Babies who are born addicted to opiates have no choice in the matter. Their bodies were acclimatized to the drugs while they were still developing in the womb. They are physically, but not emotionally or psychologically addicted. However, if they do not receive careful treatment, they will suffer consequences and may die.
The picture of a heroin addicted pregnancy is not a pretty one. Statistically, these mothers are younger and with fewer family support mechanisms in place. Many are homeless or committing crimes to support their habits. They may be unemployed and unemployable. Mental health issues, multiple addictions and low self esteem are also common.
Prenatal care in this population is already a problem, and opiate addiction makes it even more so. There are currently some arguments about just what action should be taken. For instance, the mother could try to go on methadone maintenance and lower their dependence on heroin. But for the infant, withdrawal from methadone is actually harder than from heroin. The choices are these:
- * Stop using altogether and go through withdrawal while pregnant – higher risk of miscarriage and greater chance the mother will relapse. Depending on what stage of the pregnancy this is attempted, the outcome can mean premature delivery or even death of the fetus.
- * Go on methadone maintenance. As mentioned above, better chance of delivering, but harder withdrawal for the infant after birth. If the methadone dose can be decreased over time down to 20 mg a day, the outlook is best.
- * Stay on heroin (or other opiate). This solution is no solution at all, unless the mother can lower their dose substantially.
The consequences for the opiate addicted infant include: up to six months of withdrawal and inability to bond properly during that time; bone and skeletal defects (shorter height, larger head); missing fingers or toes; seizures; lethargy and sleep disturbances; behavioral problems. Not all of these go away. There is also a six-hundred percent increase in the risk for sudden infant death syndrome.
While the picture is grim, it is not impossible. Good treatment, administered in time, can lessen the poor outcomes. In fact, a woman who can shift her focus to her pregnancy and unborn child has a chance to improve her entire life – if she can take that opportunity.