Use of tincture of opium compared to oral morphine for the treatment of neonatal abstinence syndrome.

OBJECTIVE: To evaluate the difference in time until medical clearance when comparing tincture of opium (TO) to oral morphine (OM) in the treatment of neonatal abstinence syndrome (NAS).

DESIGN: Retrospective chart review conducted from May 2007 to July 2011.

SETTING: Level III Neonatal Intensive Care unit at Morristown Medical Center in Morristown, New Jersey.

PATIENTS, PARTICIPANTS: Clinical Drug Utilization reports identified 26 neonates who were treated with TO and 25 neonates who were treated with OM for NAS. No patients were excluded.

INTERVENTIONS: Patients were treated with either TO or OM for the indication of NAS.

MAIN OUTCOME MEASURE(S): The primary outcome is to compare the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge.

RESULTS: The median time until medical clearance for those treated with TO was 29.5 days compared to 37 days for those treated with OM (p = 0.14).

CONCLUSION: There was no statistically significant difference in the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge. There are a number of safety benefits in using OM compared to TO. Until further data are collected, it is appropriate to continue treatment of neonates with NAS with OM.