There is little consensus about the best way to diagnose and treat opioid addiction in women and infants. As part of the NICHQ-led Collaborative Improvement and Innovation Network to Reduce Infant Mortality (Infant Mortality CoIIN), ASTHO is releasing a Neonatal Abstinence Syndrome Framework to support stakeholder discussions at the state level to better understand how collective efforts can prevent in-utero opioid exposure and impact the incidence of NAS.