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Nationally, substance use during pregnancy “…increased from 1.19 to 5.63 per 1,000 hospital births.” (SAMHSA, 2016) Infants born with substance withdrawal symptoms leading to a diagnosis of Neonatal Abstinence Syndrome (NAS) affect infant mortality rate (IMR) data. Statewide research shows that in 2015, Texas’ PHR 2/3’s IMR surpassed that of the state and national average. Gleeson, (2017) Further research documents the concentration of high IMR averages being located in communities at or below the poverty line representative of underrepresented, minority populations. Bishop, Borkowski, Couillard, et al., (2017) In efforts to reduce the amount of infants born with substance ab/use diagnoses that impact Texas state’s PHR 2/3’s IMR, the author concludes that reaching highly affected populations with prevention interventions that are culturally relevant and inclusive, and ethically compliant, can be more effective than treatment that often results in relapse drug use. Additionally, focusing prevention on addressing mental health concerns of pregnant women can significantly impact their aversion to using substances as coping mechanisms. Hans (n.d.)