To the Editor During the last 2 decades, use of prescription opioids and heroin increased throughout the United States. As use of licit and illicit opioids grew among pregnant women, cases of neonatal abstinence syndrome (NAS) surged nearly 5-fold nationwide.1 In their article, Brown et al2 described the rapid rise of NAS diagnoses in Kentucky from 2008 to 2014, growing at a rate twice the national mean. The authors raised the concern that state and federal public health interventions implemented to combat opioid use disorder during the study period may not have been effective, given that rates of NAS did not decrease.
Schiff DM, Patrick SW. Treatment of Opioid Use Disorder During Pregnancy and Cases of Neonatal Abstinence Syndrome. JAMA Pediatr. Published online May 01, 2017. doi:10.1001/jamapediatrics.2017.0854