This page provides an overview of neonatal abstinence syndrome (NAS) in Massachusetts.
Massachusetts is currently facing an epidemic of opioid misuse, addiction, and overdose. Opioid-related deaths have increased more than 500% since 2000, and every community in the Commonwealth has been impacted .The use of opioids during pregnancy remains a particular concern. Intrauterine exposure to opioids and other licit and illicit substances may result in a neonatal condition known as Neonatal Abstinence Syndrome (NAS). Additionally, pregnancy is often a motivating and therefore opportune time for a woman to address her substance use disorder and pursue recovery. In order to best support pregnant and parenting women and their infants, opioid use needs to be addressed across three key time periods:
1. Pregnancy (Prenatal)
During pregnancy, prenatal care providers have the opportunity to universally screen women for substance use and make referrals to treatment and recovery support services. Medication assisted treatment (MAT) with either methadone or buprenorphine is considered the standard of care for pregnant women with opioid use disorders. While MAT may result in NAS symptoms among infants, it offers substantial benefits for the health and safety of both woman and fetus and prenatal engagement in MAT services is supported by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP).
2. Birth (Neonatal)
At the time of birth, labor and delivery providers can follow best practices for pain management, informed by collaborative communications with a client’s other providers, given the presence of valid, signed confidentiality releases. After delivery, medical providers can work with the new mother to coordinate best care for her infant, which may include emerging best practices for treating NAS, such as rooming-in and other non-pharmacological interventions. Prior to discharge, providers have the opportunity to make connections between families and community based supports and outpatient providers, ideally through the use of warm hand-offs and in-hospital referrals to programs such as the Early Intervention (EI) program. All infants with a diagnosis of Neonatal Abstinence Syndrome are automatically eligible for one year of EI services; other substance exposed infants may be eligible by way of a risk factors checklist.
3. Infancy (Post Discharge)
During the infant’s first year of life, providers can conduct developmental assessments, identify supports for the family, and provide referrals to services. Ongoing recovery support services are critical for the postpartum woman, whether or not she has custody of her infant. If the postpartum woman is parenting, family-centered support services are often the best option.
Explore the NAS Data Dashboard
The goal of this dashboard is to support those efforts by providing population-based data on NAS and eight other key indicators related to perinatal opioid use. Data are provided for the state overall, as well as by maternal race/ethnicity, education, age, and insurance coverage. In addition to statewide estimates, data are also presented by the six Executive Office of Health and Human Services (EOHHS) regions.
- Massachusetts Substance Use Helpline - Call Center and Website
- Massachusetts Women, Infants and Children (WIC) Program
- Massachusetts DCF Family Guide
- Massachusetts DPH Postpartum Emotional Support
- Massachusetts DPH Early Intervention
- Massachusetts Fetal Alcohol Syndrome Group
- Massachusetts New Parent Initiative
- The Journey Recovery Project
- Decisions in Recovery: Treatment for Opioid Use Disorder
A decision-making tool from SAMHSA
- Sober Mommies
An online recovery support group, with information and resources
- Ohio Perinatal Quality Collaborative
Great resources for parents of opioid-exposed infants
- Family Resource Centers
A statewide network of community-based providers offering multi-cultural parenting programs, support groups, early childhood services, information and referral resources and education for families whose children range in age from birth to 18 years of age.
- Text for Baby
A service that offers personalized health information and tips
An advocacy organization for people in recovery
- Massachusetts Bureau of Substance Addiction Services: Information for Providers
- MCPAP for Moms
- Massachusetts Perinatal Quality Collaborative (MPQC): Opioid and Pregnancy Toolkit
- Massachusetts Perinatal-Neonatal Quality Improvement Network: Substance Use Projects
- Massachusetts BSAS – Substance Use and Addictions Training & Workforce Development
- Massachusetts Responds to the Opioid Epidemic – Additional Statistics and Reports
- NIDA Quick Screen