dunn, JD, Legal Director, ACLU of South Carolina
  • Robert Newman, MD, MPH, President Emeritus of Continuum Health Partners, Inc.,   Former CEO of the Beth Israel Health Care System
           

10:30 – 11:30 Legal and Ethical Responses to Pregnant Women and Drug Use: Best Approaches

Part 2: The Tennessee law has been in effect for more than a year, so what can we learn from the experience? What can we do to ensure that it sunsets and is not reinstated? And how can we prevent this from happening in other states? 
  • Moderator: Susan Boyd, PhD, Professor at University of Victoria
  • Farah Diaz-Tello, Senior Staff Attorney at National Advocates for Pregnant Women
  • Cherisse Scott, Founder & CEO, SisterReach, TN
  • Rebecca Terrell, Healthy & Free TN
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