Revised dose schema of sublingual buprenorphine in the treatment of the neonatal opioid abstinence syndrome
Article first published online: 6 OCT 2010
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
Volume 106, Issue 3, pages 574–580, March 2011
How to Cite
Kraft, W. K., Dysart, K., Greenspan, J. S., Gibson, E., Kaltenbach, K. and Ehrlich, M. E. (2011), Revised dose schema of sublingual buprenorphine in the treatment of the neonatal opioid abstinence syndrome. Addiction, 106: 574–580. doi: 10.1111/j.1360-0443.2010.03170.x
- Issue published online: 7 FEB 2011
- Article first published online: 6 OCT 2010
- Submitted 17 June 2010; initial review completed 14 July 2010; final version accepted 12 August 2010
- neonatal abstinence syndrome;
- sublingual drug administration
Aims More than half of infants exposed to opioids in utero develop neonatal abstinence syndrome (NAS) of severity to require pharmacological therapy. Current treatments are associated with prolonged hospitalization. We sought to optimize the dose of sublingual buprenorphine in the treatment of NAS.
Design Randomized, Phase 1, open-label, active-control clinical trial comparing sublingual buprenorphine to oral morphine.
Setting Large, urban, tertiary care hospital.
Participants Twenty-four term infants requiring pharmacological treatment for NAS.
Measurements Outcomes were neonatal safety, length of treatment and length of hospitalization.
Findings Sublingual buprenorphine was safe and effective. Infants treated with buprenorphine had a 23-day length of treatment compared to 38 days for those treated with morphine (P = 0.01), representing a 40% reduction. Length of hospital stay in the buprenorphine group was reduced 24%, from 42 to 32 days (P = 0.05).
Conclusions Sublingual buprenorphine was safe in NAS, with a substantial efficacy advantage over standard of care therapy with oral morphine.