Published: 07/21/2026 | Author: Nikki Wisher

A new study finds that prenatal opioid exposure has far less influence on a child’s school performance than previously believed, once researchers accounted for factors like school quality, family income, and a mother’s education level. 

For families affected by opioid use, this study is one of the more encouraging findings to come out of neonatal abstinence syndrome (NAS) research in recent years.

The Study’s Findings

Every 25 minutes in the United States, a baby is diagnosed with NAS, a condition where infants exposed to opioids in the womb develop withdrawal symptoms after birth. Researchers at Penn State College of Medicine compared standardized test scores for 3,494 students in grades three through eight, 23% of whom had a history of NAS and 77% of whom didn’t, using an integrated data system from South Carolina that links health, education, and socioeconomic records over time.

After controlling for age, sex, and socioeconomic factors, the two groups performed similarly on English and language arts tests. In math, students with a history of NAS showed a small but statistically significant drop compared to the control group. Overall, both groups scored below the state average at every grade level.

“Historically, we’ve been quick to blame prenatal opioid exposure for poor academic achievement, but it appears that socio-environmental factors play a much larger role,” reported Dr. Tammy Corr, a corresponding author and associate professor of pediatrics at Penn State. Corr optimistically added, “There’s every reason to believe that these children can do well and thrive when given the right resources.”

Driving the Trend

More than 30% of the children in the study were born to a mother with less than a high school degree, and 85% were either uninsured or covered by Medicaid at birth. The researchers found these markers of socioeconomic status more strongly linked to academic performance than NAS history itself. Attending a lower-rated school, limited access to early childhood education, and participation in the WIC nutrition program all played a larger role in outcomes than opioid exposure alone.

In the study, children of non-Hispanic Black mothers scored a grade level lower than their non-Hispanic white counterparts. Test scores rose as maternal education levels increased. Researchers say the South Carolina data, while state-specific, reflects socioeconomic and environmental patterns similar to those seen in NAS studies elsewhere in the country.

Neonatal Abstinence Syndrome

NAS occurs when a baby exposed to opioids before birth experiences withdrawal after delivery, usually because of drugs the mother took during pregnancy. Earlier research had linked prenatal opioid exposure to increased risk of developmental, cognitive, and behavioral difficulties in early childhood, but this study tracks outcomes into the school years while accounting for the broader circumstances these children grow up in.

Researchers plan to build on the findings with interviews of parents and guardians of school-aged children with a history of NAS. They want to understand the day-to-day experiences that help or hinder academic success.

Harm Reduction & Treatment During Pregnancy

For pregnant people using opioids, medically supervised care, including medication-assisted treatment, remains the safest path for both parent and baby, by reducing the risks associated with unsupervised withdrawal. This study doesn’t change that guidance. 

Instead, it reinforces that a child’s long-term outcomes depend heavily on the support systems available after birth. Stable housing, early childhood education, nutrition assistance and the mother’s own access to continued care and recovery resources all play critical roles for a healthy future.

Starting with NA

If you’re pregnant or parenting and affected by opioid use, treatment programs exist that address both recovery and family stability.

The easiest step–and a free one–is to sign up with Narcotics Anonymous. NA meetings offer peer support at every stage of recovery, and case management services can help connect families to WIC, early childhood education, and other resources shown to matter for a child’s long-term success.

Getting started is simple. Call 800-934-1582(Sponsored) and speak with an expert or browse our directory to find NA chapters anywhere in the USA.