Buprenorphine Superior to Morphine in Neonatal Abstinence Syndrome

HealthDay News — Sublingual buprenorphine is associated with shorter duration of treatment than oral morphine for infants with neonatal abstinence syndrome, according to a study published in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Pediatric Academic Societies, held from May 6 to 9 in San Francisco.

Walter K. Kraft, MD, from the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, and colleagues conducted a double-blind, double-dummy clinical trial involving 63 term infants who had been exposed to opioids in utero and had signs of neonatal abstinence syndrome. The infants were randomized to receive sublingual buprenorphine or oral morphine. Adjunctive phenobarbital was used to treat infants with symptoms that were not controlled with the maximum dose of opioid.

The researchers found that, compared with morphine, buprenorphine correlated with significantly shorter median duration of treatment (15 vs 28 days) and median length of hospital stay (21 vs 33 days) (both P <.001). Adjunctive phenobarbital was administered to 15 and 23% of infants in the buprenorphine and morphine groups, respectively (P =.36). Similar rates of adverse events were seen in the groups.

“Among infants with the neonatal abstinence syndrome, treatment with sublingual buprenorphine resulted in a shorter duration of treatment and shorter length of hospital stay than treatment with oral morphine, with similar rates of adverse events,” the authors wrote.


Kraft WK, Adeniyi-jones SC, Chervoneva I, et al. Buprenorphine for the treatment of the neonatal abstinence syndrome [published online May 4, 2017]. N Engl J Med. doi:10.1056/NEJMoa1614835