Abstract 1152

In June of 1998, The American Academy of PediatricsFootnote 1 published an article recommending the usage of tincture of opium rather than paregoric for the treatment of opioid related drug withdrawal. The Committee on Drugs indicated that opium decreased the length of treatment (LOT, days), and acted as a less toxic medical therapy. Following the recommendation, our institution changed protocol from paregoric to opium. We evaluated 20 term infants prior to this change and 9 term infants subsequently. Inclusion criteria selected infants with a gestational age (GA, weeks) ≥ 35 and a diagnosis of NAS based on a physical exam, maternal urine drug screen and the Finnegan scoring system. This scoring system ranges from 0 to 46 and measures neurologic, metabolic, vasomotor, respiratory, and gastrointestinal (GI) disturbances. Higher scores equate to higher withdrawal symptoms. Exclusions were GA < 35 and/or other complicating diagnoses. Mean GA, birth weight (BW, grams), and discharge weight (d/c wt, grams), were statistically similar (p>0.05). Finnegan NAS scores were obtained every 3 to 4 hours. The highest and lowest scores during the patient's hospital stay were recorded. Additionally, the highest peak mean score over a 24-hour period was calculated. Both groups had similar low Finnegan score values, high score values, and mean peak 24 hour score values (p>0.05). The worst GI scores (from 0 to 9) during treatment were statistically similar as well (p>0.05). Mean ± SD values were: (Table) These data indicated that the LOT between paregoric and opium does not differ (p>0.05). There was no differences in adverse events recorded between the two groups. This suggests there is no difference in the efficacy of tincture of opium and paregoric in the treatment of NAS.

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