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Opioid Dependence Treatment, Buprenorphine Or Methadone, Has The Smallest Potential For Causing Neonatal Abstinence Syndrome?

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Research Question
The researchers conducting this study wanted to know which opioid dependence treatment, buprenorphine or methadone, has the smallest potential for causing neonatal abstinence syndrome (NAS) in newborns.
Rationale for Treatment Methadone is typically given to treat opioid dependence. This drug, which is a mu-opioid agonist, works by limiting withdrawal symptoms and the desire to use opiates. However, methadone has been shown to have a high incidence of causing neonatal abstinence syndrome (NAS) in the child. This leads severe problems in the infant such as, hyperirritability of the central nervous system, autonomic system malfunction, respiratory disorders, and others. NAS results in longer hospitalization and more
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The independent variables in this study were buprenorphine and methadone and the dependent variables were the number of neonates requiring treatment for NAS, the peak NAS score, the total amount of morphine needed to treat NAS, the length of the hospital stay for the neonates, and neonatal head circumference.
Discussion
The main threats identified in the study fall under the historical category. The study began with 175 participants beginning treatment, but only 131 women finished the study; 28 women on buprenorphine and 16 women on methadone dropped out of the study, showing distinctly different rates of attrition. As a result, the outcomes of the study could have shown bias in favor of the buprenorphine group. However, statistically, there were no significant between-group differences in women who completed the study and those who did not, suggesting that the differences in attrition rates are unlikely to explain the outcomes. The authors of the study explicitly addressed this concern and stated that the results should, “Be considered in light of the markedly different rates of attrition” (Jones, et al, 2010, p. 2330). They also discussed possible reasons for the differences in attrition rates and said that the rates should not matter as the final analysis conducted excluded women who were on over 100 mg of methadone, removing 19% of the sample. In terms of subject maturation, testing, and instrumentation, there are no
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