For decades, the diagnosis of neonatal abstinence syndrome (NAS) was relatively rare in the US; however, the recent epidemic of prescription and nonprescription opioid use across the country has made this once novel diagnosis common. The number of infants diagnosed with NAS in the US has grown nearly 5-fold since 2000. Today, one infant with NAS is born every 25 minutes, accounting for an estimated $1.5 billion in hospital charges. The rapid rise of NAS in our nurseries and neonatal intensive care units demands that improvements in research and care delivery systems keep pace.