MATERNAL DRUG USE AND THE EFFECTIVENESS OF PHARMACOTHERAPY FOR NEONATAL ABSTINENCE

Infants undergoing neonatal abstinence due to maternal drug use are commonly treated with paregoric, phenobarbital or diazepam. This study was designed to test the effectiveness of each of these agents as the first treatment drug in the control of abstinence symptomatology. The relationship of the type of maternal drug use to the effectiveness of treatment was also examined. Subjects were 134 infants treated for abstinence at Thomas Jefferson University Hospital between 1979 and 1983. Infants with serious medical complications were eliminated from the study. A series of least squares linear regression analyses was performed using the treatment drug, type of maternal drug use (opiates, non-opiates, or both), and the interaction of treatment and maternal drugs as predictors of whether or not a second pharmacotherapeutic agent was needed to bring the infant under control. Results revealed that if maternal drug use was limited to non-opiates, phenobarbital therapy was a significant predictor of successful treatment with one drug. Treating an infant with diazepam, however, significantly predicted the need for a second agent, regardless of maternal drug use. Paregoric was a significant predictor of successful treatment if maternal drug use included opiates or a combination of opiates and other drugs, and was a significant predictor of unsuccessful treatment if the mother abused only non-opiates. These results emphasize the ineffectiveness of diazepam for the treatment of neonatal abstinence as well as the relationship of maternal drug use to effective pharmacotherapy.