JAMA

📊 Research Summary: For infants with opioid withdrawal syndrome cared for with the approach, symptom-based opioid dosing shortened time to medical readiness for discharge vs a scheduled opioid taper, without differences in safety through 3 months.

Symptom-Based Dosing for Neonatal Opioid Withdrawal: Research Summary This study assessed whether a symptom-based dosing strategy for opioid treatment reduces time to medical readiness for discharge compared with scheduled opioid taper in infants with neonatal opioid withdrawal syndrome (NOWS) cared for with the Eat, Sleep, Console approach (ESC) or Finnegan-based...

💬 Editorial by Matthew Grossman, MD1, Adam Berkwitt, MD, and Rachel Osborn, MD: In a multicenter randomized clinical trial across diverse US hospitals, symptom‑based dosing for infants treated for was associated with faster readiness for discharge and fewer opioid doses vs scheduled tapering. These findings support symptom‑based dosing with ESC‑based assessment as an evidence‑based standard with implications for reducing hospital length of stay and health care resource use.

As-Needed Medications in Newborn Opioid Withdrawal Neonatal opioid withdrawal syndrome (NOWS) remains a consequential downstream effect of the ongoing opioid epidemic in the US. Although we have improved both access and approach to medical management of opioid use disorder in pregnancy, exposure confers a risk of withdrawal to the infant, regardless...

Among infants with neonatal opioid withdrawal syndrome cared for with the approach, symptom-based opioid dosing was associated with a shorter time to medical readiness for discharge than a scheduled opioid taper. The trial found no differences in safety outcomes through 3 months of age, supporting symptom-based dosing as a clinically effective option when pharmacologic treatment is needed.

Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial | Critical Care Medicine | JAMA | JAMA Network This crossover randomized clinical trial examines the effect of symptom-based dosing vs scheduled opioid taper on time to medical readiness for discharge