As states across the country look for ways to combat the ongoing opioid crisis, one overlooked issue is how we address the impact of this crisis on our communities’ youngest. Infants exposed to opioids in utero may experience a variety of potentially debilitating symptoms associated with opioid withdrawal, collectively known as Neonatal Abstinence Syndrome (NAS). As the opioid crisis and NAS receive greater attention, children’s advocates and public health professionals have pushed for more focused strategies and greater resources to assist. Efforts have focused not only on those infants specifically diagnosed with NAS, but also on additional substance-exposed newborns (SEN) who may experience problems related to other types of prenatal substance exposure.

At the federal level, the Protecting Our Infants Act of 2015, sponsored by Rep. Katherine Clark (D-MA) and Sen. Mitch McConnell (R-KY), helped bring greater attention to the issue, particularly the need to gather data to comprehensively assess the impact on infants and their families over time. Increasing awareness is an important first step in reversing the rise in newborns exposed to harmful substances. And while there are numerous efforts on the ground to combat the epidemic and support infants and their families in recovery, many are reliant on finite resources and have yet to be integrated into a system that will ensure their long-term sustainability.  

In Massachusetts, over the past year, Community Catalyst’s New England Alliance for Children’s Health (NEACH) convened a working group of practitioners, early childhood specialists, advocates and public health stakeholders to help the state take the next step to advance uniform policies across human and health services to support infants and their families. With the help of the Children’s Health Access Coalition (CHAC), the working group pushed the state to take more concrete steps to improve care for substance-exposed newborns. These efforts produced a resounding victory last month – the state’s FY 2017 budget included language establishing an inter-agency task force dedicated to addressing NAS and SEN. The relevant section declares that “all executive agencies work in coordination to address the needs of newborns, infants and young children impacted by exposure to substances.”

Importantly, the taskforce brings together state agency leaders who play an important role in the care of children and their parents. This list includes the Secretary of Health and Human Services, the Attorney General, the Commissioner of Children and Families, the Commissioner of Mental Health, the Commissioner of Public Health and the Executive Director of the Massachusetts Health Policy Commission. Additionally, an advisory council of experts and community leaders was formed from across the continuum of care for infants and parents experiencing the effects of substance use disorders. The establishment of this task force is a major step forward and presents a considerable opportunity for improving the care and outcomes for parents with substance use disorders and their children throughout the Commonwealth.

While the establishment of the task force is but one step in addressing a very large problem, it does make significant progress around coordination and communication among state agencies – one of the greatest barriers to establishing comprehensive systems of care on a state-wide basis. Due to the multiple issues involved, NAS and SEN necessitate the involvement and interaction of several agencies and departments. As states look to address NAS and SEN, the ability to coordinate effectively will be critical to ensuring the development and implementation of successful plans.