Department of Health
John J. Dreyzehner, MD, MPH, Commissioner

Neonatal Abstinence Syndrome is a condition in which a baby has withdrawal symptoms after being exposed to certain substances. Many times, the baby is exposed when the mother uses substances such as medications or illicit drugs during pregnancy, and after the baby is born (and separated from the mother’s body), the baby goes through withdrawal because it is no longer receiving the substances. Less commonly, very sick babies may receive medications after birth to help control pain or agitation, and once those medications are stopped, the baby may go through withdrawal.

The kinds of medications that may cause withdrawal include those known as opioids (painkillers) or benzodiazepines (which help with anxiety or sleep). Illicit drugs such as cocaine may also cause withdrawal. Withdrawal can occur when a mother is using a medication as prescribed, such as a mother who is receiving treatment for pain or addiction; when a mother is using a prescription medication inappropriately (such as when she uses too much of a medication, takes the medication too often, or takes someone else’s prescription); or when a mother is using an illegal drug.

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

Over the past decade, we have seen a nearly ten-fold rise in the incidence of babies born with NAS in Tennessee. Infants with NAS stay in the hospital longer than other babies and they may have serious medical and social problems.

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Effective January 1, 2013, all cases of NAS diagnosed among Tennessee resident births should be reported to the Tennessee Department of Health at the time of diagnosis.

• NAS Reporting Portal (Use this to report cases)
• Quick Reference Guide for reporting cases of NAS
• Frequently Asked Questions about reporting cases of NAS to the Tennessee Department of Health
• Letter from TDH Commissioner Dr. John Dreyzehner regarding reporting requirement
• Weekly NAS Surveillance Summary Archive

Additional Reporting Resources

• Update on NAS Reporting Webinar (March 19, 2013)
• Questions and Answers from the NAS Reporting Webinar (March 19, 2013)
• Slides from NAS Reporting Webinar (March 19, 2013)

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Neonatal Abstinence Syndrome — Frequently Asked Questions (FAQ)

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• National Library of Medicine:
  Neonatal Abstinence Syndrome
• American Academy of Pediatrics:
  Clinical Report — Neonatal Drug Withdrawal
• American College of Obstetrics and Gynecology:
   Committee Opinion — Opioid Abuse, Dependence, and Addiction in Pregnancy
• Tennessee Initiative for Perinatal Quality Care:
  TIPQC

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For General Information:
Call: 615-741-7353
Email: MCH_Health@tn.gov

For Media Inquiries:
Call: 615-741-3111

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