Neonatal Opiate Withdrawal: Pharmacologic Management

It is estimated that 5.2% of four million women in the United States abuse illicit drugs during pregnancy. As a result, approximately 208 000 newborn infants will be born to these drugs in utero. Of those infants who are exposed to opiates in utero, approximately 50% to 90% of them will have neonatal opiate withdrawal. A number of drugs have been used to treat neonatal abstinence; however, it is unclear what treatment is best. This article will describe the signs and symptoms of opiate withdrawal in the neonate, the clinical assessment tools that can be used to observe for neonatal withdrawal, and the possible treatment regimens used to treat neonatal abstinence.