The United States (U.S.) government has been attempting to combat the growing opioid epidemic ravaging the nation. The opioid epidemic has had a significant impact on public health and forensic science laboratories. Moreover, this epidemic has moderate to fatal health consequences for expectant mothers with substance use disorder and their child who may develop Neonatal Abstinence Syndrome (NAS), otherwise known as Neonatal Opioid Withdrawal Syndrome (NOWS). The objective of this thesis is to emphasize that further research is needed for the identification and quantification of opioids in human breast milk. This topic has public health implications such as discussing the information gaps as it relates to a highly vulnerable group, women, and infants, affected by the opioid epidemic. Furthermore, there are implications in forensic science connected to postmortem toxicology and pathology when determining the cause of death and contributing factors in pediatric cases. This emphasis on the need for greater research will be accomplished by highlighting the opioid epidemic, its impact and further understanding of the addictive drug class known as opioids. The history of the crisis, effects on society as well as pharmaceutical knowledge of opioids will assist in development of plans to suppress growth and provide care for the afflicted. Furthermore, this thesis will attempt to demonstrate the need for further research involving opioids will be of significant value for public health and forensic science. As the forensic laboratories and various medical facilities are at the forefront of the opioid epidemic, there is a need for more robust, validated, inexpensive, and fast drug detection methodologies. Increasing rates of new designer drugs, addiction, and opioid-related deaths has caused a backlog in the forensic laboratories due to the great number of cases. While, the higher instances of maternal substance use disorder (SUD)/ opioid use disorder (OUD) with parallel increases in cases of NAS incidences are a few of the issues that need to be managed by public health leaders. Additionally, this thesis will examine current methodologies for drug quantification of opioids in human breast milk. The valid methodologies developed as well as the findings by the few available studies allowed for the current recommendations related to the acceptability of mothers in MAT programs, using methadone and buprenorphine during pregnancy and postpartum, being able to breastfeed their infant. By examining these studies and the findings, standardization criteria for the development of study designs for new methodologies relating to drug determination in human breast milk could be developed. The establishment of standardization criteria and acknowledging information gaps in current knowledge will be significant as these findings could influence policies, guidelines and procedures relating to maternal SUD/OUD, NAS/NOWS, and pediatric death determination as well as postmortem toxicology.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/42141 |
| Date | 20 February 2021 |
| Creators | Durocher, Adrianna U. K. |
| Contributors | Hall, Adam B. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NoDerivatives 4.0 International, http://creativecommons.org/licenses/by-nd/4.0/ |
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