TY - JOUR
KW - buprenorphine
KW - Humans
KW - Infant, Newborn
KW - Methadone
KW - Neonatal abstinence syndrome
KW - Opiate Substitution Treatment
KW - opioid-related disorders
KW - Pregnancy Complications
AU - Bonny Whalen
AU - Kathryn MacMillan
AU - William Edwards
A1 - 
AB - The clinical trial by Kraft et al. provides evidence of a practical alternative pharmacologic approach to the management of the neonatal abstinence syndrome. However, accumulating data show that the appropriate use of nonpharmacologic therapy, especially rooming-in care by parents, results in substantially fewer infants who require opioid therapy to control withdrawal symptoms after exposure to opioids in utero.1-4 In the treatment of withdrawal in infants, the use of the model for treatment in adults, which involves suppression of symptoms with an opiate followed by a tapering reduction in dose, may also need to be challenged. The use of opioid treatment on an as-needed basis3 may prove to be a safer and healthier approach than the use of opioid treatment on a scheduled basis. We strongly advocate that centers caring for infants with the neonatal abstinence syndrome adopt a model of care in which nonpharmacologic treatment is considered to be the primary treatment, with pharmacotherapy secondary. In particular, the facilitation of rooming in and increased parental presence aids in achieving the triple aim of improved quality, improved patient experience, and reduced health care costs.5
AD - Children's Hospital at Dartmouth-Hitchcock, Lebanon, NH; bonny.l.whalen@hitchcock.org; Children's Hospital at Dartmouth-Hitchcock, Lebanon, NH; Children's Hospital at Dartmouth-Hitchcock, Lebanon, NH
BT - The New England journal of medicine
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 10
CY - United States
DO - 10.1056/NEJMc1709121
IS - 10
JF - The New England journal of medicine
LA - eng
M1 - Journal Article
N2 - The clinical trial by Kraft et al. provides evidence of a practical alternative pharmacologic approach to the management of the neonatal abstinence syndrome. However, accumulating data show that the appropriate use of nonpharmacologic therapy, especially rooming-in care by parents, results in substantially fewer infants who require opioid therapy to control withdrawal symptoms after exposure to opioids in utero.1-4 In the treatment of withdrawal in infants, the use of the model for treatment in adults, which involves suppression of symptoms with an opiate followed by a tapering reduction in dose, may also need to be challenged. The use of opioid treatment on an as-needed basis3 may prove to be a safer and healthier approach than the use of opioid treatment on a scheduled basis. We strongly advocate that centers caring for infants with the neonatal abstinence syndrome adopt a model of care in which nonpharmacologic treatment is considered to be the primary treatment, with pharmacotherapy secondary. In particular, the facilitation of rooming in and increased parental presence aids in achieving the triple aim of improved quality, improved patient experience, and reduced health care costs.5
PP - United States
PY - 2017
SN - 1533-4406; 0028-4793
SP - 996
T1 - Buprenorphine for the Neonatal Abstinence Syndrome
T2 - The New England journal of medicine
TI - Buprenorphine for the Neonatal Abstinence Syndrome
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 28880502
U3 - 10.1056/NEJMc1709121
VL - 377
VO - 1533-4406; 0028-4793
Y1 - 2017
Y2 - Sep 7
ER -