HHS Unveils Standard Clinical Definition for Opioid Withdrawal in Infants

The US Department of Health and Human Services (HHS) announced recently that an in effort to help improve care for newborns and their mothers, it has collaborated with clinicians, researchers, and policy makers to develop a standard clinical definition for opioid withdrawal in infants.

HHS’s new standard clinical definition for opioid withdrawal in neonates was published in The Journal of Pediatrics.

With opioid-related diagnoses among pregnant women documented at delivery increasing by about 130% from 2010 to 2017, according to HHS data, the department set out to develop guidelines for identifying clinical and supportive care needs for mothers and their infants. In a study published by HHS in January, a lack of a standard clinical definition was among the data collection challenges influencing state-level strategies to treat opioid use disorder in pregnant and postpartum women, as well as their infants, that were highlighted.

“Lacking a standard clinical definition for the past 45-plus years has been a historical gap in the care of mothers and infants affected by opioid exposure, and created inconsistencies in diagnosing infants,” HHS wrote in a news release. “This has resulted in multiple challenges including medical coding, public health surveillance, research, public health policy, and program development.”

The new definition for diagnosis includes prenatal exposure and specific, evidence-based clinical signs, including: excessive crying, fragmented sleep, tremors, increased muscle tone, and gastrointestinal dysfunction. The definition can be applied in the context of neonatal abstinence syndrome or neonatal opioid withdrawal syndrome.

References

HHS announces a standard clinical definition for opioid withdrawal in infants. News release. US Dept of Health and Human Services. January 31, 2022. Accessed February 22, 2022.

Jilani SM, Jones HE, Grossman M, Khodyakov D, Patrick SW, Davis JM. Standardizing the Clinical Definition of Opioid Withdrawal in the Neonate. J Pediatr. Published online December 20, 2021. doi: 10.1016/j.jpeds.2021.12.021

Jilani SM, West K, Jacobus-Kantor L, et al. Evaluation of State-Led Surveillance of Neonatal Abstinence Syndrome — Six U.S. States, 2018–2021. MMWR Morb Mortal Wkly Rep. 2022;71(2):37-42.