Substance Addiction Clinical Trial
Official title:
Can Maternal Acupuncture for Chemically Dependent Pregnant Women Reduce the Severity of Neonatal Abstinence Syndrome? - A Randomized Controlled Trial
To determine the efficacy of daily maternal acupuncture treatments in reducing the frequency and severity of neonatal abstinence syndrome among infants born to substance-using women..
Potential study subjects will be recruited from the Chemical Dependency Unit by a trial
coordinator. After obtaining written informed consent, the coordinator will take a
sequentially numbered opaque envelope from a box on the unit. This envelope will contain a
card indicating the treatment group to which the woman is allocated. Women participating in
the treatment group of our study will have access to a quiet room furnished with comfortable
reclining chairs. The acupuncturist will swab the ears with alcohol and insert sterile,
disposable needles. Following the treatment, which is 45-minutes in length, participants
will remove the needles themselves and place them in protective sharps boxes. A sham
acupuncture procedure will not be used. Chinese traditional medicine does not include the
concept of a placebo. Those who argue that auricular acupuncture stimulates the vagus nerve,
which innervates the ear concha state that needles placed anywhere in the concha should
produce the same effects. 58 Studies utilizing sham procedures have failed to show a
difference between the control and active experimental conditions.
In this unit, morphine is prescribed for the neonate by pediatricians (11 in total) if there
is a constellation of symptoms unresponsive to environmental control including: 1)
convulsions, 2) inconsolability or crying continuously for 3 hours, 3) persistent tremors or
jitteriness when undisturbed, 4) continuous central nervous system irritability including
hyperactive Moro reflex, tremors, jitteriness, increased muscle tone and unprovoked muscle
jerks, 5) persistent vomiting or projectile vomiting over a 12 hour period; or 6) explosive
diarrhea for 2-3 consecutive episodes. Additional clinical signs such as tachycardia,
tachypnea, watery stools, fever, or weight loss > 10% may justify use of morphine after
consideration of differential diagnoses. Morphine 1mg/ml is started at a rate of 0.03
mg/kg/dose every 3 hours. The dose is reviewed daily and titrated based on daily weights and
ongoing symptoms.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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