Bottom Line: Neonatal abstinence syndrome (NAS), which are symptoms that primarily occur in newborns exposed to opioids during pregnancy, has increased over the last two decades but there is limited information on its association with economic conditions or clinician supply. This study, which included 580 U.S. counties in eight states and 6.3 million births from 2009 to 2015, found higher rates of NAS at the county level to be associated with high rates of long-term unemployment and areas with a shortage of mental health clinicians. Neonatal abstinence syndrome rates were often highest in rural, remote counties. The design of the study does not allow for cause-and-effect interpretations of the findings.
Authors: Stephen W. Patrick, M.D., M.P.H., M.S., Vanderbilt University, Nashville, and coauthors.
(doi:10.1001/jama.2018.20851)
Editor's Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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