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Neonatal Abstinence Syndrome

Some babies born to opioid using pregnant women may experience Neonatal Abstinence Syndrome (NAS). Populations of women who may give birth to infants with NAS include women who use heroin, women who use or misuse prescription opioids (e.g. prescription pain medications), or women undergoing MAT for opioid use disorders. The resources below offer additional information.


Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus

American Academy of Pediatrics: Prenatal Substance Abuse, Short and Long-Term Effects on the Exposed Fetus. This report provides information on the most common drugs involved in prenatal exposure: nicotine, alcohol, marijuana, opiates, cocaine, and methamphetamine. (PDF 784 KB)

Neonatal Abstinence Syndrome

National Association of State Alcohol and Drug Abuse Directors (NASADAD) Neonatal Abstinence Syndrome Fact Sheet. This resources offers an overview and symptoms of NAS, promising practices and grant initiatives that address serving infants with NAS and their families. (PDF 548 KB)

Fetal Alcohol Spectrum Disorders (FASD)

Fetal Alcohol Spectrum Disorders (FASD): Online Course (SAMHSA). Provides an overview of risk factors for FASD, signs and symptoms, and prevention and treatment methods. The course includes seven modules that can be completed at each individual’s pace. Designed primarily for health, mental health, and social services providers, educators, and other professionals who work with children, adolescents, and adults with an FASD. Parents, caregivers, and family members of individuals with an FASD may also find it helpful.

Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care

Association of State and Territorial Health Officials (ASTHO): Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge for Primary Prevention and Best Practices of Care. This publication descries prevention and intervention opportunities to serve pregnant women with opioid use disorders and infants with NAS.

Substance-Exposed Newborns: New Federal Law Raises Some Old Issues

National Conference of State Legislatures (NCSL) Children’s Policy Initiative: Substance-Exposed Newborns: New Federal Law Raises Some Old Issues. This publication describes the federal law to protect children who are affected by prenatal exposure to illegal drugs, provides an overview of existing state reporting laws, discusses the role of child protective services, and highlights the importance of prevention. (PDF 116 KB)

Prenatal Drug Use and Newborn Health: Federal Efforts Need Better Planning and Coordination

U.S. Government Accountability Office (GAO) Report to Congressional Requesters: Prenatal Drug Use and Newborn Health, Federal Efforts Need Better Planning and Coordination (February 2015). The GAO examined federal agency efforts related to prenatal opioid use and NAS to identify gaps and determine how federal efforts are planned and coordinated. The report recommends the United States Department of Health and Human Services (US DHHS) to designate a focal point to lead departmental planning and coordination on the issues. ONDCP and HHS concurred with the GAO recommendations.

Brief – State-Level Policy Advocacy for Children Affected by Parental Substance Use

State Policy Academy and Reform Center: State Level Policy Advocacy for Children Affected by Parental Substance Use. This SPARC brief, authored by Sid Gardner from Children and Family Futures, provides compelling data to demonstrate that alcohol and drug use is a key factor in a high percentage of child welfare involved families, outlines eight barriers to taking substance abuse seriously in the child welfare system, summarizes five levers for advocates aiming at going beyond pilot projects to systems change and highlights policy and practice innovations that advocates can promote.

Substance-Exposed Infants: State Responses to the Problem

Substance Abuse and Mental Health Services Administration (SAMHSA): Substance Exposed Infants, State Responses to the Problem. This study assessed State policy from the broadest perspective: prevention, intervention, identification, and treatment of prenatal substance exposure, including immediate and ongoing services for the infant, the mother, and the family. (PDF 1.5 MB)

Webinars and Videos

  • WebinarTreatment of Opioid Use Disorders in Pregnancy and Infants Affected by Neonatal Abstinence Syndrome: Hendree Jones, PhD; Carl Seashore, MD; and Anne Johnston, MD discuss the treatment of opioid use disorders in pregnancy and of infants prenatally exposed to opioids. Facilitated as part of a webinar series.
  • Indian Health Services Webinar Series: Addresses various issues, including Breastfeeding and Substance Abuse: What do we really know? IHS Best Practice Guidelines and Neonatal Abstinence Syndrome: Scoring and Training Options
  • Texas State Department of Health Services, Stronger Together, NAS Soothing Techniques for Mommies and Babies: Video showcasing professionals and mothers demonstrating techniques to help soothe withdrawal symptoms and the important role that birth mothers play in their child’s recovery.
  • University of Maryland Medical Center: Video describing Neonatal Abstinence Syndrome – symptoms, screening/identification, and treatment. Includes a mother’s experience in having a baby born with Neonatal Abstinence Syndrome.

Recent Research Studies

  • hand holding pen writing on paperPatrick, S.W., Davis, M.M., Lehmann, C.U., & Cooper, W.O. (2015). Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. Journal of Perinatology, 35, 650-655. doi:10.1038/jp.2015.36.

    This study investigated recent changes in NAS and its geographic variability to inform state and local governments in targeting public health resources.
  • Patrick, S.W., Schumacher, R.E., Benneyworth, B.D., Krans, E.E., McAllister, J.M., & Davis, M.M. (2012). Neonatal abstinence syndrome and associated health care expenditures: United States, 2000–2009. Journal of the American Medical Association, 307(18), 1934-1940. doi: 10.1001/jama.2012.3951.

    This study investigated the national incidence of NAS and antepartum maternal opiate use and to characterize trends in national health care expenditures associated with NAS between 2000 and 2009.
  • Tolia, V.N., Patrick, S.W., Bennett, M.M., Murthy, K., Sousa, J., Smith, P.B., Clark, R.H., & Spitzer, A.R. (2015). Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. The New England Journal of Medicine, 372, 2118-2126. doi: 10.1056/NEJMsa1500439.

    This study analyzed data from infants with the neonatal abstinence syndrome from 2004 through 2013 in 299 neonatal intensive care units (NICUs) across the United States and evaluated trends in incidence and health care utilization and changes in infant and maternal clinical characteristics.
  • Chasnoff, I. & Gardner, S. (2015). Neonatal abstinence syndrome: a policy perspective. Journal of Perinatology, 35, 539-541. doi: 10.1038/jp.2015.53.

    This article investigates the policy implications of Neonatal Abstinence Syndrome.
woman holding an infant


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