some States, there are as many as 96 to 143 pre-
scriptions for opioids per 100 adults per year. 
(2) In recent years, there has been a steady rise 
in the number of overdose deaths involving heroin. 
According to the Centers for Disease Control and 
Prevention, the death rate for heroin overdose dou-
bled from 2010 to 2012. 
(3) At the same time, there has been an in-
crease in cases of neonatal abstinence syndrome (re-
ferred to in this section as ‘‘NAS’’). In the United 
States, the incidence of NAS has risen from 1.20 
per 1,000 hospital births in 2000 to 3.39 per 1,000 
hospital births in 2009. 
(4) NAS refers to medical issues associated 
with drug withdrawal in newborns due to exposure 
to opioids or other drugs in utero. 
(5) The average cost of treatment in a hospital 
for NAS increased from $39,400 in 2000 to $53,400 
in 2009. Most of these costs are born by the Med-
icaid program. 
(6) Preventing opioid abuse among pregnant 
women and women of childbearing age is crucial. 
(7) Medically appropriate opioid use in preg-
nancy is not uncommon, and opioids are often the 
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safest and most appropriate treatment for moderate 
to severe pain for pregnant women. 
(8) Addressing NAS effectively requires a focus 
on women of childbearing age, pregnant women, and 
infants from preconception through early childhood. 
(9) NAS can result from the use of prescription 
drugs as prescribed for medical reasons, from the 
abuse of prescription drugs, or from the use of ille-
gal opioids like heroin. 
(10) For pregnant women who are abusing 
opioids, it is most appropriate to treat and manage 
maternal substance use in a non-punitive manner. 
(11) According to a report of the Government 
Accountability Office (referred to in this section as 
the ‘‘GAO report’’), more research is needed to opti-
mize the identification and treatment of babies with 
NAS and to better understand long-term impacts on 
children. 
(12) According to the GAO report, the Depart-
ment of Health and Human Services does not have 
a focal point to lead planning and coordinating ef-
forts to address prenatal opioid use and NAS across 
the department. 
(13) According to the GAO report, ‘‘given the 
increasing use of heroin and abuse of opioids pre-
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scribed for pain management, as well as the in-
creased rate of NAS in the United States, it is im-
portant to improve the efficiency and effectiveness of 
planning and coordination of Federal efforts on pre-
natal opioid use and NAS’’. 
SEC. 
3. 
DEVELOPING 
RECOMMENDATIONS 
FOR 
PRE-
VENTING AND TREATING PRENATAL OPIOID 
ABUSE AND NEONATAL ABSTINENCE SYN-
DROME. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this Act as the ‘‘Sec-
retary’’), acting through the Director of the Agency for 
Healthcare Research and Quality (referred to in this sec-
tion as the ‘‘Director’’), shall conduct a study and develop 
recommendations for preventing and treating prenatal 
opioid abuse and neonatal abstinence syndrome, soliciting 
input from nongovernmental entities, including organiza-
tions representing patients, health care providers, hos-
pitals, other treatment facilities, and other entities, as ap-
propriate. 
(b) REPORT.—Not later than 1 year after the date 
of enactment of this Act, the Director shall publish on the 
Internet Web site of the Agency for Healthcare Research 
and Quality a report on the study and recommendations 
under subsection (a). Such report shall address each of 
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the issues described in paragraphs (1) through (3) of sub-
section (c). 
(c) CONTENTS.—The study described in subsection 
(a) and the report under subsection (b) shall include— 
(1) a comprehensive assessment of existing re-
search with respect to the prevention, identification, 
treatment, and long-term outcomes of neonatal ab-
stinence syndrome, including the identification and 
treatment of pregnant women or women who may 
become pregnant who use opioids or other drugs; 
(2) an evaluation of— 
(A) the causes of and risk factors for 
opioid use disorders among women of reproduc-
tive age, including pregnant women; 
(B) the barriers to identifying and treating 
opioid use disorders among women of reproduc-
tive age, including pregnant and postpartum 
women and women with young children; 
(C) current practices in the health care 
system to respond to and treat pregnant women 
with opioid use disorders and infants born with 
neonatal abstinence syndrome; 
(D) medically indicated use of opioids dur-
ing pregnancy; 
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(E) access to treatment for opioid use dis-
orders in pregnant and postpartum women; and 
(F) access to treatment for infants with 
neonatal abstinence syndrome; and 
(3) recommendations on— 
(A) preventing, identifying, and treating 
neonatal abstinence syndrome in infants; 
(B) treating pregnant women who are de-
pendent on opioids; and 
(C) preventing opioid dependence among 
women of reproductive age, including pregnant 
women, who may be at risk of developing opioid 
dependence. 
SEC. 4. IMPROVING PREVENTION AND TREATMENT FOR 
PRENATAL OPIOID ABUSE AND NEONATAL 
ABSTINENCE SYNDROME. 
(a) REVIEW
OF PROGRAMS.—The Secretary shall 
lead a review of planning and coordination within the De-
partment of Health and Human Services related to pre-
natal opioid use and neonatal abstinence syndrome. 
(b) STRATEGY TO CLOSE GAPS IN RESEARCH AND 
PROGRAMMING.—In carrying out subsection (a), the Sec-
retary shall develop a strategy to address research and 
program gaps, including such gaps identified in findings 
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