Neonatal Abstinence Syndrome

Priority 6: Medication Assisted Treatment

NAS Medical AssistanceThe Substance Abuse and Mental Health Services Administration (SAMHSA) developed clinical guidance to assist providers in optimizing outcomes for women and their babies. The literature supports innovative care alternatives including models that integrate prenatal care, counseling, medication-assisted treatment and unique approaches to stakeholder engagement across all health professions. The goal is to build a trusted provider-patient relationship that supports an improved prenatal care and birth experience and increased resilience for relapse prevention.

Referral to appropriate treatment also can optimize maternal and fetal outcomes. The American Society of Addiction Medicine (ASAM) defines treatment as any planned, intentional interventions designed to help the individual “achieve and maintain sobriety, physical, spiritual, and mental health, and a maximum functional ability.” ASAM treatment dimensions are used to determine which level of care are most appropriate, given the unique needs of the individual. Treatment referrals should be based on a comprehensive assessment that considers the ASAM criteria:

Dimension 1: Acute intoxication and/or withdrawal potential
Dimension 2: Biomedical conditions and complications
Dimension 3: Emotional, behavioral, or cognitive conditions and complications
Dimension 4: Readiness to change
Dimension 5: Relapse, continued use, or continued problem potential
Dimension 6: Recovery environment.


  • Ensure patient interaction is delivered in an empathetic, non-judgmental way.
  • Use a standardized, validated screening instrument for self-identified polysubstance use.
  • Implement a formal screening, brief intervention and referral to treatment (SBIRT) protocol.
  • Refer to counseling and education services on the medical and social consequences of pharmacotherapy for opioid use disorder.
  • Counsel patient on risks to mother and baby at time of relapse.
  • Offer medication-assisted treatment that includes methadone or buprenorphine and evidence-based behavioral interventions.

For more information on NJHA’s activities to improve maternal and child health,