BUPRENORPHINE WITHDRAWAL SYNDROME IN A NEWBORN

A pregnant woman who was addicted to heroin rapidly withdrew from illi cit drugs after the onset of a 4 mg/day buprenorphine treatment. In th e newborn's blood, urine, and meconium 20 hours after birth, high conc entrations of buprenorphine and its metabolite norbuprenorphine were d etected, with a higher buprenorphine/norbuprenorphine ratio than in ad ults, possibly as a consequence of immature hepatic function; no illic it drugs were found. The child had a weak withdrawal syndrome on the s econd day of life and recovered rapidly. The measured buprenorphine da ily dose ingested by the newborn through mother's milk was very low (3 .28 mu g) and probably had little pharmacologic effect because no with drawal signs could be noted when maternal feeding was later abruptly i nterrupted. Further investigations are required to determine whether b uprenorphine can be considered to be a good alternative to methadone i n the treatment of pregnant heroin addicts to prevent marked withdrawa l syndromes in newborns.