title: Home-based detoxification for neonatal abstinence syndrome reduces length of hospital admission without prolonging treatment.
abstract: OBJECTIVE
  Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome, secondary to in utero chemical exposure and characterised by tremor, irritability and feed intolerance. It often requires prolonged hospital treatment and separation of families. Outpatient therapy may reduce this burden, but current literature is sparse. This review aimed to evaluate the safety and efficacy of our home-based detoxification programme and compare it with standard inpatient care.
  
  
  METHODS
  Infants requiring treatment for NAS between January 2004 and December 2010 were reviewed. Data on demographics, drug exposure, length of stay and type of therapy were compared between infants selected for home-based therapy and those treated conventionally.
  
  
  RESULTS
  Of the 118 infants who were admitted for treatment of NAS, 38 (32%) were managed at home. Infants receiving home-based detoxification had shorter hospital stays (mean 19 days vs. 39 days), with no increase in total duration of treatment (mean 36 days vs. 41 days), and were more likely to be breastfeeding on discharge from hospital care (45% vs. 22%).
  
  
  CONCLUSIONS
  In selected infants, home-based detoxification is associated with reduced hospital stays and increased rates of breastfeeding, without prolonging therapy. Safety of the infants remains paramount, which precludes many from entering such a programme.
authors.affiliation: Department of Newborn Services, Royal Women's Hospital, Parkville, VIC, Australia.
authors.forename: Cameron L
authors.initials: CL
authors.lastname: Smirk
authors.forename: Ellen
authors.initials: E
authors.lastname: Bowman
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.forename: Omar
authors.initials: O
authors.lastname: Kamlin
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D001942:Breast Feeding / Q000706:statistics & numerical data; D003363:Cost Control; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D006771:Hospitals, Maternity; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use; D008658:Inactivation, Metabolic; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009035:Mothers / Q000193:education* / Q000523:psychology / Q000706:statistics & numerical data; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D009769:Object Attachment; D017063:Outcome Assessment, Health Care; D010287:Parent-Child Relations; D061214:Patient Safety; D010634:Phenobarbital / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D012944:Social Support; D019966:Substance-Related Disorders / Q000628:therapy; D014739:Victoria; D015430:Weight Gain
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009020:Morphine; D010634:Phenobarbital
keywords: Detoxification; Drug withdrawal; Neonatal abstinence syndrome; Outpatient; Treatment