(Abstracted from JAMA 2019;321(4):385–393)
Neonatal abstinence syndrome (NAS) has increased over the last 2 decades, likely related to the increase in opioid use in the United States from 1999 to 2014. The increased use of opioid analgesics, heroin, and fentanyl, associated with increased opioid overdose death rates, has severely impacted poor, rural counties, where residents are at risk because they have poor access to health care and other economic and social opportunities.
Department of Pediatrics (S.W.P., T.A.S.) and Mildred Stahlman Division of Neonatology (S.W.P., T.A.S.), Vanderbilt University; Vanderbilt Center for Child Health Policy (S.W.P.); Department of Health Policy, Vanderbilt University (S.W.P., J.D.), Nashville, TN; RAND Corporation, Pittsburgh, PA (S.W.P., B.D.S.); RAND Corporation (L.J.F., A.W.D.) and School of Medicine, Boston University (L.J.F.), Boston, MA; and School of Medicine, University of Pittsburgh, Pittsburgh, PA (B.D.S.)