Psych CASC / OSCE · Addiction psychiatry — neonatal abstinence
Explain neonatal abstinence to parents after OAT pregnancy — CASC communication station
MRCPsych/FRANZCP-style communication station: explain NAS/NOWS in plain language, non-pharmacologic care and possible medicines, why maternal OAT continues, breastfeeding basics, and non-punitive safeguarding without false reassurance about all risks.
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Station brief
Format. Communication station, approximately 7–10 minutes after reading. You are the psychiatry/addiction registrar with perinatal liaison. The examiner plays one or both parents. [1]
Candidate instructions. Explain why the baby can show withdrawal after methadone even when mother did “the right treatment.” Describe monitoring and care (comfort measures first; medicines if needed). Explain why mother should continue methadone. Address child-protection fears honestly without promising outcomes you cannot control. Offer breastfeeding discussion if asked. Check understanding. [1][2][3]
References5ShowHide
- [1]Patrick SW, Barfield WD, Poindexter BB Neonatal Opioid Withdrawal Syndrome Pediatrics, 2020.PMID 33106341
- [2]Wachman EM, Schiff DM, Silverstein M Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment JAMA, 2018.PMID 29614184
- [3]American College of Obstetricians and Gynecologists Committee Opinion No. 711 Summary: Opioid Use and Opioid Use Disorder in Pregnancy Obstet Gynecol, 2017.PMID 28742670
- [4]Young LW, Ounpraseuth ST, Merhar SL, et al. Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal N Engl J Med, 2023.PMID 37125831
- [5]Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure N Engl J Med, 2010.PMID 21142534