Document Detail


Buprenorphine treatment of opioid-dependent pregnant women: a comprehensive review.
MedLine Citation:
PMID:  23106923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk and longer-term developmental effects.
METHODS: Within each outcome area, findings are summarized first for the three randomized clinical trials and then for the 44 non-randomized studies (i.e. prospective studies, case reports and series and retrospective chart reviews), only 28 of which involve independent samples.
RESULTS: Results indicate that maternal treatment with buprenorphine has comparable efficacy to methadone, although difficulties may exist with current buprenorphine induction methods. The available fetal data suggest buprenorphine results in less physiological suppression of fetal heart rate and movements than methadone. Regarding neonatal effects, perhaps the single definitive conclusion is that prenatal buprenorphine treatment results in a clinically significant less severe neonatal abstinence syndrome (NAS) than treatment with methadone. The limited research suggests that, like methadone, buprenorphine is compatible with breastfeeding. Data available thus far suggest that there are no deleterious effects of in utero buprenorphine exposure on infant development.
CONCLUSIONS: While buprenorphine produces a less severe neonatal abstinence syndrome than methadone, both methadone and buprenorphine are important parts of a complete comprehensive treatment approach for opioid-dependent pregnant women.
Authors:
Hendrée E Jones; Sarah H Heil; Andjela Baewert; Amelia M Arria; Karol Kaltenbach; Peter R Martin; Mara G Coyle; Peter Selby; Susan M Stine; Gabriele Fischer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  107 Suppl 1     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-10-22     Revised Date:  2014-05-16    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  5-27     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00271219
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MeSH Terms
Descriptor/Qualifier:
Buprenorphine / adverse effects,  pharmacology,  therapeutic use*
Child Development / drug effects
Female
Fetus / drug effects
Humans
Infant, Newborn
Length of Stay
Methadone / therapeutic use
Milk, Human / chemistry
Morphine / therapeutic use
Narcotic Antagonists / adverse effects,  pharmacology,  therapeutic use*
Neonatal Abstinence Syndrome / drug therapy
Opiate Substitution Treatment*
Opioid-Related Disorders / drug therapy*,  urine
Pain Management / methods
Patient Dropouts
Pregnancy
Pregnancy Complications / drug therapy*
Prenatal Exposure Delayed Effects / therapy
Randomized Controlled Trials as Topic
Substance Abuse Detection*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
M01 RR000095/RR/NCRR NIH HHS; M01 RR000109/RR/NCRR NIH HHS; M01RR00095/RR/NCRR NIH HHS; M01RR109/RR/NCRR NIH HHS; R01 DA 015738/DA/NIDA NIH HHS; R01 DA 015741/DA/NIDA NIH HHS; R01 DA 015764/DA/NIDA NIH HHS; R01 DA 015778/DA/NIDA NIH HHS; R01 DA 017513/DA/NIDA NIH HHS; R01 DA 018410/DA/NIDA NIH HHS; R01 DA 018417/DA/NIDA NIH HHS; R01 DA 15832/DA/NIDA NIH HHS; R01 DA015764/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Narcotic Antagonists; 40D3SCR4GZ/Buprenorphine; 76I7G6D29C/Morphine; UC6VBE7V1Z/Methadone

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