Neonatal Abstinence Syndrome: Buprenorphine Instead of Morphine

New research may change the prevailing approach to treating neonatal abstinence syndrome (NAS), according to the authors of a New England Journal of Medicine article published last week. Currently, babies born to mothers who have used opioids, and who then suffer symptoms of withdrawal, are administered opioids and then tapered off over a 1-month period. The process requires a prolonged hospital stay. But the research team, at the Sidney Kimmel Medical College at Thomas Jefferson University found that treatment with buprenorphine instead of morphine could reduce the therapy duration by one-half. Lead author Walter Kraft, MD, commented, “We predict that buprenorphine will become the new standard of care for NAS.”

The clinical trial enrolled 63 infants with symptoms of NAS, randomly divided into treatment with either morphine or buprenorphine. Group assignment was blinded to both families and clinicians. The 30 infants treated with morphine needed an average of 28 days of therapy to fully control their NAS symptoms, whereas the 33 member buprenorphine cohort achieved the same results in an average of just 15 days. Fellow researcher Michelle Ehrlich, MD, said, "The beauty of our results is that the drug is immediately readily available, unequivocally effective, noninvasive and safe. In future studies, Dr. Kraft and I hope to research how genetics may inform and influence an infant’s response to medication.”

Read a news story about the findings.

The journal abstract may be read here.

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• opioids

• primary care