Neonatal opioid withdrawal syndrome: a review of the science and a look toward the use of buprenorphine for affected infants

J Perinatol. 2022 Mar;42(3):300-306. doi: 10.1038/s41372-021-01206-3. Epub 2021 Sep 23.

Abstract

Neonates born to mothers taking opioids during pregnancy are at risk for neonatal opioid withdrawal syndrome (NOWS), for which there is no recognized standard approach to care. Nonpharmacologic treatment is typically used as a first-line approach for management, and pharmacologic treatment is added when clinical signs are not responding to nonpharmacologic measures alone. Although morphine and methadone are the most commonly used pharmacotherapies for NOWS, buprenorphine has emerged as a treatment option based on its pharmacologic profile and results from initial single site clinical trials. The objective of this report is to provide an overview of NOWS including a summary of ongoing work in the field and to review the state of the science, knowledge gaps, and practical considerations specific to the use of buprenorphine for the treatment of NOWS as discussed by a panel of experts during a virtual workshop hosted by the National Institutes of Health.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Buprenorphine* / adverse effects
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Methadone / adverse effects
  • Neonatal Abstinence Syndrome* / diagnosis
  • Neonatal Abstinence Syndrome* / drug therapy
  • Opioid-Related Disorders* / drug therapy
  • Pregnancy

Substances

  • Analgesics, Opioid
  • Buprenorphine
  • Methadone