Opioid Replacement Therapy Drug Found to Be Effective in Treating Neonatal Withdrawal Symptoms
The majority of newborn babies who were exposed to in utero opioid use require pharmacologic therapy to treat the onset of severe opioid withdrawal symptoms, known as neonatal abstinence syndrome (NAS). When undergoing this type of therapy, infants must be hospitalized much longer than average newborns, and therefore are deprived of the crucial maternal-infant bonding period.
Currently, infants born with NAS are treated with a standard oral morphine replacement therapy that requires a prolonged hospital stay and increases related healthcare costs. Now, a new study by researchers at Thomas Jefferson University has shown that a semi-synthetic opioid, known as buprenorphine, can potentially improve the treatment process and overall health of opioid-addicted infants. Buprenorphine—traditionally used in higher doses to treat opioid withdrawal symptoms in adults and gaining more momentum in addiction therapy—has clinically been shown to shorten hospitalization time needed for opioid-dependent infants and in effect drastically reduce healthcare costs and improve maternal bonding development.
Lead researcher Dr. Walter Kraft, an associate professor in the Department of Pharmacology and Experimental Therapeutics at Jefferson, and his team of addiction, clinical pharmacology, neonatology, and pediatric neurology experts compared the use of oral morphine to the use of sublingual buprenorphine in infants with NAS in a randomized, open-labeled trial. Twenty-four infants chosen for the study were born in a large, urban tertiary care hospital and were suffering from severe opioid withdrawal symptoms. Half of the infants were administered morphine orally to treat their symptoms while the other half was administered buprenorphine sublingually, or under the tongue, then given pacifiers to suck to help the medication become absorbed into their blood streams. In the study, the researchers measured the infants’ level of neonatal safety, length of treatment, and length of hospital stay.
As a result, the length of time needed to treat opioid-addicted infants was reduced by 40% when they were administered sublingual buprenorphine. The 12 infants who had received morphine therapy required 38 days of treatment compared to the 12 infants who received buprenorphine therapy, whom only required 23 days of treatment. Furthermore, the length of hospital stay in the buprenorphine group was only 32 days compared to 42 days for the infants in the morphine group, a reduction of 24%. Not only was buprenorphine found to be safe and effective in treating NAS, but it produced substantially more advantages than the current standard form of NAS treatment involving morphine.
The researchers highly recommend buprenorphine as a potentially new standard in therapeutic treatment, a medication that has proven effective not just for opioid-addicted adults, but also for newborn babies with NAS. When used in the treatment of neonatal opioid withdrawal, the safe semi-synthetic opioid medication could save millions of dollars in healthcare costs. Each day that an opioid-dependent infant must be treated and monitored under hospital supervision, healthcare costs could run almost $2,000 per day, which over 30 of hospitalization could total to tens of thousands of dollars. With a believed estimate of 16,000 cases of NAS in infants born each year, the current standard healthcare costs needed to treat the severe syndrome could run well over $1 billion annually. By implementing buprenorphine therapy for NAS, healthcare costs could be cut by at least 20%, or nearly $150 million.
Researchers will conduct a new double-blind randomized trial in infants with NAS to further prove the efficacy of this type of therapy and to help determine whether the medication can become a new preferred standard treatment option for neonatal opioid withdrawal.
The researchers’ study was published online October 6 in the journal Addiction.
Source: Jefferson University Hospitals, Drug That Helps Adults Addicted To Opioid Drugs Also Relieves Withdrawal Symptoms in Newborns, October 6, 2010
