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Study evaluates prenatal opioid addiction treatments

December 13, 2010
by News release
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According to a recent study funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, babies born to women addicted to opioids fare better when their mothers are treated with either the addiction medication buprenorphine or methadone than babies whose mothers are not treated at all.
The study was conducted by a multi-disciplinary team of researchers from North America and Europe and published in the
New England Journal of Medicine.

Methadone is currently the recommended treatment for opioid-addicted pregnant women, and when properly used is considered relatively safe for the fetus. However, methadone has been associated with neonatal abstinence syndrome (NAS)—a cluster of symptoms stemming from opioid withdrawal in the newborn—often requiring medical treatment and extended hospital stays.

Buprenorphine was approved by the FDA in 2002 for the treatment of opioid addiction in non-pregnant patients, but less is known about its effects in pregnant women and their babies. According to the study, buprenorphine resulted in similar maternal and fetal outcomes (compared to methadone) yet had lower severity of NAS symptoms, thus requiring less medication (1.1 versus 10.4 milligrams) and less time in the hospital for their babies (10 versus 17.5 days).

“Finding medications to help an addicted mother and her newborn is crucial,” said Dr. Nora D. Volkow, director of NIDA. “By comparing two effective medications for treating opioid addiction, this study will give health care providers and their patients vital information that will help them choose the treatment offering the greatest benefits.”

The research project, called The Maternal Opioid Treatment: Human Experimental Research (MOTHER), was one of the first to prospectively follow opioid-dependent pregnant women from enrollment until at least 28 days after giving birth. Women who volunteered for the study were addicted to opioids, such as heroin or prescription painkillers, with low rates of other illicit drug use, which meant the NAS could be clearly attributable to the opioids. In all, the eight-site international study included 131 mothers and their newborns.

“In addition to providing support for the viability of buprenorphine to treat pregnant women, we were able to closely examine the severity of NAS following prenatal exposure to methadone or buprenorphine,” said Dr. Hendree Jones, the study's primary author and a senior researcher at RTI International and professor in the departments of psychiatry and obstetrics and gynecology at Johns Hopkins University, Baltimore, Md. “We were pleased to be able to identify a medication that lessens the withdrawal distress to newborns, and gets them out of the hospital more quickly.” A similar study titled “Revised Dose Schema of Sublingual Buprenorphine in the Treatment of the Neonatal Opioid Abstinence Syndrome” was published Oct. 6 in

Addiction, by Kraft et al. An abstract of the study can be found

here.

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