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Prescription Opioid Drug Use and Abuse by Pregnant Women Could Lead to Drug Withdrawal Symptoms in Newborns

Last updated May 1, 2015

Approved by: Maulik P. Purohit MD, MPH

A study published in the New England Journal of Medicine (NEJM) on April 26, 2015 states that the incidence of Neonatal Abstinence Syndrome (NAS) in the USA is on the rise.

A study published in the New England Journal of Medicine (NEJM) on April 26, 2015 states that the incidence of Neonatal Abstinence Syndrome (NAS) in the USA is on the rise.

Neonatal Abstinence Syndrome (NAS) is defined as a set of problems occurring in a newborn exposed to addictive opiate drugs during gestation. When a pregnant woman takes opioid drugs such as heroin, codeine, oxycodone, etc., the drugs pass through the placenta and enter the fetus, thereby making the fetus addicted to the drug/s as well. In other words, NAS is the term used for drug-withdrawal symptoms in a newborn.

Newborns with NAS have symptoms like irritability, poor sucking reflex, highly tense muscles, inability to control some functions that the body does naturally/automatically (For example, digestion, blood pressure control etc.), weight gain issues, etc.

The study in the NEJM was designed to look into the rate of NAS occurrence, the rate of hospitalizations in Neonatal Intensive Care Units (NICUs), the duration of hospital stays, and changes in infant and maternal clinical characteristics from 2003 through 2014. Data from a total of 299 NICUs were analyzed for this investigation. The results show that:

  • Of the 674,845 infants admitted to NICUs, 10, 327 were identified with NAS.
  • This number increased from 0.7% to 2.7% in the years studied.
  •  The average NICU stay increased from 13 days to 19 days.
  • Some centers reported that as much as 20% of NICU admissions were for NAS.
  • Infants were treated with morphine in a majority of cases.


The authors conclude “From 2004 through 2013, the neonatal abstinence syndrome was responsible for a substantial and growing portion of resources dedicated to critically ill neonates in NICUs nationwide.”

Calling this a dramatic problem, the lead author of the NEJM research article, Dr. Alan Spitzer, says to Forbes magazine “Increasingly these are not illicit street drugs, but prescription drugs that mothers are using that they’re getting from a variety of sources, some from obstetricians, some from pain clinics now that have appeared all over the place.”

 “Having discussed this with many of our physicians as well as some parents I think they’ve been led to believe that if they have aches and pains, and they take these medications, it’s perfectly safe. And it’s not.”

With the backdrop of increased deaths associated with use of narcotic painkillers and substantial hospitalization charges for the NICU (one estimate puts the cost at $40,000 per infant), combined with lack of data on the long-term effects of gestational opioid exposure on the brain, overuse of prescription painkillers is a problem that needs to be dealt with in an expeditious manner.


Primary Reference:

Tolia, V., Patrick, S., Bennett, M., Murthy, K., Sousa, J., Smith, B., . . . Spitzer, A. (2015). Increasing Incidence of the Neonatal Abstinence Syndrome in U.S. Neonatal ICUs. New England Journal of Medicine.



Additional References:

Neonatal abstinence syndrome: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved April 30, 2015, from http://www.nlm.nih.gov/medlineplus/ency/article/007313.htm

Prescription Drug Abuse. (n.d.). Retrieved April 30, 2015, from http://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-opioids

Prescription Pain Pill Overuse Is Leading To Thousands Of Hospitalized Newborns. (n.d.). Retrieved April 30, 2015, from http://www.forbes.com/sites/matthewherper/2015/04/26/the-pain-pill-epidemic-is-hurting-newborn-babies/

The Innocent Victims. (n.d.). Retrieved April 30, 2015, from http://nationalrxdrugabusesummit.org/2012/10/the-innocent-victims/

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 1, 2015
Last updated: May 1, 2015