This clinical review examines how prenatal substance-use screening and biochemical toxicology testing during pregnancy and after birth can influence care for families affected by neonatal abstinence syndrome. The author distinguishes supportive screening that encourages engagement and planning for newborn care from testing practices that may increase stigma, discourage disclosure, or disrupt relationships with clinicians. The article argues that testing decisions should be guided by clinical usefulness and attention to unintended consequences. It is a review of care practices, not a study measuring the effectiveness of a new screening protocol.
