Intended for healthcare professionals


Opioids in pregnancy

BMJ 2016; 352 doi: (Published 12 January 2016) Cite this as: BMJ 2016;352:i19
  1. Nora D Volkow, director
  1. 1National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
  1. nvolkow{at}

High prescribing rates have probably contributed to recent increases in neonatal abstinence syndrome

The steep increase in the number of opioid prescriptions dispensed in the United States has been associated with a parallel rise in their misuse, fatal overdoses, and heroin use. More recently, attention has been focused on the large increase in the number of infants born with neonatal abstinence syndrome (NAS). In the US, between 2000 and 2009, the incidence of NAS increased from 1.20 to 3.39 per 1000 live births,1 and between 2004 and 2013 the total percentage of days spent in intensive care because of NAS increased from 0.6% to 4.0%.2 The rise in NAS is also likely to be a consequence of increased opioid prescriptions—estimates indicate that 14-22% of pregnant women in …

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