Current Management of Neonatal Abstinence Syndrome Secondary to Intrauterine Opioid Exposure

Neonatal abstinence syndrome (NAS) comprises a constellation of drug withdrawal symptoms that result from chronic intrauterine exposure to a variety of substances, including opioids, benzodiazepines, barbiturates, selective serotonin reuptake inhibitors, ethanol, nicotine and caffeine. Most non-opioid fetal drug exposures result in limited clinical presentation, respond well to supportive care measures and rarely require pharmacologic intervention [1, 2]. Chronic in utero exposure to opioids is well characterized and is particularly problematic because of its high prevalence and frequent need for pharmacotherapy to mitigate withdrawal signs, especially when the opioid exposure is in the broader context of maternal polysubstance consumption.