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Maternal Addiction

A newborn baby

Alcohol and drug use by pregnant women is known as maternal addiction. It is a serious problem with long-lasting effects and consequences for a child’s social, emotional and cognitive development. Heroin, methadone, and heavy alcohol consumption during pregnancy are associated with lower birth weight and central nervous system (CNS) dysfunction. Babies born to mothers who abuse cocaine during pregnancy are often delivered prematurely, have low birth weights and smaller head circumferences, and are shorter in length than babies born to mothers who do not abuse cocaine. Mothers who abuse substances have higher rates of reported child abuse, neglect, and placement of children into foster care.

Babies born to women who used substances during their pregnancies may display signs of addiction and withdrawal, which are a result of the mother’s dependence on substances during pregnancy. The withdrawal or abstinence symptoms develop shortly after birth. Symptoms include:

  • loud, high-pitched crying
  • sweating
  • yawning
  • digestive difficulties

It is difficult to estimate the full extent of the consequences of maternal drug abuse and to determine the specific hazard of a particular drug to the unborn child. This is because multiple factors, such as the amount and number of all drugs abused, including nicotine; extent of prenatal care; possible neglect or abuse of the child; exposure to violence in the environment; socioeconomic conditions; maternal nutrition; other health conditions; and exposure to sexually transmitted diseases. All of these factors can all interact to impact maternal, fetal, and child outcomes. If someone wants to become pregnant or is pregnant, stopping substance use early is the best prevention method.

Neonatal Abstinence Syndrome (NAS)

Neonatal withdrawal or neonatal abstinence syndrome (NAS) is a withdrawal syndrome in babies caused by the mother stopping the misuse of prescription pain killers or illegal opioid street drugs. NAS can have a number of negative effects on the baby, including premature birth, creating additional short– and long–term health challenges. NAS babies often require longer hospitalizations. Signs and symptoms of NAS newborns are:

  • difficulties with tone and movement, such as tight muscles and tremors and/or jitteriness. These problems can lead to difficulties in feeding, causing weight loss or failure to thrive.
  • difficulties maintaining a quiet alert state, which is needed to interact with caretakers, be able to eat, and grow. They may have difficulties going smoothly from sleep to waking states, and often become irritable and cry.
  • difficulties with reacting to stimuli, such as touch, sound, movement, or visual stimulation. They can become either over-stimulated or have limited reaction to stimuli.
  • difficulties with regulating their bodily functions resulting in gagging, vomiting, diarrhea, color changes, fever, and having fast breathing or hiccupping.

Long term effects of NAS are the result of permanent damage. Early exposure to drug use can decrease one’s thinking ability, including information processing and attention to tasks. Long term effects of NAS include:

  • negative mental effects
  • negative behavioral effects

The type of drugs used by the mother can leave specific long term-effects on newborns. Drug-specific long term effects include:

  • Stimulants—slower growth, problems with language, thinking and less self-control, school and behavioral problems
  • Opiates—problems with behavior and less ability to control impulses
  • Cannabinoids—more impulsive and trouble with thinking skills when older
  • Hallucinogens—specifics are unknown, but may be similar to stimulants
  • Sedatives—specifics are unknown at this time.

Treatment Approach

Investment in Family-Based Treatment (FBT) programs may save countless families and lives, because the rapid recovery of addicted mothers affects the child welfare, juvenile justice, and adult criminal justice systems. Family-based substance abuse treatment programs provide direct services or referrals for services including: substance abuse treatment, early childhood intervention, mental health, family counseling, trauma therapy, housing, medical care, nursery and preschool, parenting skills training, and educational or job training.

FBT involves the patient along with at least one significant other such as a cohabiting partner or a parent (in the case of adolescents).

  • Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment.
  • Patients are encouraged to develop behavioral goals for preventing substance use and HIV infection, which are anchored to a contingency management system.
  • Substance-abusing parents are prompted to set goals related to effective parenting behaviors.
  • During each session, the behavioral goals are reviewed, with rewards provided by significant others when goals are accomplished.
  • Patients participate in treatment planning, choosing specific interventions from a menu of evidence-based treatment options.