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PostPosted: Wed May 10, 2017 9:48 am 
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Buprenorphine Halves Neonatal Abstinence Syndrome (NAS) Treatment Times in May 4 2017 New England Journal of Medicine.

Compared to morphine, buprenorphine almost halves treatment time and hospital stay.

https://www.ncbi.nlm.nih.gov/pubmed/28468518

As opiate use disorder has increased in the US, the rate of NAS has increased almost 5 times over the last 15 yrs.

Two thirds of babies exposed to opiates during pregnancy require medication to control withdrawal symptoms.

Study results need to be replicated. Could be a game changer bc innovations to treat NAS have been lacking and the stress and cost to babies, Mom's, families, facilities etc could be markedly reduced.

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PostPosted: Wed May 10, 2017 9:03 pm 
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That's welcome good news Pelican. Thanks for posting. Tough enough to be yanked into this cold, chaotic world without having to go through withdrawal.


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PostPosted: Thu May 11, 2017 8:00 am 
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Thanks Godfrey,

When I first came here i didn't post in this section but read a jennjenn post expressing the need to better support the pregnant ladies who come here.

I've often wondered why give babies morphine for NAS when we already know babies born exposed to bup have far less NAS than those exposed to a full agonist, like methadone. So this was the first study to use bup for NAS and the positive results are exciting. Hopefully, the use of bup for NAS will catch on and there will be less stress for all involved - a great result!

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PostPosted: Thu May 11, 2017 9:42 am 
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Awesome post pelican! Thank u very much!

I can't imagine what these ladies and babies have to go through. If we can possibly give information and gather it like u have, it's really priceless when someone comes here looking for information or desperate for any kind of answers.

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PostPosted: Thu May 11, 2017 12:38 pm 
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Buried somewhere in my documents file is a protocol being used by a hospital. They were using buprenorphine for infants with NAS whose mom had been taking Suboxone. Same result, much shorter stays.
Hope this NEJM article gets summarized and repeated through out the OB and Perinatology literature.
Thanks for posting Pelican.


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PostPosted: Fri May 12, 2017 8:43 am 
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Thanks jennjenn!

docm2, Thanks. Your right - when a mom is on bup during pregnancy and if her baby experiences NAS, aka withdrawal, why switch the baby to morphine when the baby is already acclimated to bup? Given bup is approved for use during pregnancy it makes sense it should be approved for use if her baby experiences withdrawal. Hopefully this recent study will get traction as you describe. Can the Mom ask for/influence the med used if her child experiences NAS? I'd sure like them to get their precious baby home sooner. Is it up to each hospital to determine its NAS treatment protocol? Who makes the decision what med is used to treat newborn NAS?

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PostPosted: Fri May 12, 2017 11:03 am 
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I haven't been around a nursery for almost 30 years. But, many units that frequently use a drug or procedure will have a written protocol outlining when it will be used, labs, monitoring, dosage etc. Usually it will go through a policy/procedure committee prior to implementation. It will stay in place until an 'internal' (think staff) or external (literature or advocates) will drive a review or rewrite. When I was with the state psychiatric hospital all protocols underwent review every 3 years. Occasionally sooner if a new medication or therapy was proving to be much better than previous.
Often they are written with enough detail so an intern can't mess it up.
I doubt that a mom, at the time decisions are being made about treating NAS, can have much influence about what drug will be used.
But I agree with you, seems ludicrous to put a baby on morphine or methadone when they have been receiving buprenorphine for months.


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