CSAT Announces Important Error in MAT-TIP 43 <o:p></o:p>

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( AT Forum NEWS NOTES & UPDATES #107 - released 11/1/07) <o:p></o:p>

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In late October, the Center for Substance Abuse Treatment (CSAT) announced an important error in their Treatment Improvement Protocol (TIP) 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, 2005.

This document also is known at the MAT-TIP.

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In Chapter 13, page 219, incorrect information about medication treatment for neonatal abstinence syndrome was published: <o:p></o:p>

·        Column 1, line 9 from the bottom, reads �?.4 mg/kg/dose.�?However, it should read �?.4 mg/kg/day.�?<o:p></o:p>

·        Column 1, line 6 from the bottom, reads �?U>0.4 mg/kg/dose.�?It should read �?U>0.04 mg/kg/dose.�?

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In subsequent printings of TIP 43, page 219, the paragraphs regarding this topic will be changed to correctly read as follows:

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“If pharmacological management is indicated, several methods have been found useful. The American Academy of Pediatrics Committee on Drugs policy statement on Neonatal Drug Withdrawal (1998) describes several agents for the treatment of NAS including methadone, tincture of opium, paregoric, and morphine. One method (J. Greenspan, Thomas Jefferson University Hospital, Philadelphia, personal communication, October 2006) uses neonatal opium solution (0.4 mg/mL morphine-equivalent; starting dosage, 0.4 mg/kg/day orally in six to eight divided doses [timed with the feeding schedule]). Dosage is increased by 0.04 mg/kg/dose until control is achieved or a maximum of 2.0 mg/kg/day is reached. If Neonatal Abstinence Scores stay high but daily dosage nears maximum, symptoms are reassessed and concurrent phenobarbital therapy considered. When control is achieved, the dosage is continued for 72 hours before pharmacological weaning, in which dosages are decreased 10 percent daily or as tolerated. When 0.2 mg/kg/day is reached, medication may be stopped. Decisions about dosage decrease during pharmacological weaning are based on Neonatal Abstinence Scores, weight, and physical exams.�?lt;o:p></o:p>

Practitioners should carefully note these changes, which can impact neonatal health. CSAT regrets any confusion this error has caused. <o:p></o:p>

Source: Correction notice provided by CSAT and JBS International, October 31, 2006<o:p></o:p>