In the USA, opiate addiction and other drugs have become a leading cause for the removal of a child and the termination of parental rights of a biological mother. Foster care and Domestic adoptions have become  a way to remove the infant child from the harmful environment, and place that child with a family giving  them a chance at a more normal life.
The drugs that are frequently used during the pregnancy of expectant mothers are:

  1. Illegal Drugs such as: Opiates, Heroin, Methamphetamines, Marijuana, Crack & Cocaine.
  2. Prescription  withdrawal medications such as Methadone and Suboxone.
  3. Some of the Immediate short term impacts of Opiates (Oxycontin & Oxycodone) ingestion during pregnancy is something that is called the “Neonatal Abstinence Syndrome or NAS.”These infants are born addicted to narcotics and once the umbilical cord is cut, the supply of the drug “The Fix”  is immediately stopped, and the newborn begins to go through withdrawal symptoms at birth.

Withdrawal Symptoms of NAS: include being more tremulous or jittery, difficulty with sucking and swallow this causing feeding issues’ There are also issues with loose stools and in severe cases seizure activity. These infants are generally uncomfortable and irritable  immediately after birth. Self regulation is alway a problem. They are often times difficult to console, present with colic like behavior, and just are never able to settle down.
The seriousness of the withdrawal symptoms is dependent upon the severity of the ingestion. Babies born with true addiction the biggest risk of seizure activity, pauses in breathing patterns. These infants need to be monitored in NICU setting. Withdrawal generally occurs right after the delivery. The treatment is comprised of therapy is a tincture of morphine to alleviate the withdrawal symptoms, and the dose  gets titrated downwards as the child’s symptoms improve.

If an adopted infant is born dependent, therapy could take 72 hours to three weeks, to come down from the withdrawal. Sometimes of there is a reliable caregiver the infant can be discharged, and the morphine wean could be done as  an outpatient. Every baby is different so each case is individually determined. The morphine therapy is given in a liquid form.
In order to follow the symptoms we use an objective rating score called the finnegans scale.Some of the long term effects of opiates exposure are as these children grow into toddlers and preschoolers, that there could be an impact in the early childhood development.

  1. Slightly lower developmental scores in psychomotor and cognitive abilities.
  2. Slightly lower language score
  3. Increase in the attention deficit disorder spectrum.

For mothers that are on methadone or suboxone therapy during the pregnancy, it  helps the mother for it has a longer ½ life and takes more time to leave the body, but to the developing infant brain, and opiate is an opiate so there is no protection from that.
The Long term and Short Term outcomes  for  methadone or suboxone are the same as it is with any opioids. The only protection that the treatment medication is that the mother is not using injections to get the drugs so bloodborne disease are not a problem. Things that will help a child that has suffered from NAS, is early intervention services, such as (PT,OT,ST). With the right therapy in the early years of development, the baby’s brain can be rewired.

Prenatal exposure to drugs is a risk factor but it does not mean that every child will have long term effects from it. This could be because the part of the brain that is impacted is that part that is not fully functional until later in life. A stable, structured and nurturing home as well as early intervention therapy can help can a child that has suffered from early prenatal exposures to drugs, to alleviate some of the long term negative outcomes.

Written By: George Rogu MD CPE of, the GO To Place for Adoption Education and Consulting.