# Non-opiate treatment after prenatal opiate exposure to Prevent Postnatal Injury to the Young Brain (No-POPPY)

> **NIH NIH R01** · UNIVERSITY OF KENTUCKY · 2020 · $729,160

## Abstract

ABSTRACT
The number of newborns that develop the constellation of drug withdrawal symptoms or Neonatal Abstinence
Syndrome (NAS) in the US has increased to epidemic proportions. The pharmacologic treatment of NAS with
morphine or methadone is highly concerning as it corresponds with a timeframe of rapid postnatal brain 
development. The negative effects of opioids on the developing brain include decreased neurogenesis, 
synaptogenesis, and corticogenesis, decreased brain size, and decreased brain volumes in older children with prenatal
opiate exposure. Furthermore, response of neonates to treatment is highly variable and limited 
pharmacogenetic and metabolic activity data, which can be used to optimize therapy in this population, pose additional
challenges in using any drug to treat NAS. Collectively, these issues present a critical need to evaluate and
optimize the use of a non-opioid drug for treatment of NAS. The long term goals of our research is to establish
the best pharmacological treatment for NAS and determine how pharmacologic treatment of NAS affects 
long-term developmental outcomes. The objective of this application is to evaluate the effectiveness of clonidine, an
α2 adrenergic receptor agonist, as a treatment for neonates with NAS, in a randomized clinical trial. Our 
central hypothesis is that clonidine will effectively treat drug withdrawal manifestations in neonates. Preliminary
clinical evidence supports this hypothesis. Clonidine has previously been reported by us and others as a single
drug therapy for NAS in small number of infants with relief of withdrawal symptoms and as an effective 
adjunctive treatment, when giving chloral hydrate or morphine. The rationale for the proposed research is that, once
we understand how clonidine can be used optimally in the clinic to treat NAS, a safe medication will be 
available and it could potentially minimize complications associated increased length-of-stay in the hospital,
healthcare costs and the deleterious opiate assaults on the developing brain that continue with postnatal opiate
administration. To test our central hypothesis and accomplish the objective of this application we plan to 
pursue the following three specific aims: 1) To determine whether the treatment of NAS with a non-opiate 
medication, clonidine, will be more effective than morphine. 2) To determine whether treatment of NAS with clonidine
will result in better early childhood outcomes than those treated with morphine. 3) To determine how infants
with NAS metabolize morphine and clonidine. With respect to expected outcomes, this proposal will provide
prospective evidence: a) regarding the potential of clonidine treatment to treat NAS; b) regarding how opioid
and non-opioid exposure affect early childhood development; c) regarding factors that influence response to
treatment. These results are expected to have an important positive impact, because they have the potential to
provide fundamental information regarding ...

## Key facts

- **NIH application ID:** 9872141
- **Project number:** 5R01DA043519-04
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Henrietta S. Bada
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $729,160
- **Award type:** 5
- **Project period:** 2017-05-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9872141

## Citation

> US National Institutes of Health, RePORTER application 9872141, Non-opiate treatment after prenatal opiate exposure to Prevent Postnatal Injury to the Young Brain (No-POPPY) (5R01DA043519-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9872141. Licensed CC0.

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