A NIDA-funded analysis of eight states showed a significant association between rates of neonatal abstinence syndrome (NAS) and poor economic conditions. NAS is a series of uncomfortable symptoms experienced by newborns suffering from opioid withdrawal after their mothers used opioids during their pregnancies.

The study used data from all 580 counties in Florida, Kentucky, Massachusetts, Michigan, New York, North Carolina, Tennessee and Washington state from 2009-2015. Investigators cross checked economic data with NAS cases from both rural and metropolitan areas. Economic data included 10-year unemployment rates, and health data included counties designated as mental health clinician shortage areas.

The study determined that areas with higher rates of long-term unemployment and a shortage of mental health professionals were likely to have proportionately more cases of NAS. The investigators point out that there is no clear consensus as to why the lack of economic opportunity contributes to the increased misuse of opioids in any given county, only that economic conditions might contribute to the high rates of NAS.

The period of time analyzed represented nearly six million births in the counties that were included in the study. During the study period, the overall median NAS rate per 1,000 hospital births increased from 3.2 to 14.5, underscoring the increase of opioid misuse among pregnant women in those counties in the six-year span.

The study was funded by the National Institute on Drug Abuse (NIDA). NIDA is part of the National Institutes of Health.

For a copy of the paper, published in JAMA, go to Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome.

For more information about neonatal abstinence syndrome and opioids, go to: Women and Drugs and Opioids.

For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook.

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