Why children born to drug addicts also express drug-withdrawal symptoms
When an adult becomes addicted to drugs, we’re quick to blame them for self-inflicting harm. But, what if someone is born with an addiction? This is a far too common reality. In fact, in 2015 alone, about 1744 Canadian babies were hospitalized with neonatal abstinence syndrome: a group of problems that occur in newborns that become addicted to drugs while in the mother’s womb. As a result, they exhibit withdrawal symptoms after birth, such as intense shaking. A mother that is unaware of her pregnancy or who is uneducated on the dangers of drug use acts as the greatest threat to her baby, as the first trimester is the most critical and is when the baby is most susceptible to damages from substance use.
While in the womb, the fetus attains it nourishment directly from the mother. In the same way that nutrition is supplemented, toxins are also passed through to the growing baby. A variety of illicit drugs, such as narcotics, and even medication, such as cough syrup and aspirin, can cause this syndrome. As a result, drugs as potent as heroin not only produce intense withdrawal in the mother, but can also produce life-threatening withdrawal symptoms in her baby. Often, these symptoms manifest as a high-pitched cry, tremors, sweat, and vomit, as well as seizures, diarrhea, and high irritability.
Over the years, the number of opiate and narcotic addicted babies has dramatically increased, costing the average family about $150 000 per baby for the neonatal intensive care process alone. This is almost 16 times more expensive than a normal birth. Newborns may stay in the hospital for weeks or even months following their birth. In such conditions, babies are usually given doses of morphine to create the same effects of the drug used by the mother. Over time, the amount of supplementary drug provided decreases, until there are no longer withdrawal symptoms present in the baby.
Before morphine is resorted, the first step to treating infant withdrawal symptom is the proper diagnosis, which requires disclosure of the mother’s accurate drug usage. The neonatal abstinence syndrome scoring system is used to diagnose and grade the severity of drug withdrawal and is based on the signs the newborn produces, the drug in question, whether the baby is born premature or not, and social factors. In circumstances of extreme irritation, babies are swaddled in a comforting blanket, and are gently rocked back and forth. High intensity light and loud noises also severely disturb drug-addicted babies, and so they are kept under controlled settings. The babies may have sensitive skin, and so require special ointment or cream. In cases of extreme dehydration or vomiting, the newborns are provided with additional fluids, through a vein (IV). They are also given small portions of high calorie foods since many neonatal abstinence syndrome newborns are born under weight.
Today, Ontario has the highest percentage of narcotic use in Canada, and one of the highest in the world. Although Canada has addiction support and counselling services in certain communities, drug-addicted individuals face geographic barriers and find these counselling services inaccessible . However, the government of Canada has developed procedures to cope with drug addiction pregnancies, prior to and post birth. For example, when patients are known to be using dangerous drugs, under the care of physicians and pharmacists, they are placed on methadone medication therapy. Methadone acts as a replacement drug, which is less harmful for mothers and their unborn children. It also satisfies their addiction, and is monitored by professionals. However, one of the downfalls is that throughout the therapy process, a woman’s fertility increases ; thus it is important for contraceptive counselling to be available alongside this treatment.
In-vitro, if the medical professional suspects that the baby may be born with neonatal abstinence syndrome, a postnatal screening will take place. If drugs are detected, a social worker will be involved to perform a full psychoanalysis of the family. During this time, it is essential to develop a care plan, in which the primary care giver is chose. Whether the caregiver is a foster parent, relative, or a family that has become drug-free, guidelines to take care of the infant are provided, and there are regular in-home social worker, addiction counsellor, and nurse checkups.
Even with all of these interventions, children may not be completely remediated. There have been a number of studies that have found that those born with a drug addiction have increased motor rigidity, shorter attention spans, and poorer social engagement well into adulthood . However, recent studies have provided a silver lining, stating that motor delays are better due to sociodemographic factors. Drug use of any kind can have an adverse effect on an unborn baby, but long term outcomes of neonatal abstinence syndrome and infant withdrawal symptom are difficult to determine since symptoms may also be a reflection of the parent’s social environment or other hidden medical conditions.
Canada is on the move to raise awareness for neonatal abstinence syndrome and many non-pharmaceutical techniques are emerging. For example, music therapy is being used to comfort vulnerable newborns and ultimately decrease the amount of medication used. Although Canada sees neonatal abstinence syndrome as a growing problem, further research to find an optimal solution is still underway, adding a sliver of hope to a disheartening situation.
By Dhruvika Angrish