Is Sublingual Buprenorphine Treatment Effective and Efficient When Compared to Traditional Neonatal Opium Solution (Morphine) in Treating Newborns with Neonatal Abstinence Syndrome?

Objective: The objective of this selective EBM review is to determine whether sublingual buprenorphine treatment is effective and efficient when compared to traditional neonatal opium solution (morphine) in treating newborns with neonatal abstinence syndrome (NAS). Study Design: Review of one randomized active-control clinical trial, one randomized doubleblind, double-dummy clinical trial, and one retrospective cohort analysis. Data Sources: All articles were published in English between the years of 2011 and 2017. Articles were obtained from peer-reviewed journals and databases using PubMed and Embase. Outcomes: Outcomes measured were length of stay using the neonates birth date and hospital discharge date as well as duration of treatment using the cessation date of treatment once MOTHER NAS score \u3c8. Results: Kraft et al. (2011) found a statistically significant decrease in hospital stay and duration of treatment with buprenorphine when compared to morphine treatment of NAS. Further study by Kraft et al. (2017) again found a statistically significant decrease in hospital stay and duration of treatment with buprenorphine compared to morphine. Hall et al. (2016) found in their retrospective cohort study that patients treated with buprenorphine had a shorter hospital stay and a shorter duration of treatment when compared to patients who were treated with morphine or methadone. Conclusions: All three studies confirm that buprenorphine treatment is both effective and efficient when compared to traditional neonatal opium solution (morphine) in treating newborns with neonatal abstinence syndrome. Further studies should place focus on treatment weaning the mother from the offending substance and its effect on the incidence of NAS, length of stay in the hospital, and possible elimination of pharmacologic intervention in neonates