Neonatal Abstinence Syndrome by County

This inpatient/outpatient diagnosis code is for 'neonatal withdrawal symptoms from maternal use of drugs of addiction'. During 2010-2015, NAS cases were identified based on ICD-9-CM diagnosis code 779.5 (drug withdrawal syndrome in newborn). Rate calculation.

All rates presented are crude rates. Counts and rates are suppressed when the numerator is between 1-5 for privacy and statistical stability purposes. This is indicated by DNS (Data Not Sufficient).

The denominator used to calculate rates is the number of live births in the corresponding birth year. Rates are calculated per 1,000 live births to be consistent with the CSTE case definition. [Limitations] Cases of neonatal abstinence syndrome are solely identified from inpatient and/or outpatient hospitalization records (inpatient only: 2010-2019, inpatient and outpatient: 2020-2024).

Case counts and rates may slightly differ from previously published reports due to implementation of CSTE's Tier 2 case definition, which is limited to infants with a NAS diagnosis less than 28 days after the date of birth. NAS surveillance does not distinguish between exposure due to untreated substance use disorder (i.e., opioid use disorder or other), medication assisted treatment (i.e., pregnant people receiving treatment for an opioid use disorder), or long-term treatment for a chronic disease or condition (e.g., pregnant people receiving treatment for chronic pain, anxiety disorders).

If treatment for NAS is not, or cannot, be billed, the diagnosis code may not be documented in the medical record. In these instances, cases of NAS will not be captured in the data. This is more likely to happen when infants receive non-pharmacological treatments (i.e., decreased stimulation and increased calming techniques/Eat Sleep Console), which have become increasingly common in the state.

Pregnant patients may not be screened universally and/or tested due provider biases or costs associated with testing. NAS symptoms may not occur until 5-7 days after birth. Unless re-admitted, infants discharged prior to the presentation of symptoms would not be captured in the data.

[Data Source] Data is used with permission from the Michigan Health and Hospital Association Service Corporation (MHASC). Michigan resident inpatient files (2010-2024), and outpatient files (2020-2024) created by the Division for Vital Records and Health Statistics (DVRHS), Michigan Department of Health and Human Services. Linkage for 2010-2023 datafiles completed by DVRHS.

Data linkage for 2024 datafiles and analysis conducted by the Maternal and Child Health Epidemiology Section, MDHHS. -- For more NAS data: michigan.gov/mdhhs/adult-child-serv/childrenfamilies/mchepi/infant-health-epidemiology NAS Case Definition: cdn.ymaws.com/www.cste.org/resource/resmgr/ps/ps_2023/23-MCH-01_NAS.pdf