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November 17, 2015

Long-Acting Opioids for Treating Neonatal Abstinence SyndromeA High Price for a Short Stay?

Author Affiliations
  • 1Department of Anesthesia, Stanford University School of Medicine, Stanford, California
  • 2Department of Pediatrics and Anesthesia, Stanford University School of Medicine, Stanford, California
JAMA. 2015;314(19):2023-2024. doi:10.1001/jama.2015.13537

Neonatal abstinence syndrome (NAS) is a generalized multisystem disorder that produces a constellation of symptoms in neonates and results from abrupt discontinuation of opioids used by the mother during pregnancy at the neonate’s birth. Approximately 13 500 neonates born in the United States each year develop NAS, and this number has increased nearly 5-fold between 2000 and 2012.1 The percentage of neonatal intensive care unit (NICU) days attributed to NAS increased 7-fold from 0.6% in 2004 to 4% in 2013; and up to 20% of all NICU days in several centers were attributed to NAS.2 Although some regional differences exist, this increase has occurred in all communities, all ethnicities, and in all types of hospitals. Because the period of hospitalization for the treatment of NAS now averages 16 days, the treatment costs are substantial.3 The overall cost of care for a typical neonate with NAS may be $159 000 to $238 000 greater than that of a healthy neonate.

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