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(Clin Obstet Gynecol. 2015;58(2):370–379)Statistics have shown that the abuse of opioids during pregnancy has risen significantly. Simultaneously there has been an increase in the rates of neonatal abstinence syndrome (NAS) or neonatal drug withdrawal after birth. As pregnancy provides an appropriate opportunity to identify opioid dependence (OD), health care providers can make a substantive impact on the lives of OD pregnant women and their children by treating and managing the problem effectively.