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Neonatal abstinence syndrome (NAS)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • infants born to heroin-dependent or methadone-dependent mothers have a high incidence of neonatal abstinence reaction (also less potent opioids have also been identified as causing neonatal abstinence syndrome (NAS))
    • possible clinical features of NAS are non-specific and include tremor, unrest, tachypnoea, hypertonicity, vomiting,abnormal crying, yawning, sneezing, diarrhoea, fever, poor feeding - in very severe cases of NAS convulsions may occur
    • onset of clinical NAS symptoms depends on which opioids the pregnant opioid-dependent woman received or consumed
      • for example
        • heroin, the withdrawal syndrome in the neonate occurs during the first 24 h
        • with methadone NAS does not develop until after 48 h
  • effectiveness and safety of opiate treatment in newborn infants has been published recently in Cochrane Review (2)
    • opiates are concluded as preferred initial therapy for NAS, especially for infants of mothers using opioids during pregnancy


  • (1) Ebner N et al. Management of neonatal abstinence syndrome in neonates born to opioid maintained women Drug and Alcohol Dependence 2007;87(2-3);16: 131-138.
  • (2) Osborn A et al. Opiate treatment for opiate withdrawal in newborn infants (Review).Cochrane Library 2005, Issue 2.

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