The opioid crisis has grown to affect pregnant women and infants across the United States, as evidenced by rising rates of opioid use disorder among pregnant women and neonatal opioid withdrawal syndrome among infants. Across the country, pregnant women lack access to evidence-based therapies, including medications for opioid use disorder, and infants with opioid exposure frequently receive variable care. In addition, public systems, such as child welfare and early intervention, are increasingly stretched by increasing numbers of children affected by the crisis. Systematic, enduring, coordinated, and holistic approaches are needed to improve care for the mother-infant dyad. In this statement, we provide an overview of the effect of the opioid crisis on the mother-infant dyad and provide recommendations for management of the infant with opioid exposure, including clinical presentation, assessment, treatment, and discharge.

IMPORTANCEAdolescent major depressive disorder (MDD) prevalence has nearly doubled in the past decade. The US Preventive Services Task Force endorses universal adolescent MDD screening in primary care; however, most adolescents lack preventive health care, resulting in worsening disparities in MDD screening and treatment. OBJECTIVE To evaluate the effectiveness of universal adolescent MDD screening in the school setting in an effort to reduce disparities and improve MDD identification and treatment initiation. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial, conducted from November 6, 2018, to November 20, 2020, compared the usual school practice of targeted or selected screening based on observable behaviors of concern with universal MDD screening. Students within an identified school were randomized by grade to 1 of the 2 study groups. Study groups were compared using mixed-effects logistic regression. Participants included students in grades 9 through 12 enrolled at 1 of the 14 participating Pennsylvania public high schools.Author affiliations and article information are listed at the end of this article.

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The COVID-19 pandemic has challenged health-care systems across the world and magnified health inequalities related to systemic racism and globalization. As of February 2021, there have been over 100 million confirmed cases of COVID-19 and over two million deaths reported to the World Health Organization [1]. Within the United States (U.S.), Black, Indigenous, Latinx, and other People of Color (BILPOC) are diagnosed, hospitalized, and die at 1.5, 3.3, and 2.8 times the rates of Whites, respectively [2]. BILPOC are also more likely to have defined medical conditions associated with higher risk of severe COVID-19 infections [2]. The disproportionate morbidity and mortality seen among BILPOC adults also impacts BILPOC adolescents and young adults (AYAs). Compared with Whites, BILPOC AYAs are 1) more likely to be essential workers and unable to work from home; 2) less likely to be