Status Report on Protecting Our Infants Act Implementation Plan. BACKGROUND


A new study revealed that from 2004 to 2014, the rate of US infants diagnosed with opioid withdrawal symptoms increased 433%, from 1.5 to 8.0 per 1000 hospital births. This translates to one infant being born every 15 minutes with withdrawal symptoms due to prenatal opioid exposure. [1], [2]

The Protecting Our Infants Act of 2015 (POIA) became law on November 25, 2015. The Act (Public Law 114-91) addressed problems related to prenatal opioid exposure and included several mandates for the U.S. Department of Health and Human Services (HHS). The law called for HHS to review planning and coordination of HHS activities related to prenatal opioid exposure and neonatal abstinence syndrome (NAS), which includes neonatal opioid withdrawal syndrome (NOWS), and to study and develop recommendations for the prevention, identification, and treatment of NAS as well as the treatment of opioid use disorder (OUD) in pregnant women. In May of 2017 HHS released a POIA strategy to address gaps in research, overlap of federal programs and coordination of federal efforts to address NAS and NOWS.

In addition, the Comprehensive Addiction and Recovery Act of 2016 (CARA) included a provision for the Government Accountability Office (GAO) to examine NAS in the United States and related treatment services for the condition. The GAO study was published in October, 2017 and found limited physical capacity to care for infants with NAS; limited coordination of care for mothers and infants with NAS; and gaps in research and data on NAS.

Finally, Section 7062 of the SUPPORT for Patients and Communities Act (P.L. 115-271, enacted October 24, 2018) requires a report about the implementation of the recommendations in the POIA strategy, to be submitted to specified congressional committees and made available to the public on the Department's website within 60 days of enactment.

In response to POIA, the GAO study, and the SUPPORT for Patients and Communities Act, HHS developed an implementation plan to inform planning and policy across the Department. Recommendations range from aspirational to practical and include preventing prenatal opioid exposure, providing evidence-based treatment for both mother and infant, increasing the accessibility of family-friendly services for pregnant and parenting women with OUD, supporting continuing education for healthcare providers, and determining optimal family and developmental support services for children who have experienced prenatal opioid exposure.