Early Treatment for Neonatal Abstinence Syndrome: A Palliative Approach.

To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal.  This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth.  For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted. Per birth, mean hospital charges were $10,946.96; mean costs were $5,908.93.  This study is the first to describe an early treatment model in a low-acuity nursery to prevent severe neonatal opioid withdrawal. The described model may be safe, effective, low-cost, and feasible for replication.