Narcotic use in pregnancy remains a critical problem in 1990. Maternal and neonatal morbidity and mortality are increased significantly in pregnancies complicated by opioid addiction. Methadone maintenance is an important component of the management of many pregnant opioid addicts. The unavailability in most communities of specialized services dealing with perinatal addiction contributes to the dismal outcome frequently observed. The helpless fetus does not get the opportunity to just say no to drugs. As a society, we must just say no to continuing to ignore this problem.