# Project 4:  Neonatal Abstinence Syndrome (NAS): Fetus to First Years

> **NIH NIH P20** · RHODE ISLAND HOSPITAL · 2020 · $483,324

## Abstract

PROJECT SUMMARY 
Opioid use disorders are a public health concern of epidemic proportion. Our project will contribute significantly 
to this COBRE Center on Opioids and Overdose, as misuse of opioids during pregnancy effects infants, our 
most vulnerable population. The focus of this project is on Neonatal Abstinence Syndrome (NAS), the withdrawal 
that infants suffer after being born to a mother who is dependent on opioids. NAS has increased fivefold since 
2000, now affecting 60-80% of infants exposed to opioids in utero. The cost to treat NAS in 2012 was $1.5 billion 
with the majority of infants enrolled in state sponsored insurance programs. NAS is typically treated by the 
reintroduction of opioids (morphine or methadone and more recently, buprenorphine) followed by gradual 
weaning and increasingly with non-pharmacological interventions as well (e.g. rooming-in). Unfortunately, 
treatments are not evidence-based and there are no standardized protocols resulting in a wide variability in the 
management of these infants and the potential for mismanagement. The overall objective of this proposal is to 
develop the evidence based tools needed to define best practice and develop a standardized approach to 
improve the treatment and management of infants with NAS. Our central hypothesis is that establishment of a 
standardized perinatal to postnatal treatment program for maternal opioid dependency and the management of 
NAS will shorten length of stay and length of treatment, reduce health care costs, and prevent or mitigate 
potential adverse long term neurodevelopmental outcomes. In this project we propose to 1) develop a multi- 
disciplinary, buprenorphine-based prenatal care model for pregnant women being treated for opioid use 
disorders, 2) conduct a single center randomized control trial of buprenorphine vs. morphine for NAS, and 3) 
develop a preliminary Risk Stratification Safety Assessment tool (RSSA), using Classification and Regression 
Tree (CART) statistical decision making analysis to help determine which families are most at risk of medication 
noncompliance. By tailoring treatment prenatally and removing barriers to novel interventions and working 
synergistically with the Cores we will transform our current approach the treatment and management of NAS.

## Key facts

- **NIH application ID:** 10006605
- **Project number:** 5P20GM125507-03
- **Recipient organization:** RHODE ISLAND HOSPITAL
- **Principal Investigator:** Adam James Czynski
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $483,324
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10006605

## Citation

> US National Institutes of Health, RePORTER application 10006605, Project 4:  Neonatal Abstinence Syndrome (NAS): Fetus to First Years (5P20GM125507-03). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10006605. Licensed CC0.

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