Infants who are prenatally exposed to opioids are at risk for adverse birth outcomes and neonatal abstinence syndrome (NAS). NAS describes a withdrawal syndrome that includes symptoms such as inconsolable crying, sleep disturbance, and poor weight gain. National rates of NAS have tripled since 2000, and Bexar County has been disproportionately affected, accounting for 30 percent of all NAS cases reported annually in Texas. Therefore, a community collaborative was needed to address this growing public health concern. The Bexar County NAS Collaborative (BCNC) is a partnership between academic researchers, healthcare agencies, community stakeholders, and patient/family partners. Our mission is to support individuals and families impacted by NAS, through collaborative education, research, and clinical practice. The BCNC is governed by a 10-member advisory council that meets monthly. We also hold regular community-wide meetings and have a website that allows the Bexar County community to provide input. The aim of the BCNC is to design and conduct comparative effectiveness research focused on health outcomes that matter most to patients and families impacted by NAS as well as the greater Bexar County community. Therefore, during this Tier II project, the work of the BCNC will be focused on the further development and refinement of a comparative effectiveness research question focused on NAS, measurable outcomes that matter to patients and their families, and an initial research design draft that will be further developed in Tier 3 of this project.