title: The Growing Burden of Neonatal Opiate Exposure on Children and Family Services in Massachusetts.
abstract: Increasing opiate use among women of reproductive age has led to a rise in adverse pregnancy outcomes, including neonatal abstinence syndrome (NAS). Recent studies have documented the increased incidence of NAS, but subsequent impact on the chain of organizations within the social service system remains unexplored. In this article, we begin to estimate the reach of this issue by assessing the labor costs of caring for NAS infants within the Massachusetts Department of Children and Families (MA DCF). Based on a process map of services, we modeled social service hours using encounter-level hospital data as inputs. In this manner, we estimate that MA DCF professionals now devote more than 10,000 hours per month to this single problem. As opiate addiction increases across America, substantial additional investment in social service providers, foster care, Early Intervention Programs, and other family services will be required.
authors.affiliation: Department of Anesthesia, Perioperative, and Pain Medicine, Division of Critical Care, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Urbano L
authors.initials: UL
authors.lastname: França
authors.affiliation: Massachusetts Department of Children and Families, Braintree, MA, USA.
authors.forename: Shaheer
authors.initials: S
authors.lastname: Mustafa
authors.affiliation: Department of Anesthesia, Perioperative, and Pain Medicine, Division of Critical Care, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA michael.mcmanus@childrens.harvard.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: McManus
mesh_terms: D002648:Child; D005260:Female; D005380:Financing, Government; D006077:Government Agencies; D005102:Health Expenditures / Q000639:trends; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009357:Neonatal Abstinence Syndrome / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D009293:Opioid-Related Disorders / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology; D015813:Substance Abuse Detection / Q000639:trends*; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology / Q000628:therapy
keywords: child welfare services; child welfare workers; epidemiology; policy; substance abuse