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Neonatal abstinence syndrome: essentials for the practitioner

Anita Siu1, Christine A Robinson2

  • 1Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey ; Jersey Shore University Medical Center, Neptune, New Jersey.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|October 14, 2014
PubMed

Insights

Neonatal Abstinence Syndrome (NAS) is rising due to maternal opiate use. Current treatments involve opioid replacement, with clonidine showing promise as an adjunctive therapy for infants.

Area of Science:

  • Neonatal care
  • Pharmacology
  • Public health

Background:

  • The incidence of Neonatal Abstinence Syndrome (NAS) has significantly increased over the last 15 years.
  • This rise is primarily attributed to increased antepartum maternal opiate use.
  • Optimal management strategies for NAS remain controversial due to limitations in existing research.

Purpose of the Study:

  • To review current treatment options for Neonatal Abstinence Syndrome (NAS).
  • To evaluate the efficacy of different pharmacologic interventions for NAS.
  • To identify areas for future research in NAS management.

Main Methods:

  • Review of published literature on Neonatal Abstinence Syndrome (NAS) treatment.
  • Analysis of primary treatment options: opioid replacement therapy (morphine, methadone).
  • Evaluation of adjunctive therapies, including phenobarbital and clonidine.

Main Results:

  • Opioid replacement therapy with morphine or methadone is the primary treatment for NAS.
  • Paregoric and tincture of opium are no longer recommended due to safety concerns.
  • Buprenorphine shows promise as an emerging treatment option.
  • Clonidine appears beneficial as an adjunctive therapy for infants not responding to monotherapy.

Conclusions:

  • Current NAS management relies on opioid replacement, with emerging options like buprenorphine.
  • Adjunctive therapies, particularly clonidine, may improve outcomes for difficult-to-treat cases.
  • Further research is needed, including comparative trials and exploring pharmacogenomics for optimized NAS management.

Keywords:
abstinence syndromebuprenorphineclonidinemethadonemorphine

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