New research highlights the continuing struggles to identify effective ways to address the growing number of infants born addicted to opioids and other drugs, but indicates that the pain killer buprenorphine is currently the best option to treat neonatal abstinence syndrome.
Canadian researchers published a study in the medical journal JAMA Pediatrics on January 22, indicating that buprenorphine is the most effective pharmacological treatment so far for neonatal abstinence syndrome. However, researchers warn that there is a lack of good data and information.
Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome, which occurs primarily among infants after birth who were exposed to narcotic painkillers during pregnancy. While other drugs have been implicated in NAS, it is most often attributed to in utero opioid exposure.
NAS can result from maternal prescription opioid use, opioid abuse, and medication-assisted treatment. The most common opioids abused include OxyContin, Vicodin, Percocet and fentanyl, as well as other illicit opioids, such as heroin.
In this latest study, researchers from Dalhousie University in Nova Scotia looked at data from 18 clinical trials, involving 1,072 babies born with NAS. They looked for how long treatment took, the length of hospital stays, adjuvant therapy and adverse events in the use.
Researchers found a number of drugs were used to ease the effects of drug addiction in infants, including buprenorphine, clonidine, diluted tincture of opium and clonidine, diluted tincture of opium, morphine, methadone and phenobarbital. Buprenorphine appeared to be associated with the shortest length of treatment and length of hospital stay; nearly 13 days shorter in treatment than morphine and resulting in nearly 12 fewer days for infants to be hospitalized.
“The current evidence suggests that buprenorphine is the optimal treatment for neonatal abstinence treatment, but limitations are considerable and wide-scale adoption requires a large multisite trial,” the researchers concluded. “Morphine, which is considered standard of care in most hospitals, was the lowest-ranked opioid for length of treatment and length of stay.”
The study comes about two years after the U.S. Centers for Disease Control and Prevention (CDC) first warned about increasing numbers of children born with opioid-induced NAS across the U.S.
That researched warned that cases of babies born addicted to opioids increased more than 300% from 1999 to 2013. The CDC warned that by 2013, there were six cases of neonatal abstinence syndrome for every 1,000 hospital births in the U.S.