30-40% of pregnant women receive opioid prescriptions for pain, mostly short acting http://pediatrics.aappublications.org/content/early/2015/04/08/peds.2014-3299a

Incidence of NAS in the US are increasing at a staggering rate US Nationwide rate 2000-2012 TN State rate 1999-2016 https://www.cdc.gov/mmwr/volumes/65/wr/mm6531a2.htm https://bettertennessee.com/health-brief-neonatal-abstinence-syndrome/

Existing cost models do not account for the true cost of NAS Birth to discharge $67,000 First Year $159,000 to $238,000 Long Term Care $1,500,000 + Average NAS birth cost is $66,700 compared to a normal birth at $3,700 Length of stay average is 16.9 days compared to normal birth at 2 days CURRENT COST MODELS ONLY ACCOUNT FOR THIS NAS Babies require feeding assistance and growth monitoring Discharge to home with social services Nutritional care and medication Care for increased rates of: ADHD, developmental delay, vision problems, cognitive deficiency, otitis media, spina bifida, motor development issues, cleft palate and heart defects http://www.ncdrugtreatmentcourts.com/NAS.html http://www.empowerhealthusa.com/assets/research-paper---long-term-outcomes-of-infants-with-nas.pdf

$40,500,000,000 lifetime care cost for babies born in 1 year The BIG number When we look at a more accurate estimate of the cost to care for each of these babies and multiply it by the rate of incidence, we get an idea of the true costs 27,000 NAS babies per year $1,500,000 lifetime care cost $40,500,000,000 lifetime care cost for babies born in 1 year This means NAS births over the last 5 years will cost : $202,500,000,000 https://hcup-us.ahrq.gov/reports/statbriefs/sb193-Neonatal-Maternal-Hospitalizations-Substance-Use.pdf https://jpo.wrlc.org/bitstream/handle/11204/3796/FAQ_Costs%20Associated%20with%20the%20Birth%20of%20Drug%20and%20or%20Alcohol%20Addicted%20Exposed%20Infants.pdf?sequence=3&isAllowed=y

Less than 3% of the tobacco settlement went to addressing the problem $246 billion in tobacco settlement fund States have budgeted less than 2% for tobacco prevention and health programs Mandates to spend money on programs were passed but not enforced New York issued bonds against settlement to divert money into general fund https://www.cagw.org/thewastewatcher/state-tobacco-settlement-funds-go-smoke

This cannot happen again We need a comprehensive plan that addresses long term care and developmental delay accommodations Using current best practice methods to follow children and provide for multi specialty care ​ Feeding assistance and growth monitoring​ Developmental and behavioral specialists At birth weaning and developmental rehabilitation needs Discharge to home with social services Behavioral counseling and cognitive rehabilitation therapy  Medical monitoring to include medication / treatment for : ADD, Depression, anger and social issues known to be associated with NAS Medical treatment to include surgical correction for congenital defects

Opioid Justice Now has THE plan We are developing a comprehensive developmental and behavioral care model specific for NAS babies with renowned Stanford University Professor of Pediatrics, Dr. Kanwaljeet “Sunny” Anand who is a world leader in the clinical care of these infants His research focus over the past 30+ years has contributed fundamental knowledge about pediatric pain/stress, long-term effects of pain in early life, management of pain, mechanisms for opioid tolerance and withdrawal Finances will be distributed by HGI who has been a trusted administrator of billions in public grant and self insured funds and program development. This keeps the money out of the hands of an interested party to insure that the funds end up benefiting the damaged parties https://profiles.stanford.edu/kanwaljeet-anand

Adolescent to adulthood Prenatal Care Birth Event Postnatal Adolescent to adulthood Outreach and Education Nutritional Care Medication assisted therapy Public service Announcements Early Intervention Emphasis on prenatal education and nutrition and weaning addicted mothers from opioids early in the pregnancy birthing centers for keeping baby with mother and preventing the mother from being incarcerated with neonatal nursing in house and counselling Medical treatment to include surgical correction and medication for congenital defects Identify and respond to needs of exposed child. Respond to needs of mother and other family members. Provide an appropriate education, screening, and support as exposed children approach adolescence and adulthood to prevent adoption of high-risk behaviors such as: substance abuse, attention deficit medication, tutorial services, behavioral counseling ,occupational therapy, physical therapy, speech therapy , swallowing therapy, auditory therapy, life skills therapy, vocational education, cardiology and digestive and neurology monitoring and medical / surgical interventions if necessary. Universally screen pregnant women for substance abuse and make referrals to treatment when appropriate. Provide enhanced prenatal services, including referrals to services in which coordination can occur with all relevant entities (hospitals, DCF, substance-abuse treatment providers, etc.) prior to birth. Academic and clinical research towards identifying genetic markers for those with high risk based on pre-disposition Provide developmental services. Ensure an environment safe from abuse and neglect. Respond to immediate needs of other family members, including treatment of the parent-child relationship http://www.astho.org/prevention/nas-neonatal-abstinence-report/