Neonatal Abstinence Syndrome


Neonatal abstinence syndrome (NAS) is a condition in which a baby has withdrawal symptoms after being exposed to prescription medications (e.g., opiates) or illicit drugs the mother has used during pregnancy. These drugs can easily pass through the placenta—the organ that connects the baby to the mother. After the baby is born, it goes through withdrawal because it is no longer receiving the substances.

Sometimes—although this is less common—very sick babies who receive medications after birth to help control pain or agitation can go through withdrawal once those medications are stopped.

Prescription medications that can cause withdrawal include:

  • Opioids (painkillers, including methadone, codeine and others)
  • Benzodiazepines (substances that help with anxiety or sleep)

Illegal drugs that can cause withdrawal include:

  • Cocaine
  • Heroin
  • Marijuana
  • Amphetamines
  • Barbiturates (drugs that cause sleepiness or relaxation)

Withdrawal can occur:

  • When a mother is using a medication as prescribed, such as a treatment for pain or addiction
  • When a mother is using a prescription medication inappropriately
    • Using too much of a medication
    • Taking the medication too often
    • Taking someone else’s prescription
  • When a mother is using an illegal drug


Sometimes, mothers who are addicted to illegal drugs, such as heroin, will receive treatment with another drug (methadone or buprenorphine, for example) to help treat their addiction. Even in these cases, if the mother is treated during pregnancy, the baby can go through withdrawal after birth.

Infants with NAS stay in the hospital longer than other babies (an average of two to four weeks), and they may have serious medical and social problems.

What can you do?

  1. Be aware of the risks involved when taking narcotic medication. You can become addicted, and if you become pregnant, your baby can be born dependent as well. Ask your doctor if there are other less risky medicines or alternative therapy options (such as physical therapy, counseling, exercise or chiropractic care) that would work for your health problem.
  2. Half of all pregnancies are unintended. Don’t be one of them—especially if you are taking narcotics or another addictive substance. Talk to your doctor about whether you should be on birth control.
  3. Take medications only as directed. Never share and never take someone else’s medication.
  4. When you no longer need the narcotic medication you have been prescribed, properly dispose of the medication. Pharmaceutical drop-off locations are available across the state. Find a drop-off location near you.

Exams and Tests

It is important to have your baby seen by a pediatrician, since many other conditions can produce the same symptoms as neonatal abstinence syndrome. The doctor will need to know about any drugs you took during pregnancy, and when they were taken. Tests may be done to diagnose withdrawal in a newborn.

When to Contact a Medical Professional

It is extremely important to tell your doctor or nurse about any drugs you take during pregnancy, and let the doctor or nurse know immediately if your baby has symptoms of neonatal abstinence syndrome. Treatment programs are available for new mothers or pregnant women who want help to stop using prescription or illegal drugs. Visit the Tennessee Department of Mental Health and Substance Abuse Services to see a listing of programs sorted by region and type of service provided.


You should discuss the use of all medications, alcohol and tobacco with your doctor. If you are already pregnant, talk to your doctor about the best way to stop using, to keep yourself and your baby safe.

You can learn more about neonatal abstinence syndrome at our FAQ page.

Click here for additional NAS resources.