Neonatal Abstinence Syndrome: Is Buprenorphine Better?

Methadone has been the recommended treatment for opioid-dependent pregnant women despite its association with neonatal abstinence syndrome (NAS). In this prospective, randomized, double-blind, multicenter study, investigators compared outcomes associated with methadone — a full µ-opioid agonist — and buprenorphine — a partial µ-opioid agonist and κ-opioid antagonist — in infants born to 175 opioid-dependent mothers.

Significantly more women who received buprenorphine than methadone discontinued treatment before delivery (33% vs. 18%), and, among buprenorphine recipients, more women who discontinued reported dissatisfaction with the medication (71% vs. 13%). Among infants of mothers who did not discontinue treatment, no differences were noted…