Ch. 4: Neonatal Abstinence Syndrome (NAS)

Many psychotropic (and other) substances have the potential to wreak havoc on fetal development if used by a pregnant woman. This is true across the entire pregnancy period, though the specific nature and intensity of risks might vary as a function of which of the fetal organ systems are developing at the point of exposure, as well as the dose/duration of exposure. We have discussed this topic of prenatal exposure in each of our modules, and are paying special attention to it in this module because of the importance of knowing about Neonatal Abstinence Syndrome (NAS). The piece that you are assigned is presented by the March of Dimes—an organization dedicated to preventing birth defects (March of Dimes, 2017). This is a non-technical piece that can be easily shared with clients or family members.

In this brief chapter you will read about:

• What NAS is and how it is assessed
• Substances that might cause NAS
• Prevention and treatment of NAS

When you read the list of substances presented in this piece, it is important to also consider the fact that some medications used to treat opioid addiction are, themselves, opioid drugs. For example, methadone maintenance therapy (MMT) during pregnancy may be an improvement over “street” opioids (heroin and prescription abuse) for the baby’s birth outcomes, but babies exposed in utero to methadone may very well still have to be treated for NAS. Buprenorphine is another form of medication used to treat opioid addiction and has less severe NAS outcomes than methadone (Jones et al., 2012).