Nonopioid Management of Neonatal Abstinence Syndrome

Abstract

Background: Current standard therapy for moderate to severe neonatal abstinence syndrome (NAS) includes opioid administration and often results in separation of mother and infant. Impaired maternal-infant bonding and extended neonatal opiate exposure may be associated with adverse developmental outcomes. Increased use of nonopioid adjunctive NAS therapies may decrease postnatal opioid exposure and length of stay (LOS), thereby promoting positive developmental outcomes for NAS-affected infants.

Purpose: To review the efficacy of rooming-in care and acupuncture as nonpharmacologic adjunctive agents to reduce the magnitude of postnatal opioid exposure and LOS.

Methods: PubMed, Ovid Medline, Embase, and CINAHL databases were searched for primary studies on rooming-in care and acupuncture as adjunctive treatments for NAS; 8 are included in this review.

Findings: Rooming-in care may decrease postnatal opioid exposure and LOS in NAS-affected infants. Acupuncture is safe in NAS patients; however, its definitive effect on narcotic use and length of hospitalization are inconclusive.

Implications for practice: Rooming-in care should be offered to NAS patients. Strong evidence does not exist to recommend acupuncture as a routine NAS treatment.

Implications for research: Additional randomized clinical trials are necessary to assess the efficacy of acupuncture and to confirm the effect of rooming-in care on NAS outcomes, and delineate optimal elements of a rooming-in care model.