As the NAS Crisis Worsens, a New Study Offers Treatment Guidelines

The incidence of neonatal abstinence syndrome (NAS) has been climbing steadily, according to a 2016 Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC). The report, published August 12, indicated that the number of NAS cases rose from 1.5 per 1,000 hospital births in 1999 to 6 per 1,000 in 2013.

Yet guidelines for treating NAS have been lacking, according to a study in JAMA Pediatrics. The study, published online June 18, found that although several different approaches are being used, “no universal evidence-based pharmacological treatment strategy exists.” The article also noted that the FDA hasn’t approved any drug for treating infants who have NAS.

The authors of the JAMA Pediatrics study said that, without clear treatment guidelines, caregivers have typically chosen either methadone or morphine to treat their young NAS patients.

New Guidelines

Which medication—methadone or morphine—is better, and how to decide on an appropriate dose? Some studies have suggested basing the dose on the infant’s weight; others, on the severity of NAS, as assessed by the Finnegan Neonatal Abstinence Scoring System.

The JAMA Pediatrics team set out to answer the medication questions. They designed a treatment plan, then carried out what they believe is the first multisite, double-blind, randomized trial comparing the safety and efficacy of methadone and morphine in NAS. They published their results online June 18. (atforum.com, USA, 04.09.2018)

http://atforum.com/2018/09/nas-crisis-worsens-study-offers-treatment-guidelines/