Results of this first systematic statewide PAE prevalence study demonstrate that PAE might be more prevalent than previously thought. Active case ascertainment efforts for FASD coupled with systematic objective assessment of PAE should expand to the national level to better estimate public health needs required to provide adequate services for children affected by PAE.

Effective intervention strategies for increasing dispensing of intranasal naloxone by pharmacists should focus on pharmacists' concerns, include education to multiple audiences, and address provider-level, system-level, and society-level barriers.

Results highlight the need for targeted dietary interventions for opioid-using pregnant women.

Background: While use of prescription opioids and medication assisted therapy (MAT) for opioid use disorder in pregnancy, as well as the prevalence of neonatal opioid withdrawal syndrome (NOWS) continue to rise, little is known about outcomes for children with NOWS beyond the newborn period. Methods: We examined 1) prenatal MAT exposure vs. unexposed healthy controls [HC]; and 2) treatment for NOWS and NOWS severity on infant neurodevelopmental and behavioral outcomes at 5–8 months of age in 78 maternal-infant pairs from the ENRICH prospective cohort study. Data were obtained from 3 study visits: prenatal, delivery, and neurodevelopmental evaluation at 5–8 months of age. Neurodevelopmental outcomes included the Bayley Scales of Infant Development [BSID-III], caregiver questionnaires (Parenting Stress Index [PSI-SF], Infant Behavior Questionnaire [IBQ-R], Sensory Profile), and the experimental Still-Face Paradigm (SFP). Results: No differences in the BSID-III, PSI-SF, or IBQ-R scores were observed between MAT groups and HC; however, MAT-exposed and HC infants differed with respect to SFP self-regulation (β=−18.9; p=0.01) and Sensory Profile sensation seeking (OR=4.87; 95% CI: 1.55; 15.30) after adjusting for covariates. No significant differences between Treated-for-NOWS vs. not-Treated-for-NOWS were observed. Shorter timing to NOWS treatment initiation was associated with higher Total Stress (β=−9.08; p=0.035), while longer hospitalization was associated with higher Parent-child dysfunction (p=0.018) on PSI-SF. Conclusions: Our results provide additional evidence of little-to-no effect of MAT and pharmacological treatment of NOWS on infant neurodevelopmental and behavioral outcomes at 5–8 months of age. However, prolonged hospitalization might increase family psychosocial stress and requires further examination.

Background Given that opioid misuse/abuse and opioid overdose have reached epidemic proportions in the U.S., expansion of naloxone access programs are desperately needed. The objective of this study was to describe emerging trends in Naloxone Rescue Kit (NRK) prescription patterns by pharmacists in New Mexico as an example of a unique healthcare delivery system. Methods The study presents cross-sectional analysis of the data on NRK prescriptions by pharmacists who received Naloxone Pharmacist Prescriptive Authority Certification since 2013. Data were obtained from the Prevention of Opioid Overdose by NM Pharmacists (POINt-Rx) Registry, maintained by the University of New Mexico and the New Mexico Pharmacists Association. Results Since 2013, 133 NRKs prescribed by pharmacists have been reported to the POINt-Rx Registry. The mean age of the patients was 41.5±12.0 years (range: 19–67 years) and there were 60.2% female participants. Only 11.3% of the prescriptions were from pharmacists practicing in rural/mixed urban-rural areas. The majority of NRKs (89.5%) were first-time prescriptions. The most common reason for a NRK prescription was patient request (56.4%), followed by a pharmacist’s prescription of NRK due to high-dose of prescription opioids (28.6%) and history of opioid misuse/abuse (15.0%). In addition to opioids, other frequently reported substances included alcohol (9.2%) and benzodiazepines (10.8%). More than a third of patients (38.5%) reported polysubstance use in the previous 72 hours. Conclusions These results indicate that patients at-risk of opioid overdose might feel comfortable soliciting NRKs from a pharmacist. Participation of pharmacists in rural areas in the naloxone prescriptive authority highlight the opportunity for this novel healthcare delivery model in underserved areas; however, the program is clearly underutilized in these areas. Such a model can provide expanded patient access in community practices, while systematic efforts for uptake of the program by policy makers, communities, and pharmacists continue to be needed nationwide.