Modified Finnegan Neonatal Abstinence Score (NAS)
Assesses severity of neonatal abstinence syndrome (NAS) in neonates exposed to opioids in utero. 21 signs scored at regular intervals. Total ≥8 for 3 consecutive scores suggests pharmacological treatment needed.
Score interpretation
NAS score <8 — mild withdrawal symptoms; pharmacotherapy not yet indicated
→ Continue non-pharmacological management: swaddling, low stimulation environment, breastfeeding if not contraindicated, skin-to-skin contact; score every 3–4 hours; continue supportive care
NAS score 8–11 — significant withdrawal; consider pharmacotherapy
→ If score ≥8 on 3 consecutive assessments: commence morphine or methadone per local NAS protocol; continue non-pharmacological measures; neonatology review; monitor weight and feeding
NAS score ≥12 — severe withdrawal; pharmacotherapy indicated
→ Commence NAS pharmacological treatment urgently; morphine NAS solution (dose per local protocol); consider adjunct therapy (clonidine, phenobarbitone) if monotherapy insufficient; NICU/SCBU admission; frequent rescoring; neonatology + multidisciplinary social care team
Interpretation bands for the Finnegan NAS. Apply clinical judgement and local guidance.
References
- Finnegan LP et al. Neonatal abstinence syndrome: assessment and management. Addict Dis. 1975;2(1–2):141–158.
Related
Curated clinical cross-links plus same-class fallbacks.
- Morphine (Oral) · Strong Opioid Analgesic — Step 3 WHO Ladder
- Oxycodone · Strong Opioid Analgesic — Step 3 WHO Ladder
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Poractant Alfa (Porcine Surfactant) · Lung Surfactant (Respiratory Distress Syndrome — Neonatal)
- Clonidine · Alpha-2 Adrenoceptor Agonist (ADHD / Opioid Withdrawal / Tic Disorders)
- Oxycodone · Opioid Analgesic (Moderate-Strong)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.