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Updated: Mar 11, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Early Treatment for Neonatal Abstinence Syndrome: A Palliative Approach

Jennifer Hudson1, Rachel Mayo2, Lori Dickes3

  • 1Department of Pediatrics, Greenville Health System, Greenville, South Carolina.

American Journal of Perinatology
|December 2, 2016
PubMed

Insights

An early methadone treatment model for neonatal opioid withdrawal in a low-acuity nursery appears safe and effective. This approach reduced severe withdrawal symptoms and demonstrated feasibility for replication.

Area of Science:

  • Neonatal care
  • Pharmacology
  • Public Health

Background:

  • Neonatal opioid withdrawal syndrome (NOWS) poses significant challenges.
  • Early intervention models are crucial for managing NOWS.
  • Current treatment strategies require evaluation for safety and efficacy.

Purpose of the Study:

  • To evaluate medical, safety, and healthcare utilization outcomes.
  • To assess an early treatment model for NOWS.
  • To determine the feasibility of this model in a level I nursery.

Main Methods:

  • Retrospective review of 117 opioid-exposed infants.
  • Treatment with methadone initiated within 48 hours of birth.
  • Data collected on length of stay, safety events, readmissions, and costs.

Main Results:

  • Mean length of stay was 8.3 days.
  • Infrequent hospital safety events, with no medication errors or deaths.
  • 14% of infants visited the emergency department and 7% were readmitted within 30 days.
  • Mean hospital charges were $10,946.96 and costs were $5,908.93 per birth.

Conclusions:

  • This is the first study to describe an early treatment model for NOWS in a low-acuity nursery.
  • The model appears safe, effective, and low-cost.
  • The model is feasible for replication in similar settings.

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