January report from the Centers for Disease Control (CDC), drug overdoses killed more than 33,000 people in 2005, the last year for which firm data are available. That makes drug overdose the second leading cause of accidental death, behind only motor vehicle accidents (43,667) and ahead of firearms deaths (30,694).
What's more disturbing is that the 2005 figures are only the latest in such a seemingly inexorable increase in overdose deaths that the eras of the 1970s heroin epidemic and the 1980s crack wave pale in comparison. According to the CDC, some 10,000 died of overdoses in 1990; by 1999, that number had hit 20,000; and in the six years between then and 2005, it increased by more than 60%.
"The death toll is equivalent to a hundred 757s crashing and killing everybody on board every year, but this doesn't make the news," said Dan Bigg of the Chicago Recovery Alliance, a harm reduction organization providing needle exchange and other services to drug users. "So many people have died, and we just don't care."
Fortunately, some people care. Harm reductionists like Bigg, some public health officials, and a handful of epidemiologists, including those at the CDC, have been watching the up-trend with increasing concern, and some drug policy reform organizations are devoting some energy to measures that could bring those numbers down.
But as youth sociologist and long-time critic of the drug policy establishment's overweening fascination with teen drug use Mike Males noted back in February, the official and press response to the CDC report has been "utter silence." That's because the wrong people are dying, Males argued: "Erupting drug abuse centered in middle-aged America is killing tens of thousands and hospitalizing hundreds of thousands every year, destroying families and communities, subjecting hundreds of thousands of children to abuse and neglect and packing foster care systems to unmanageable peaks, fostering gun violence among inner-city drug dealers, inciting an epidemic of middle-aged crime and imprisonment costing Americans tens of billions of dollars annually, and now creating a spin-off drug abuse epidemic among teens and young adults. Yet, because today's drug epidemic is mainly white middle-aged adults -- a powerful population that is "not supposed to abuse drugs" -- the media and officials can't talk about it. The rigid media and official rule: Drugs can ONLY be discussed as crises of youth and minorities."
The numbers are there to back up Males' point. Not only are Americans dying of drug overdoses in numbers never seen before, it is the middle-aged -- not the young -- who are doing most of the dying. And they are not, for the most part, overdosing on heroin or cocaine, but on Oxycontin, Lorcet, and other opioids created for pain control but often diverted into the lucrative black market created by prohibition.
Back in October, CDC epidemiologist Leonard Paulozzi gave Congress a foretaste of what the January report held. Drug death "rates are currently more than twice what they were during the peak years of crack cocaine mortality in the early 1990s, and four to five times higher than the rates during the year of heroin mortality peak in 1975," he said in testimony before the House Oversight and Investigations Committee.
"Mortality statistics suggest that these deaths are largely due to the misuse and abuse of prescription drugs," Paulozzi continued. "Such statistics are backed up by studies of the records of state medical examiners. Such studies consistently report that a high percentage of people who die of prescription drug overdoses have a history of substance abuse."
But there is more to it than a mere correlation between increases in the prescribing and abuse of opioid pain relievers and a rising death rate, said Dr. Alex Krall, director of the Urban Health Program for RTI International, a large nonprofit health organization. Krall, who has been doing epidemiological research on opioid overdoses for 15 years, said there are a variety of factors at work.
"There hasn't been a big increase in heroin use," he said. "What's changed has been prescription opiate drug use. Oxycontin is probably a big part of the answer. The pharmaceutical companies have come up with good and highly useful versions of opioids, but they have also been diverted and used in illicit ways in epidemic fashion for the past 15 years."
But Krall also pointed the finger at the resort to mass imprisonment and forced treatment of drug offenders as a contributing factor. "What happens is that people who are opiate users go into prison or jail and they get off the drug, but when they come out and start using again, they use at the same levels as before, and they don't have the same kind of tolerance. We know that recent release from jail or prison is a big risk factor for overdose," he said.
"The last piece of the puzzle is drug treatment," Krall said. "Besides the tolerance problems for people who have been abstaining in treatment, there has been an increase in the use of methadone and buprenorphine, which is a good thing, but people are managing to overdose on those as well."
There are means of reducing the death toll, said a variety of harm reductionists, and the opioid antagonist naloxone (Narcan) was mentioned by all of them. Naloxone is a big part of the answer, said the Chicago Recovery Alliance's Bigg. "It's been around for 40 years, it's a pure antidote, and it has no side effects. It consistently reverses overdoses via intramuscular injection; it's very simple to administer. If people have naloxone, it becomes much, much easier to avoid overdose deaths."
"Naloxone should be made available over the counter without a prescription," said Bigg. "In the meantime, every time a physician prescribes opioids, he should also prescribe naloxone."
"For a couple of years now, we've been talking about trying to get naloxone reclassified so it's available over the counter or maybe prescribed by a pharmacist," said Hilary McQuie, Western director for the Harm Reduction Coalition. "The problem is that you don't just need congressional activity, you also need to deal with the FDA process, and it's hard to find anyone in the activist community who understands that process."
Harm reductionists also have to grapple with the changing face of drug overdoses. "We're used to dealing with injection drug users," McQuie admitted, "and nobody really has a good initiative for dealing with prescription drug users. In our lobbying meetings about the federal needle exchange funding ban, we've started to talk about this, specifically about getting naloxone out there."
But while the overdose epidemic weighs heavily on the movement, no one wants to spend money to bring the numbers down. "This is a very big issue, it's very present for harm reduction workers," said McQuie. "But we haven't done a lot of press on it because there is no funding for overdose prevention. We have a very good program in San Francisco to train residential hotel managers and drug users at needle exchanges. It's very cheap; it only cost $70,000, including naloxone. But we can't get funders interested in this. We write grants to do this sort of work around the state, and we never get any money."
Perversely, the Office of National Drug Control Policy also opposes making naloxone widely available -- on the grounds that it is a moral hazard. "First of all, I don't agree with giving an opioid antidote to non-medical professionals. That's No. 1," ONDCP's Deputy Director of Demand Reduction said in January. "I just don't think that's good public health policy."
But even worse, Madras argued that availability of naloxone could encourage drug users to keep using because they would be less afraid of overdoses. And besides, Madras, continued, overdosing may be just what the doctor ordered for drug users. "Sometimes having an overdose, being in an emergency room, having that contact with a health care professional is enough to make a person snap into the reality of the situation and snap into having someone give them services," Madras said.
"The drug czar's office argues that if you take away the potential consequences, in this case, a fatal overdose, you facilitate the use, but betting someone's life on that is just cruel and bizarre," snorted Bigg.
RTI's Kraal noted that there are now 44 naloxone programs run by community groups across the country. "It would be wonderful if there were more of them, because they are staving off a lot of deaths, but they are controversial. The ONDCP says they condone drug use, but you can't rehabilitate a dead drug user."
While battles over naloxone access continue, said Bigg, there are other things that can be done. "We need to engage people, and that means overcoming shame," said Bigg. "Every couple of months, I get a call from a family that has lost a member to drugs and I ask them if they're willing to come forward and talk to reporters to stop it from happening again, and they say 'let me think about it,' and I never hear from them again.
Another means of reducing the death toll would be to start local organizations of people whose friends or family members have died or are still using and at risk. "We could call them 'First Things First,' as in first, let's keep our folks alive," he suggested.
"When people found out naloxone is out there, that it's this medicine that has no ill effects -- it has no effect at all unless you're using opioids -- and that it can't be abused, and that their family member could have had it and still be alive, that's a hard thing to realize," said Bigg. "Everyone who has lost a loved one wants him back, and to think he could still be alive today if there were naloxone is a bitter, bitter pill to swallow."
Despite the apparent low profile of drug policy reform groups, they, too, have been fighting on the overdose front. "We worked to pass groundbreaking overdose prevention bills in California and New Mexico," said Bill Piper, national affairs director for the Drug Policy Alliance. "We're working to advance overdose prevention bills in Maryland and New Jersey. We had a bill in 2006 in Congress that would have created a federal grant program for overdose prevention," he said, pointedly adding that not a single federal dollar goes to overdose prevention. "We've tried to introduce that in the new Congress but can't find someone to take a lead. To be frank, few politicians care about this issue. Their staff care even less."
A massive public education campaign is needed, said Piper, adding that DPA is working on a report on this very topic that should appear in a few weeks.
In the meantime, while politicians and drug war bureaucrats avert their gaze and deep-pocketed potential donors keep their purses tightly closed, while the nation worries about baseball players on steroids and teenagers smoking pot, the bodies pile up like cordwood.
Wednesday, April 23, 2008
Remembering Reproductive Rights for Prisoners
The recent news that the Supreme Court let stand a lower court ruling that incarcerated women have a constitutional right to access abortion services caught my attention. It highlights the issue of reproductive rights for incarcerated women and reminds us that women are the fastest growing part of America's prison population.
2,319,258 people are incarcerated in America. The staggering reality is that 1 in 100 adults are in prison. A Pew Center on the States report found that, although men are still ten times more likely to be in jail, the numbers of incarcerated women are growing at a faster pace. Among women ages 35-39 years old, one in 265 are incarcerated. The racial break-down in that age group shows that one in 355 are white women, one in 297 are Hispanic women and one in 100 are black women.
Within these numbers are mothers, sisters, daughters and friends all facing the variety of reproductive health issues any woman "on the outside" may face. The only difference is that they face them while incarcerated with prison policies being weighed against their reproductive rights.
In her article Women in Prison, Pam Adams explores the work of psychologist Susan George, who studied the impact of incarceration on Illinois families. The article points out that the number of Illinois women incarcerated has nearly tripled in a decade, with many of those arrested as a result of incidents related to drug addiction and poverty, and with histories of sexual abuse and physical abuse. Many women had parents who were incarcerated and children of incarcerated parents are five times more likely to go to jail.
Mentor programs like Amachi Pittsburgh attempt to break the cycle of multi-generation incarceration. Amachi, modeled after Big Brothers Big Sisters with a target of children ages 4 to 18, is a faith-based program that partners with local churches to match at risk children with mentors; the goal being to break the cycle where the children of incarcerated adults become incarcerated adults themselves. Though the mentor programs have seen success, communities and families are still paying the price for America's reluctance to fight the war on poverty, reform drug policies and support risk reduction programs with the same passion shown the building of new prisons.
Among the women arrested for drug related offenses, drug addicted pregnant women are also targeted for incarceration based on drug use during pregnancy. In 2007 I was privileged to blog the National Advocates for Pregnant Women (NAPW) Summit and hear the stories of women who have faced incarceration for using drugs during pregnancy. NAPW "seeks to protect the rights and human dignity of all women, particularly pregnant and parenting women and those who are most vulnerable including low income women, women of color, and drug-using women." Through their work NAPW gives a voice to women who are targeted for arrest and prosecution because of addiction and shines a light on the need for sane drug policies, affordable and quality healthcare and treatment options for pregnant women.
Women who continue their pregnancies behind bars face the challenge of poor nutrition, stress and the prospect of parenting from prison. Amie Newman's article Pregnant Behind Bars: The Prison Doula Project highlighted the work of The Birth Attendants who provide doulas to assist pregnant inmates. The doulas provide physical, emotional and psychological support before, during and after the birth of the baby. The article points out that some women are shackled during childbirth and that there are few resources available for keeping mother and child together after birth.
As activists we are constantly challenged to look beyond our world and connect studies with reality and policy to communities. One challenge before us is to vigilantly defend the reproductive rights of incarcerated women who remain vulnerable to the denial of access to abortion services. We are also challenged to include youth at risk due to the incarceration of a parent in our struggle. These young people need us to be mentors, participate in community programs and continue to demand the empowerment of comprehensive sex education.
Our struggle for reproductive freedom is key to the social justice movement and it must include the women within the one in 100 adults incarcerated in America.
2,319,258 people are incarcerated in America. The staggering reality is that 1 in 100 adults are in prison. A Pew Center on the States report found that, although men are still ten times more likely to be in jail, the numbers of incarcerated women are growing at a faster pace. Among women ages 35-39 years old, one in 265 are incarcerated. The racial break-down in that age group shows that one in 355 are white women, one in 297 are Hispanic women and one in 100 are black women.
Within these numbers are mothers, sisters, daughters and friends all facing the variety of reproductive health issues any woman "on the outside" may face. The only difference is that they face them while incarcerated with prison policies being weighed against their reproductive rights.
In her article Women in Prison, Pam Adams explores the work of psychologist Susan George, who studied the impact of incarceration on Illinois families. The article points out that the number of Illinois women incarcerated has nearly tripled in a decade, with many of those arrested as a result of incidents related to drug addiction and poverty, and with histories of sexual abuse and physical abuse. Many women had parents who were incarcerated and children of incarcerated parents are five times more likely to go to jail.
Mentor programs like Amachi Pittsburgh attempt to break the cycle of multi-generation incarceration. Amachi, modeled after Big Brothers Big Sisters with a target of children ages 4 to 18, is a faith-based program that partners with local churches to match at risk children with mentors; the goal being to break the cycle where the children of incarcerated adults become incarcerated adults themselves. Though the mentor programs have seen success, communities and families are still paying the price for America's reluctance to fight the war on poverty, reform drug policies and support risk reduction programs with the same passion shown the building of new prisons.
Among the women arrested for drug related offenses, drug addicted pregnant women are also targeted for incarceration based on drug use during pregnancy. In 2007 I was privileged to blog the National Advocates for Pregnant Women (NAPW) Summit and hear the stories of women who have faced incarceration for using drugs during pregnancy. NAPW "seeks to protect the rights and human dignity of all women, particularly pregnant and parenting women and those who are most vulnerable including low income women, women of color, and drug-using women." Through their work NAPW gives a voice to women who are targeted for arrest and prosecution because of addiction and shines a light on the need for sane drug policies, affordable and quality healthcare and treatment options for pregnant women.
Women who continue their pregnancies behind bars face the challenge of poor nutrition, stress and the prospect of parenting from prison. Amie Newman's article Pregnant Behind Bars: The Prison Doula Project highlighted the work of The Birth Attendants who provide doulas to assist pregnant inmates. The doulas provide physical, emotional and psychological support before, during and after the birth of the baby. The article points out that some women are shackled during childbirth and that there are few resources available for keeping mother and child together after birth.
As activists we are constantly challenged to look beyond our world and connect studies with reality and policy to communities. One challenge before us is to vigilantly defend the reproductive rights of incarcerated women who remain vulnerable to the denial of access to abortion services. We are also challenged to include youth at risk due to the incarceration of a parent in our struggle. These young people need us to be mentors, participate in community programs and continue to demand the empowerment of comprehensive sex education.
Our struggle for reproductive freedom is key to the social justice movement and it must include the women within the one in 100 adults incarcerated in America.
Health commissioner: Tobacco companies target girls
In Jefferson County, 30 percent of mothers smoke during pregnancy. Over 20 percent of Indiana high school girls smoke, along with over 10 percent of girls in middle school. Marketing may be responsible for some of those numbers."It's clear that the tobacco companies target women and young girls," said Dr. Judy Monroe, Indiana state health commissioner.Monroe spoke to an audience including doctors, nurses, community members and a handful of young girls during a special presentation at King's Daughters' Hospital on Tuesday night. The presentation was part of the Influence Women's Health Forum, a program to educate Indiana communities about women's health issues.The forum began last year in response to a marketing campaign featuring Camel No. 9 cigarettes, a brand Monroe said was targeted directly to young women. Part of the campaign featured "ladies only" nights where women were given a variety of free items including manicures, makeup, cell phone accessories and cigarettes."They really had to take me off the ceiling. I was outraged when I heard this," Monroe said.Yet marketing tobacco to women is nothing new. Brands like Lucky Strike started advertising directly to women around World War II. In the 1970s, Virginia Slims were introduced. One advertisement for the slender cigarettes proclaimed that they were made "especially for women because they are biologically superior to men."Advertising, especially in magazines, has continued to feature women smoking in the hopes of conveying various messages to target audiences."There has been an increased effort to target young women in recent times," Monroe said.In Indiana, smoking rates are higher for middle school girls than boys. "They've got a market," Monroe said. "They're going to go where the money is."Part of the Influence Women's Health forum, which is an ongoing state initiative, is to empower women to become educated on the issues and advocate for change. Monroe praised KDH for its smoke-free campus."That's really a powerful message for a hospital to give the community," she said.In response to an audience member's question about what else can be done at the community level to decrease smoking rates, Monroe responded that education is a key component."I think raising youth awareness is one area where we can do more," she said.Another audience member cited Mr. Potato Head as an example of the strides made to decrease smoking's appeal to youngsters. The popular children's toy featured a pipe until 1987."Habits and attitudes, they do start early," Monroe said.A seventh-grader in the audience asked Monroe what she could do to help keep her peers from lighting up. The student said the topic had been covered in her health class and that "a lot of girls looked very upset" when the teacher showed cigarette ads that could appeal to young girls."Getting upset about it is a really healthy thing," Monroe said. "They're targeting you."Monroe encouraged the student to talk about the issues with friends, parents and teachers to find creative ways to promote a non-smoking lifestyle.While the forum is focused on women's health issues, Monroe knows the addiction affects everyone in the state. Smoking costs Indiana over $2 billion in total medical costs each year and results in over 9,800 deaths. For Monroe, who is also a family physician, the numbers behind the dollar signs demand action."As a physician, the quality of life is the one that always pulls at my heartstrings," she said.Elizabeth Auxier, the tobacco cessation program coordinator at KDH, first heard Monroe speak at a Shape Up Indiana event and knew the local community could benefit from her expertise."The message was so right," Auxier said. "We were just honored that she could make it down here."Help is available for Indiana residents who want to quit smoking by calling the Indiana Tobacco Quitline at 1-800-QUIT-NOW.
Babies born to drug dependent mothers doubles in four years - Lamb
The number of babies born to drug dependent mothers has almost doubled in the past four years, reaching 2000 a year, new figures uncovered by the Liberal Democrats have revealed. The figures also show that 100 babies a month were born addicted to drugs last year, a 15% increase.Commenting, Liberal Democrat Shadow Health Secretary, Norman Lamb said:"These babies have a tragically unfair start in life. They are being put at an enormous disadvantage by their mothers’ addiction to drugs."As well as the obvious damage to their health, they are more likely to need intervention from social services, as a drug-dependent parent will probably not be able to care for their child alone."Early intervention is vital. Medical and social services staff must have the resources and the ability to identify and treat any drug problems early in a pregnancy. The sooner exposure to drugs is stopped the better."This is a harsh wake up call showing the urgent need to tackle the devastating impact of drug addiction in this country."
Applicability: this item refers to the UK.
Applicability: this item refers to the UK.
FROM HAMBURG, GERMANY: SUCCESSFUL PREGNANCY OUTCOME WITH HEROIN-ASSISTED TREATMENT OF OPIATE DEPENDENCE:
A successful outcome has just been described in a 31 year old long-time addict who had failed to respond favorably to methadone maintenance. Eur Addict Res. 2008;14(2):113-4. Ultimately, therapeutic decisions require weighing of the alternatives, and whatever reservations one might have about clinical prescribing of heroin to pregnant women, for those whom methadone does not help and who reject other forms of care, the alternative is probably abandonment!
UseMethamphetamine In The Changes Of The Pregnancy That Learn The Ability Of The Offspring
The studies had suggested that the infants had displayed to methamphetamines when in womb they can suffer to the damages from brain irreversible, even so the accurate effect of these drugs during the pregnancy were hard to locate due to many other negative behaviors that occur frequent in users of meth.
Now, using a model of the pig of the guinea that can evaluate changes neural in the loaded offspring to the mothers given methamphetamine during a pregnancy in another normal way, the Dr. Sanika Samuel Chirwa supplies to the new evidence the damages cognitive of these drugs.
In preliminary studies, Chirwa and the colleagues had found that the younglings of dog of the loaded pig of the guinea to the mothers who had received 1 mg/day from methamphetamine during the exhibition of the pregnancy a damaged ability to distinguish objects from the novel of articles they had seen before. This lack of recognition correlated with the changes in the region of the brain, hippocampus, associated with the formation of the memory.
The article was adaptou today for Medical Notice of the release of the original press.
Source: Sarah GoodwinAmerican society for biochemistry and molecular biology
Now, using a model of the pig of the guinea that can evaluate changes neural in the loaded offspring to the mothers given methamphetamine during a pregnancy in another normal way, the Dr. Sanika Samuel Chirwa supplies to the new evidence the damages cognitive of these drugs.
In preliminary studies, Chirwa and the colleagues had found that the younglings of dog of the loaded pig of the guinea to the mothers who had received 1 mg/day from methamphetamine during the exhibition of the pregnancy a damaged ability to distinguish objects from the novel of articles they had seen before. This lack of recognition correlated with the changes in the region of the brain, hippocampus, associated with the formation of the memory.
The article was adaptou today for Medical Notice of the release of the original press.
Source: Sarah GoodwinAmerican society for biochemistry and molecular biology
Path Clinic, Honolulu
This Perinatal Addiction Treatment Clinic was formed in Hawaii after founder Tricia Wright became aware of the lack of resources for this population. Their premise is "that suffering from an addiction doesn't make someone less human."
This Perinatal Addiction Treatment Clinic was formed in Hawaii after founder Tricia Wright became aware of the lack of resources for this population. Their premise is "that suffering from an addiction doesn't make someone less human."
Perinatal Addiction Research and Education Update
Perinatal Addiction Research and Education Update. National Assn. for Perinatal Addiction Research and Education, 11 E. Hubbard St., Suite 200, Chicago IL 60611, 312-329-2512. Magazine; FAS/E resource.
Perinatal Addiction Research and Education Update. National Assn. for Perinatal Addiction Research and Education, 11 E. Hubbard St., Suite 200, Chicago IL 60611, 312-329-2512. Magazine; FAS/E resource.
Perinatal Addiction Research and Education Update
Perinatal Addiction Research and Education Update. National Assn. for Perinatal Addiction Research and Education, 11 E. Hubbard St., Suite 200, Chicago IL 60611, 312-329-2512. Magazine; FAS/E resource.
Perinatal Addiction Research and Education Update. National Assn. for Perinatal Addiction Research and Education, 11 E. Hubbard St., Suite 200, Chicago IL 60611, 312-329-2512. Magazine; FAS/E resource.
Forgotten fathers An exploratory study of mothers' report of drug and alcohol problems among fathers of urban newborns
Deborah A. Frank, , a, Jeffrey Brownb, Sarah Johnsonc and Howard Cabrald a Department of Pediatrics, Boston University School of Medicine, Boston, MA, USAb American Pediatric Society and Society for Pediatric Research Student Research Program, Brown University School of Medicine, Providence, RI, USAc American Pediatric Society and Society for Pediatric Research Student Research Program, Cornell Medical College, NY, USAd Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA Received 23 August 2001; revised 15 November 2001; accepted 19 December 2001 Available online 3 February 2002.
Abstract
Objectives: To investigate the relationship between fathers' substance use and maternal and paternal background characteristics, infant outcome measures, and fathers' frequency of caregiving at 6 months postpartum in a cohort of cocaine-exposed and unexposed infants. Methods: Secondary analysis was completed on data collected through interviews and medical records obtained from 252 mothers participating in an ongoing longitudinal study of cocaine-exposed and unexposed mothers and infants. Results: By maternal report, 22% of the mothers reported that the father of the baby had a history of a drug and/or alcohol problem. Mothers who were classified as heavier cocaine users were 1.6 times more likely than lighter cocaine users and 2.6 times more likely than nonusers to report that the father of the baby had a history of a drug and/or alcohol problem. There was a significant relationship between the father's reported history of a drug and/or alcohol problem and the mother's history of mental and physical abuse during pregnancy; P=.03, P=.001, respectively). Fathers with a history of a drug and/or alcohol problem were more likely to have been in jail (P=.001) and to be unemployed at the time of delivery (P=.04) than fathers without a history of a drug and/or alcohol problem. On bivariate analysis, newborns of fathers with a history by mother's report of a drug or alcohol problem had significantly lower mean birthweights (3003 vs. 3213 g, P=.005) and lengths (47.5 vs. 48.6 cm, P=.01) than newborns of fathers with no such history. However after control for mothers' prenatal use of cocaine, marijuana, cigarettes, and alcohol and for infant gender and gestational age, the differences were not statistically significant (P=.15 for both measurements). Head circumference did not differ significantly between groups in either bivariate or multivariate analyses. Fathers with a reported history of drug and/or alcohol problems were more likely to care for the baby at least once a week than fathers without such a history of a drug and/or alcohol problem at 6 months postpartum. Conclusions: Childhood cognitive and behavioral outcomes currently attributed to maternal substance abuse may also reflect the genetic, teratogenic, and social influence of fathers. Within an urban, at-risk population, it is important to inquire about the father's participation in the day-to-day life of the infant and to address the father's as well as the mother's possible need for substance abuse treatment and support in parenting.
Deborah A. Frank, , a, Jeffrey Brownb, Sarah Johnsonc and Howard Cabrald a Department of Pediatrics, Boston University School of Medicine, Boston, MA, USAb American Pediatric Society and Society for Pediatric Research Student Research Program, Brown University School of Medicine, Providence, RI, USAc American Pediatric Society and Society for Pediatric Research Student Research Program, Cornell Medical College, NY, USAd Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA Received 23 August 2001; revised 15 November 2001; accepted 19 December 2001 Available online 3 February 2002.
Abstract
Objectives: To investigate the relationship between fathers' substance use and maternal and paternal background characteristics, infant outcome measures, and fathers' frequency of caregiving at 6 months postpartum in a cohort of cocaine-exposed and unexposed infants. Methods: Secondary analysis was completed on data collected through interviews and medical records obtained from 252 mothers participating in an ongoing longitudinal study of cocaine-exposed and unexposed mothers and infants. Results: By maternal report, 22% of the mothers reported that the father of the baby had a history of a drug and/or alcohol problem. Mothers who were classified as heavier cocaine users were 1.6 times more likely than lighter cocaine users and 2.6 times more likely than nonusers to report that the father of the baby had a history of a drug and/or alcohol problem. There was a significant relationship between the father's reported history of a drug and/or alcohol problem and the mother's history of mental and physical abuse during pregnancy; P=.03, P=.001, respectively). Fathers with a history of a drug and/or alcohol problem were more likely to have been in jail (P=.001) and to be unemployed at the time of delivery (P=.04) than fathers without a history of a drug and/or alcohol problem. On bivariate analysis, newborns of fathers with a history by mother's report of a drug or alcohol problem had significantly lower mean birthweights (3003 vs. 3213 g, P=.005) and lengths (47.5 vs. 48.6 cm, P=.01) than newborns of fathers with no such history. However after control for mothers' prenatal use of cocaine, marijuana, cigarettes, and alcohol and for infant gender and gestational age, the differences were not statistically significant (P=.15 for both measurements). Head circumference did not differ significantly between groups in either bivariate or multivariate analyses. Fathers with a reported history of drug and/or alcohol problems were more likely to care for the baby at least once a week than fathers without such a history of a drug and/or alcohol problem at 6 months postpartum. Conclusions: Childhood cognitive and behavioral outcomes currently attributed to maternal substance abuse may also reflect the genetic, teratogenic, and social influence of fathers. Within an urban, at-risk population, it is important to inquire about the father's participation in the day-to-day life of the infant and to address the father's as well as the mother's possible need for substance abuse treatment and support in parenting.
The treatment of perinatal addiction. Identification, intervention, and advocacy.
M Jessup
West J Med. 1990 May; 152(5): 553–558.
Women of reproductive age who use and abuse psychoactive drugs and alcohol present a special challenge to primary care physicians. There are compelling medical reasons for identifying and intervening with pregnant women who are addicted or have alcoholism. The teratogenicity of all drugs of abuse and alcohol, the risk of infection with the acquired immunodeficiency syndrome (AIDS), and the potential for full recovery of a pregnant woman from addiction are some of the reasons that identification and intervention in the problem are indicated. Whether encountered in the clinic setting or in private practice, chemically dependent pregnant or postpartum women are usually responsive to appropriate physician interventions that include a detailed and caring confrontation- and advocacy-oriented support. Complex legal and ethical issues surround perinatal addiction including the role of toxicologic screening, reports to child welfare services, issues in noncompliance, and interdisciplinary case management.
Women of reproductive age who use and abuse psychoactive drugs and alcohol present a special challenge to primary care physicians. There are compelling medical reasons for identifying and intervening with pregnant women who are addicted or have alcoholism. The teratogenicity of all drugs of abuse and alcohol, the risk of infection with the acquired immunodeficiency syndrome (AIDS), and the potential for full recovery of a pregnant woman from addiction are some of the reasons that identification and intervention in the problem are indicated. Whether encountered in the clinic setting or in private practice, chemically dependent pregnant or postpartum women are usually responsive to appropriate physician interventions that include a detailed and caring confrontation- and advocacy-oriented support. Complex legal and ethical issues surround perinatal addiction including the role of toxicologic screening, reports to child welfare services, issues in noncompliance, and interdisciplinary case management.
M Jessup
West J Med. 1990 May; 152(5): 553–558.
Women of reproductive age who use and abuse psychoactive drugs and alcohol present a special challenge to primary care physicians. There are compelling medical reasons for identifying and intervening with pregnant women who are addicted or have alcoholism. The teratogenicity of all drugs of abuse and alcohol, the risk of infection with the acquired immunodeficiency syndrome (AIDS), and the potential for full recovery of a pregnant woman from addiction are some of the reasons that identification and intervention in the problem are indicated. Whether encountered in the clinic setting or in private practice, chemically dependent pregnant or postpartum women are usually responsive to appropriate physician interventions that include a detailed and caring confrontation- and advocacy-oriented support. Complex legal and ethical issues surround perinatal addiction including the role of toxicologic screening, reports to child welfare services, issues in noncompliance, and interdisciplinary case management.
Women of reproductive age who use and abuse psychoactive drugs and alcohol present a special challenge to primary care physicians. There are compelling medical reasons for identifying and intervening with pregnant women who are addicted or have alcoholism. The teratogenicity of all drugs of abuse and alcohol, the risk of infection with the acquired immunodeficiency syndrome (AIDS), and the potential for full recovery of a pregnant woman from addiction are some of the reasons that identification and intervention in the problem are indicated. Whether encountered in the clinic setting or in private practice, chemically dependent pregnant or postpartum women are usually responsive to appropriate physician interventions that include a detailed and caring confrontation- and advocacy-oriented support. Complex legal and ethical issues surround perinatal addiction including the role of toxicologic screening, reports to child welfare services, issues in noncompliance, and interdisciplinary case management.
Paternal Alcoholism, Parental Psychopathology, and Aggravation with Infants
Rina Das Eiden Ph.D., , a and Kenneth E. Leonarda, b a Research Institute on Addictions, Buffalo, NY 14203, USAb State University of New York at Buffalo Medical School, Buffalo, NY, USA The purpose of this study was to examine the role of paternal alcohol problems, antisocial behavior, and depression in predicting parental attitudes toward their 12-month-old infants. Families were recruited from birth records and the final sample consisted of 216 families, 101 in the control group and 115 families with alcoholic fathers (92 with light drinking partners and 23 with heavy drinking partners). Results indicated that fathers' alcoholism was associated with higher paternal aggravation with the infant. Further, fathers' depression mediated the relationship between fathers' current alcohol problems and aggravation. Fathers' alcoholism was indirectly associated with maternal aggravation and warmth through the relationship with maternal antisocial behavior and depression. Results suggest that at least during early infancy, parental psychopathology associated with fathers' alcohol problems may play a more important role in predicting parental attitudes toward their infants than alcoholism per se. Results are further discussed in terms of their implications for parenting and later development among infants of alcoholics.
Rina Das Eiden Ph.D., , a and Kenneth E. Leonarda, b a Research Institute on Addictions, Buffalo, NY 14203, USAb State University of New York at Buffalo Medical School, Buffalo, NY, USA The purpose of this study was to examine the role of paternal alcohol problems, antisocial behavior, and depression in predicting parental attitudes toward their 12-month-old infants. Families were recruited from birth records and the final sample consisted of 216 families, 101 in the control group and 115 families with alcoholic fathers (92 with light drinking partners and 23 with heavy drinking partners). Results indicated that fathers' alcoholism was associated with higher paternal aggravation with the infant. Further, fathers' depression mediated the relationship between fathers' current alcohol problems and aggravation. Fathers' alcoholism was indirectly associated with maternal aggravation and warmth through the relationship with maternal antisocial behavior and depression. Results suggest that at least during early infancy, parental psychopathology associated with fathers' alcohol problems may play a more important role in predicting parental attitudes toward their infants than alcoholism per se. Results are further discussed in terms of their implications for parenting and later development among infants of alcoholics.
Emotion-Focused Coping as a Mediator of Maternal Cocaine Abuse and Antisocial Behavior*1
Denise A. Hien, , a, b and Gloria M. Mielec a School of Social Work, Columbia University, USAb Women's Health Project, St. Luke's–Roosevelt Hospital Center, USAc College of Physicians and Surgeons, Columbia University, USA Received 22 October 2001; revised 20 May 2002; accepted 21 May 2002. ; Available online 28 March 2003.
Abstract
A great deal of data implicate parental drug use as a potential risk factor for child abuse; however, theories for understanding the links between maternal drug use and antisocial behavior have yet to be examined empirically. This case-control study investigated correlates of adult antisocial behavior among 279 inner-city mothers in 3 comparison groups: drug abusers (n = 112), depressed mothers (n = 73), and nonsubstance abusing controls (n = 94). Using hierarchical regression techniques and mediational analyses controlling for ethnicity, current depression, and family history of substance abuse, support was provided for an emotion-focused coping style as a link between addictive and antisocial behavior. These results highlight the importance of focusing on emotion regulation models in the prevention and treatment of violence in drug-abusing women.
Denise A. Hien, , a, b and Gloria M. Mielec a School of Social Work, Columbia University, USAb Women's Health Project, St. Luke's–Roosevelt Hospital Center, USAc College of Physicians and Surgeons, Columbia University, USA Received 22 October 2001; revised 20 May 2002; accepted 21 May 2002. ; Available online 28 March 2003.
Abstract
A great deal of data implicate parental drug use as a potential risk factor for child abuse; however, theories for understanding the links between maternal drug use and antisocial behavior have yet to be examined empirically. This case-control study investigated correlates of adult antisocial behavior among 279 inner-city mothers in 3 comparison groups: drug abusers (n = 112), depressed mothers (n = 73), and nonsubstance abusing controls (n = 94). Using hierarchical regression techniques and mediational analyses controlling for ethnicity, current depression, and family history of substance abuse, support was provided for an emotion-focused coping style as a link between addictive and antisocial behavior. These results highlight the importance of focusing on emotion regulation models in the prevention and treatment of violence in drug-abusing women.
Tuesday, April 22, 2008
Pregnant Smokers Raise Their Child's Risk Of Stroke, Heart Attack
ScienceDaily (Mar. 5, 2007) — Women who smoke during pregnancy can cause permanent vascular damage in their children -- increasing their risk for stroke and heart attack, researchers said today at the American Heart Association's 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
See also:
The Netherlands Atherosclerosis Risk in Young Adults (ARYA) study showed that participants who were exposed to smoke when their mothers were pregnant resulted in permanent cardiovascular damage that could be detected in young adulthood.
"This is the first report to demonstrate this association," said Cuno S. Uiterwaal, M.D., Ph.D., lead researcher and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands. "This is a preventable risk factor. Women need to stop smoking, especially in pregnancy, not only for their own health, but for their unborn child."
Smoking during pregnancy can result in intrauterine growth retardation and low birth weight. Active and passive smoking in young adults also is associated with cardiovascular disease. But until the Dutch study, researchers were unsure whether this is due to a cumulative effect of smoke or whether children are vulnerable at specific periods, such as during gestation.
The study's 732 participants were born in 1970-73 and vascular risk measurements were performed in 1999-2000. Uiterwaal and colleagues found that adult offspring of the 215 mothers who smoked during pregnancy had thicker walls of the carotid arteries in the neck. The carotid artery intima-media thickness (CIMT), an ultrasound measurement of the thickness of the inner walls of the neck arteries, is used to determine the level of atherosclerosis. Offspring whose pregnant mothers were exposed to smoke had 13.4 micrometers thicker CIMT by young adulthood when compared to the offspring of mothers who did not smoke in pregnancy, researchers reported.
Even after the researchers adjusted for other risk factors in the young adults such as age, gender, body mass index, pulse pressure and cholesterol levels, the CIMT remained 9.4 micrometers thicker in children of mothers who smoked. Adjustment for current smoking by both mothers and fathers or the number of pack years (one "pack year" is 20 cigarettes smoked/day for one year) smoked by study participants also did not change this association.
"While it is difficult to separate the problem of current smoking and smoking during pregnancy, this study indicates that smoking in pregnancy has an independent effect," Uiterwaal said.
If both parents smoked during pregnancy, the children as young adults had thicker CIMT than other participants with either one smoking parent or parents who didn't smoke. Offspring of mothers who smoked the highest number of cigarettes during pregnancy had thicker CIMT than those born to mothers smoking less than the average or those who did not smoke.
"Our findings suggest that both smoking by mothers themselves in pregnancy and exposure to passive smoking are important," he said. "More exposure leads to more vascular damage in the offspring."
The researchers found that pregnancy was a critical period for damage from smoke exposure. They compared the children of mothers who didn't smoke during pregnancy and were currently not smoking to the children of mothers who didn't smoke in pregnancy but smoked now. They found no difference in CIMT. However, children from mothers who smoked in pregnancy, but who didn't currently smoke had significantly thicker CIMT compared to offspring of abstaining mothers. "There is the possibility that the compounds in tobacco smoke go through the placenta and directly damage the cardiovascular system of the fetus," Uiterwaal said. "The damage appears to be permanent and stays with the children."
When study participants were born, about 30 percent of the mothers smoked during pregnancy. But the current rate has dropped to between 5 percent and 7 percent due to health warnings, Uiterwaal said.
"There are still substantial numbers of mothers who smoke during pregnancy," he said. "This is just another reason for expectant mothers not to smoke." This is the first study in which researchers have dealt with this issue. Uiterwaal said further evidence should come from additional studies that show similar results.
Michiel L. Bots, M.D., Ph.D., second author of the study and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands, presented the findings at the American Heart Association meeting.
The study's other co-author is Diederick E. Grobbee, M.D., Ph.D.
The ARYA study was funded by The Netherlands Organization of Health Research and Development Council.
Adapted from materials provided by American Heart Association, via EurekAlert!, a service of AAAS.
See also:
The Netherlands Atherosclerosis Risk in Young Adults (ARYA) study showed that participants who were exposed to smoke when their mothers were pregnant resulted in permanent cardiovascular damage that could be detected in young adulthood.
"This is the first report to demonstrate this association," said Cuno S. Uiterwaal, M.D., Ph.D., lead researcher and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands. "This is a preventable risk factor. Women need to stop smoking, especially in pregnancy, not only for their own health, but for their unborn child."
Smoking during pregnancy can result in intrauterine growth retardation and low birth weight. Active and passive smoking in young adults also is associated with cardiovascular disease. But until the Dutch study, researchers were unsure whether this is due to a cumulative effect of smoke or whether children are vulnerable at specific periods, such as during gestation.
The study's 732 participants were born in 1970-73 and vascular risk measurements were performed in 1999-2000. Uiterwaal and colleagues found that adult offspring of the 215 mothers who smoked during pregnancy had thicker walls of the carotid arteries in the neck. The carotid artery intima-media thickness (CIMT), an ultrasound measurement of the thickness of the inner walls of the neck arteries, is used to determine the level of atherosclerosis. Offspring whose pregnant mothers were exposed to smoke had 13.4 micrometers thicker CIMT by young adulthood when compared to the offspring of mothers who did not smoke in pregnancy, researchers reported.
Even after the researchers adjusted for other risk factors in the young adults such as age, gender, body mass index, pulse pressure and cholesterol levels, the CIMT remained 9.4 micrometers thicker in children of mothers who smoked. Adjustment for current smoking by both mothers and fathers or the number of pack years (one "pack year" is 20 cigarettes smoked/day for one year) smoked by study participants also did not change this association.
"While it is difficult to separate the problem of current smoking and smoking during pregnancy, this study indicates that smoking in pregnancy has an independent effect," Uiterwaal said.
If both parents smoked during pregnancy, the children as young adults had thicker CIMT than other participants with either one smoking parent or parents who didn't smoke. Offspring of mothers who smoked the highest number of cigarettes during pregnancy had thicker CIMT than those born to mothers smoking less than the average or those who did not smoke.
"Our findings suggest that both smoking by mothers themselves in pregnancy and exposure to passive smoking are important," he said. "More exposure leads to more vascular damage in the offspring."
The researchers found that pregnancy was a critical period for damage from smoke exposure. They compared the children of mothers who didn't smoke during pregnancy and were currently not smoking to the children of mothers who didn't smoke in pregnancy but smoked now. They found no difference in CIMT. However, children from mothers who smoked in pregnancy, but who didn't currently smoke had significantly thicker CIMT compared to offspring of abstaining mothers. "There is the possibility that the compounds in tobacco smoke go through the placenta and directly damage the cardiovascular system of the fetus," Uiterwaal said. "The damage appears to be permanent and stays with the children."
When study participants were born, about 30 percent of the mothers smoked during pregnancy. But the current rate has dropped to between 5 percent and 7 percent due to health warnings, Uiterwaal said.
"There are still substantial numbers of mothers who smoke during pregnancy," he said. "This is just another reason for expectant mothers not to smoke." This is the first study in which researchers have dealt with this issue. Uiterwaal said further evidence should come from additional studies that show similar results.
Michiel L. Bots, M.D., Ph.D., second author of the study and associate professor of clinical epidemiology at the University Medical Center Utrecht in The Netherlands, presented the findings at the American Heart Association meeting.
The study's other co-author is Diederick E. Grobbee, M.D., Ph.D.
The ARYA study was funded by The Netherlands Organization of Health Research and Development Council.
Adapted from materials provided by American Heart Association, via EurekAlert!, a service of AAAS.
Prenatal Exposure To Drugs, Alcohol And Tobacco Affect The Brain Into Early Adolescence, Scans Show
ScienceDaily (Apr. 8, 2008) — Although behavioral studies clearly indicate that exposure to drugs, alcohol and tobacco in utero is bad for a baby's developing brain, specific anatomic brain effects have been hard to tease out in humans. Often users don't limit themselves to one substance, and demographic factors like poverty can also influence brain development.
Now, a new study using magnetic resonance imaging (MRI) brain scans, led by Children's Hospital Boston neurologist Michael Rivkin, MD, suggests that prenatal exposure to cocaine, alcohol, marijuana or tobacco (alone or in combination) may have effects on brain structure that persist into early adolescence. The findings, published in Pediatrics, are of public health significance, the researchers say, since it's estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these agents in utero.
Researchers at Children's and Boston Medical Center employed volumetric MRI imaging to study the brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children, who averaged 12 years old at the time of imaging, were part of part of an historic cohort of children assembled by Deborah Frank, MD at Boston Medical Center and followed there since birth. Prenatal exposures were confirmed by a combination of maternal history, urine testing of the mother or urine or meconium (stool) testing of the infants at birth.
"We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes," says Rivkin, who is first author on the study. "Importantly, although volume reductions were associated with each of these three prenatal exposures, they were not associated with any one of these substances alone after controlling for other exposures."
Notably, the effects were found to be additive--the more substances a child was exposed to in utero, the greater the reduction in brain volume.
Rivkin notes that the study is also the first to document joint long-term neuroanatomic effects on the brain of prenatal cocaine, cigarette and alcohol exposures. Moreover, while previous studies have documented brain effects of prenatal alcohol exposure, these studies were mostly limited to children with fetal alcohol syndrome, a diagnosis that was excluded in the current study.
Although investigators initially set out to study cocaine exposure, they were struck by the finding of brain effects of prenatal tobacco exposure. "Approximately 20 percent of women who smoke continue to smoke during pregnancy," Rivkin says. "From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances."
Rivkin emphasizes that the number of children studied was too small to find statistically significant effects of single substances after controlling for exposure to other agents. The study was also too small to consider the effects of different levels of exposure. But the overall results are highly suggestive. "We're hopeful to be able to study the whole sample of 150 children followed at Boston Medical Center, which will permit such determinations," Rivkin says.
Both investigators concur that health care providers should offer pregnant women comprehensive care to help them reduce use of all psychoactive substances. Public health campaigns should not ignore the risks of some substances while focusing on others, as it may well be that the greater the number of total prenatal exposures, the higher the chance there will be adverse and lasting consequences for the developing brain.
This research was published in the April issue of Pediatrics. The study was funded by the National Institute on Drug Abuse.
References to earlier work:
SAMHSA, U.S. Department of Health and Human Services, National Survey on Drug Use and Health, 2005.
Hamilton BE et al., Births: Preliminary data for 2005, National Center for Health Statistics, 2005.
Adapted from materials provided by Children's Hospital Boston
Now, a new study using magnetic resonance imaging (MRI) brain scans, led by Children's Hospital Boston neurologist Michael Rivkin, MD, suggests that prenatal exposure to cocaine, alcohol, marijuana or tobacco (alone or in combination) may have effects on brain structure that persist into early adolescence. The findings, published in Pediatrics, are of public health significance, the researchers say, since it's estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these agents in utero.
Researchers at Children's and Boston Medical Center employed volumetric MRI imaging to study the brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children, who averaged 12 years old at the time of imaging, were part of part of an historic cohort of children assembled by Deborah Frank, MD at Boston Medical Center and followed there since birth. Prenatal exposures were confirmed by a combination of maternal history, urine testing of the mother or urine or meconium (stool) testing of the infants at birth.
"We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes," says Rivkin, who is first author on the study. "Importantly, although volume reductions were associated with each of these three prenatal exposures, they were not associated with any one of these substances alone after controlling for other exposures."
Notably, the effects were found to be additive--the more substances a child was exposed to in utero, the greater the reduction in brain volume.
Rivkin notes that the study is also the first to document joint long-term neuroanatomic effects on the brain of prenatal cocaine, cigarette and alcohol exposures. Moreover, while previous studies have documented brain effects of prenatal alcohol exposure, these studies were mostly limited to children with fetal alcohol syndrome, a diagnosis that was excluded in the current study.
Although investigators initially set out to study cocaine exposure, they were struck by the finding of brain effects of prenatal tobacco exposure. "Approximately 20 percent of women who smoke continue to smoke during pregnancy," Rivkin says. "From the vantage point of preventive health care, it is important to determine the consequences on brain structure of prenatal exposure to cigarettes, alone and in combination with other substances."
Rivkin emphasizes that the number of children studied was too small to find statistically significant effects of single substances after controlling for exposure to other agents. The study was also too small to consider the effects of different levels of exposure. But the overall results are highly suggestive. "We're hopeful to be able to study the whole sample of 150 children followed at Boston Medical Center, which will permit such determinations," Rivkin says.
Both investigators concur that health care providers should offer pregnant women comprehensive care to help them reduce use of all psychoactive substances. Public health campaigns should not ignore the risks of some substances while focusing on others, as it may well be that the greater the number of total prenatal exposures, the higher the chance there will be adverse and lasting consequences for the developing brain.
This research was published in the April issue of Pediatrics. The study was funded by the National Institute on Drug Abuse.
References to earlier work:
SAMHSA, U.S. Department of Health and Human Services, National Survey on Drug Use and Health, 2005.
Hamilton BE et al., Births: Preliminary data for 2005, National Center for Health Statistics, 2005.
Adapted from materials provided by Children's Hospital Boston
Many Moms Use Cigarettes, Marijuana, Alcohol During Pregnancy; Dads Don't Help, Study Suggests
ScienceDaily (Mar. 21, 2008) — Despite public health campaigns, a surprising number of women continue to use substances such as tobacco, marijuana and alcohol during pregnancy and their usage rebounds to pre-pregnancy levels within two years of having a baby, according to a new University of Washington study.
Men's patterns of substance use during their partners' pregnancies were even bleaker. Men typically are not targeted by these campaigns, and their levels of binge drinking, daily smoking and marijuana use remained fairly stable before, during and after pregnancy, the study showed.
This is important, according to the study's lead authors Jennifer Bailey and Karl Hill, because men's substance use may make it harder for women to stop using while they're pregnant and may make it more likely that mothers will resume smoking or drinking after their child is born. Bailey and Hill are affiliated with the Social Development Research Group in the UW's School of Social Work.
"The months after childbirth are critical for intervening with mothers," said Bailey, who is a UW research scientist. "For example, many already have done the hard work of quitting smoking and haven't smoked a cigarette in six months or more. We should support that effort so that they can continue as nonsmokers. However, we know if dad is smoking or drinking it is more likely that mom will resume smoking or drinking."
The research is the first comprehensive look at mothers' and fathers' substance use on a month-by-month basis during a three-year period that included pregnancy. Substance use around pregnancy presents a wide variety of risks to fetuses and infants including fetal alcohol syndrome, cognitive and behavioral problems and impairments, asthma and higher incidences of sudden infant death syndrome.
The study found that:
77 percent of women cigarette smokers and 50 percent of the women who smoked marijuana used those substances at some time during pregnancy.
38 percent of women cigarette smokers and 24 percent of marijuana users reported using those substances throughout their pregnancies.
While overall rates of cigarette and marijuana use and binge drinking for women declined during pregnancy, those rates began rising again during the first six months following the birth of a baby.
Month by month during pregnancy, rates of smoking among all pregnant women varied between 17 percent and 21 percent, binge drinking was between 2 percent and 3 percent and marijuana use was between 8 percent and 9 percent.
Data for the study came from the Seattle Social Development Project which is following the development of 808 Seattle children who are now young adults. The participants are interviewed every three years, and for this study data covered the period when they were 21 to 24 years of age. In interviews, they were asked about their month-by-month incidences of binge drinking (5 or more alcoholic drinks in a two-hour period) and their use of cigarettes and marijuana. They were also asked a number of questions about life events, including the birth of a child. One hundred and thirty-one women and 77 men reported the birth of 244 children during this period.
The high rate of marijuana use rivaled that of cigarette smoking and came as a surprise to the researchers, according to Hill, who is a research associate professor of social work. He said it may be partly attributed to study participants who came from a high-risk, low-income urban sample.
He and Bailey said the findings emphasize the need for more public health messages and preventive interventions.
"Women who are pregnant want the best for their baby and typically reduce their drinking and smoking," said Bailey. "But after birth part of their motivation to limit alcohol use and quit using cigarettes and marijuana is taken away. If their partner is still smoking, for example, they might think, 'Boy, that cigarette smells good.'"
"There are two ways we need to reach parents," said Hill. "Pregnancy health care providers need to talk to both fathers and mothers about their smoking, drinking and marijuana use. Pregnancy seems like such a great public health opportunity to reach parents, but no one is talking to dads and this study shows that they are not changing their substance use behavior. What dads do matters and we want them to reduce their substance use.
"We also need to change the way society presently looks at the social norms of using these drugs. Right now there is little discussion about marijuana use during pregnancy, although it may be a relatively prevalent problem."
The study was funded by the National Institute on Drug Abuse. Co-authors are J. David Hawkins and Richard Catalano, founding and current directors, respectively, of the Social Development Research Group, and Robert Abbott, a UW professor of educational psychology. The paper was published in the journal Birth Issues in Perinatal Care.
Adapted from materials provided by University of Washington.
Men's patterns of substance use during their partners' pregnancies were even bleaker. Men typically are not targeted by these campaigns, and their levels of binge drinking, daily smoking and marijuana use remained fairly stable before, during and after pregnancy, the study showed.
This is important, according to the study's lead authors Jennifer Bailey and Karl Hill, because men's substance use may make it harder for women to stop using while they're pregnant and may make it more likely that mothers will resume smoking or drinking after their child is born. Bailey and Hill are affiliated with the Social Development Research Group in the UW's School of Social Work.
"The months after childbirth are critical for intervening with mothers," said Bailey, who is a UW research scientist. "For example, many already have done the hard work of quitting smoking and haven't smoked a cigarette in six months or more. We should support that effort so that they can continue as nonsmokers. However, we know if dad is smoking or drinking it is more likely that mom will resume smoking or drinking."
The research is the first comprehensive look at mothers' and fathers' substance use on a month-by-month basis during a three-year period that included pregnancy. Substance use around pregnancy presents a wide variety of risks to fetuses and infants including fetal alcohol syndrome, cognitive and behavioral problems and impairments, asthma and higher incidences of sudden infant death syndrome.
The study found that:
77 percent of women cigarette smokers and 50 percent of the women who smoked marijuana used those substances at some time during pregnancy.
38 percent of women cigarette smokers and 24 percent of marijuana users reported using those substances throughout their pregnancies.
While overall rates of cigarette and marijuana use and binge drinking for women declined during pregnancy, those rates began rising again during the first six months following the birth of a baby.
Month by month during pregnancy, rates of smoking among all pregnant women varied between 17 percent and 21 percent, binge drinking was between 2 percent and 3 percent and marijuana use was between 8 percent and 9 percent.
Data for the study came from the Seattle Social Development Project which is following the development of 808 Seattle children who are now young adults. The participants are interviewed every three years, and for this study data covered the period when they were 21 to 24 years of age. In interviews, they were asked about their month-by-month incidences of binge drinking (5 or more alcoholic drinks in a two-hour period) and their use of cigarettes and marijuana. They were also asked a number of questions about life events, including the birth of a child. One hundred and thirty-one women and 77 men reported the birth of 244 children during this period.
The high rate of marijuana use rivaled that of cigarette smoking and came as a surprise to the researchers, according to Hill, who is a research associate professor of social work. He said it may be partly attributed to study participants who came from a high-risk, low-income urban sample.
He and Bailey said the findings emphasize the need for more public health messages and preventive interventions.
"Women who are pregnant want the best for their baby and typically reduce their drinking and smoking," said Bailey. "But after birth part of their motivation to limit alcohol use and quit using cigarettes and marijuana is taken away. If their partner is still smoking, for example, they might think, 'Boy, that cigarette smells good.'"
"There are two ways we need to reach parents," said Hill. "Pregnancy health care providers need to talk to both fathers and mothers about their smoking, drinking and marijuana use. Pregnancy seems like such a great public health opportunity to reach parents, but no one is talking to dads and this study shows that they are not changing their substance use behavior. What dads do matters and we want them to reduce their substance use.
"We also need to change the way society presently looks at the social norms of using these drugs. Right now there is little discussion about marijuana use during pregnancy, although it may be a relatively prevalent problem."
The study was funded by the National Institute on Drug Abuse. Co-authors are J. David Hawkins and Richard Catalano, founding and current directors, respectively, of the Social Development Research Group, and Robert Abbott, a UW professor of educational psychology. The paper was published in the journal Birth Issues in Perinatal Care.
Adapted from materials provided by University of Washington.
Marijuana Use Causes Early Pregnancy Failure
ScienceDaily (Aug. 4, 2006) — Marijuana use at the time of conception and early in pregnancy prevents embryos' safe passage from the ovary to the uterus, resulting in early pregnancy failure, suggests a new study in mice. The study appears in the August issue of the Journal of Clinical Investigation.
Marijuana, the most widely used illegal drug among women of reproductive age, binds to 2 receptors -- cannabinoid receptors 1 and 2 (CB1, CB2) -- which are found in the brain and other organs including sperm, eggs, and newly formed embryos. Normally, these 2 receptors are activated by the naturally occurring signaling molecule anandamide. Anandamide formation by the enzyme NAPE-PLD is carefully balanced with its degradation by the enzyme FAAH, resulting in a finely tuned local "anandamide tone" in embryos and the oviduct. This balance is required for normal embryonic development, transport along the oviduct, implantation in the uterus, and full-term pregnancy.
In the current study, Sudhansu Dey and colleagues from Vanderbilt University show that suppression of FAAH activity in the embryos and oviduct elevates anandamide levels, which inhibits embryonic development and prevents embryos from completing their passage to the uterus, causing impaired fertility. They went on to show that administration to the mice of tetrahydrocannabinol (THC), the major psychoactive component of marijuana that like anandamide also binds to CB1, swamps normal anandamide tone, causing implantation of the embryo in the earliest stages of pregnancy to fail. The results of the study show that drugs such as THC persist and swamp these finely tuned signaling systems and as such the use of THC-containing drugs such as marijuana may lead to ectopic pregnancy and/or impaired fertility in women.
In an accompanying commentary Herbert Schuel from the State University of New York discusses the sobering results of this study regarding marijuana's effects on pregnancy outcome and goes on to stress that a number of drugs currently in development or in use to suppress appetite or trigger weight-loss are also known modulators of anandamide signaling and given the results presented in the current study "such drugs need to be carefully evaluated to judge their effects on women of reproductive age and those that are pregnant."
Adapted from materials provided by Journal of Clinical Investigation, via EurekAlert!, a service of AAAS.
Marijuana, the most widely used illegal drug among women of reproductive age, binds to 2 receptors -- cannabinoid receptors 1 and 2 (CB1, CB2) -- which are found in the brain and other organs including sperm, eggs, and newly formed embryos. Normally, these 2 receptors are activated by the naturally occurring signaling molecule anandamide. Anandamide formation by the enzyme NAPE-PLD is carefully balanced with its degradation by the enzyme FAAH, resulting in a finely tuned local "anandamide tone" in embryos and the oviduct. This balance is required for normal embryonic development, transport along the oviduct, implantation in the uterus, and full-term pregnancy.
In the current study, Sudhansu Dey and colleagues from Vanderbilt University show that suppression of FAAH activity in the embryos and oviduct elevates anandamide levels, which inhibits embryonic development and prevents embryos from completing their passage to the uterus, causing impaired fertility. They went on to show that administration to the mice of tetrahydrocannabinol (THC), the major psychoactive component of marijuana that like anandamide also binds to CB1, swamps normal anandamide tone, causing implantation of the embryo in the earliest stages of pregnancy to fail. The results of the study show that drugs such as THC persist and swamp these finely tuned signaling systems and as such the use of THC-containing drugs such as marijuana may lead to ectopic pregnancy and/or impaired fertility in women.
In an accompanying commentary Herbert Schuel from the State University of New York discusses the sobering results of this study regarding marijuana's effects on pregnancy outcome and goes on to stress that a number of drugs currently in development or in use to suppress appetite or trigger weight-loss are also known modulators of anandamide signaling and given the results presented in the current study "such drugs need to be carefully evaluated to judge their effects on women of reproductive age and those that are pregnant."
Adapted from materials provided by Journal of Clinical Investigation, via EurekAlert!, a service of AAAS.
How Smoking Marijuana Damages The Fetal Brain
ScienceDaily (May 29, 2007) — A critical step in brain development is governed by endogenous cannabinoids, 'the brain's own marijuana'. Studies conducted at Swedish medical university Karolinska Institutet, with participation of scientists from Europe and the United States, are now published in Science and show that these endogenous molecules regulate how certain nerve cells recognize each other and form connections. The scientists believe that their findings will significantly advance our understanding of how cannabis smoking during pregnancy may damage the fetal brain.
See also:
The formation of connections among nerve cells occurs during a relatively short period in the fetal brain. However, proper wiring of hundreds of millions of cells in our brains determine whether we can think, remember, move, or show emotions throughout our lives. For a nerve cell, recognizing its partners and establish connections with them is the key to survive and contribute to the control of brain functions. The process through which nerve cells recognize each other is guided by specific chemical signals whose availability instructs neurons to target or to ignore specific cells.
Scientists have now identified that endogenous cannabinoids, molecules naturally produced by our brains and functionally similar to THC from cannabis, play unexpectedly significant roles in establishing how certain nerve cells connect to each other. These new and exciting results not only bolster out knowledge on the brain's normal development but may also take us closer to understanding if and when cannabis damages the fetal brain.
Endogenous cannabinoids use the same mechanism, engaging the CB1 cannabinoid receptor, as THC to exert their effects on nerve cells. Therefore, the finding that endogenous cannabinoids control the establishment of connections amongst certain nerve cells convinces the scientists that they have defined a key mechanism through which maternal cannabis use might impair fetal brain development and impose life-long cognitive, social, and motor deficits in affected offspring. "Besides identifying a fundamental mechanism in brain development, our findings may provide new perspectives to identifying the molecular changes in the brains of individuals prenatally affected by maternal cannabis abuse", says Dr. Tibor Harkany who has led the studies. "This is of social impact given the continuous growing use of marijuana, the most common illicit drug, in our society."
Earlier studies have already found that children of marijuana-smoking mothers more frequently suffer from permanent cognitive deficits, concentration disorders, hyperactivity, and impaired social interactions than non-exposed children of the same age and social background.
Reference: "Hardwiring the Brain: Endocannabinoids Shape Neuronal Connectivity", Paul Berghius, Ann M Rajnicek, Yury M Morozov, Ruth A Ross, Jan Mulder, Gabriella M Urbán, Krisztina Monory, Giovanni Marsicano, Michela Matteoli, Alison Canty, Andrew J Irving, István Katona, Yuchio Yanagawa, Pasko Rakic, Beat Lutz, Ken Mackie and Tibor Harkany, Science, May 25, 2007
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The formation of connections among nerve cells occurs during a relatively short period in the fetal brain. However, proper wiring of hundreds of millions of cells in our brains determine whether we can think, remember, move, or show emotions throughout our lives. For a nerve cell, recognizing its partners and establish connections with them is the key to survive and contribute to the control of brain functions. The process through which nerve cells recognize each other is guided by specific chemical signals whose availability instructs neurons to target or to ignore specific cells.
Scientists have now identified that endogenous cannabinoids, molecules naturally produced by our brains and functionally similar to THC from cannabis, play unexpectedly significant roles in establishing how certain nerve cells connect to each other. These new and exciting results not only bolster out knowledge on the brain's normal development but may also take us closer to understanding if and when cannabis damages the fetal brain.
Endogenous cannabinoids use the same mechanism, engaging the CB1 cannabinoid receptor, as THC to exert their effects on nerve cells. Therefore, the finding that endogenous cannabinoids control the establishment of connections amongst certain nerve cells convinces the scientists that they have defined a key mechanism through which maternal cannabis use might impair fetal brain development and impose life-long cognitive, social, and motor deficits in affected offspring. "Besides identifying a fundamental mechanism in brain development, our findings may provide new perspectives to identifying the molecular changes in the brains of individuals prenatally affected by maternal cannabis abuse", says Dr. Tibor Harkany who has led the studies. "This is of social impact given the continuous growing use of marijuana, the most common illicit drug, in our society."
Earlier studies have already found that children of marijuana-smoking mothers more frequently suffer from permanent cognitive deficits, concentration disorders, hyperactivity, and impaired social interactions than non-exposed children of the same age and social background.
Reference: "Hardwiring the Brain: Endocannabinoids Shape Neuronal Connectivity", Paul Berghius, Ann M Rajnicek, Yury M Morozov, Ruth A Ross, Jan Mulder, Gabriella M Urbán, Krisztina Monory, Giovanni Marsicano, Michela Matteoli, Alison Canty, Andrew J Irving, István Katona, Yuchio Yanagawa, Pasko Rakic, Beat Lutz, Ken Mackie and Tibor Harkany, Science, May 25, 2007
Marijuana And Alcohol Taken Together Induced Widespread Nerve Cell Death In Brains Of Young Rats
ScienceDaily (Apr. 11, 2008) — Marijuana is among the most frequently used illicit drugs by women during their childbearing years and there is growing concern that marijuana abuse during pregnancy, either alone or in combination with other drugs, may have serious effects on fetal brain development. There is strong evidence that THC, the main psychoactive component of marijuana, crosses the placenta, that maternal marijuana abuse results in intrauterine growth retardation and that infants exposed to marijuana exhibit a temporary syndrome that includes lethargy and decreased muscle tone.
Fetal exposure to THC can also result in attention deficits, learning disabilities and behavioral problems. A new study using rats found that THC combined with mildly intoxicating doses of alcohol induced widespread nerve cell death in the brain.
Led by Henrik Hansen and Chrysanthy Ikonomidou, at the Neuroscience Research Center of the Humboldt University in Berlin and the Department of Pediatric Neurology, University of Technology Dresden, Germany, researchers administered THC, a synthetic form of THC, ethanol, MK-801 (an anticonvulsant) and phenobarbital by injection to rats between 1 and 14 days old. A previous study by the same group had shown that ethanol and drugs such as sedatives, anesthetics and anticonvulsants triggered widespread nerve cell death in the developing brain of immature rodents; the current study was conducted to determine if cannabinoids had the same effect.
The results showed that THC and its synthetic form did not cause neurodegeneration when administered alone but did cause cell death when given with lower than toxic amounts of ethanol. This combined effect increased according to the dose of THC that was administered and was strongest when the rats were 7 days old. THC also enhanced the neurotoxic effect of phenobarbital and MK-801 (ethanol combines the mechanism of action used by these two drugs). In addition, marijuana activates CB1 receptor levels, which causes the psychomotor, memory, cognition and pain perception changes seen with this substance in adult humans and animals.
In the current study, THC combined with ethanol increased these levels, and the CB1 receptor blocker Rimonabant, an anti-obesity drug that may be beneficial in treating addiction, reduced these levels. Mice that did not have functioning CB1 receptors (knockout mice) were less susceptible to the neurotoxic effects of ethanol.
"Neuronal degeneration became disseminated and very severe when THC was combined with a mildly toxic ethanol dose," the authors state, adding that since this effect was completely counteracted with the CB1 receptor blocker Rimonabant, the activation of these receptors is responsible for ethanol's increased toxicity. They note that experimental evidence suggests that endocannabinoid (compounds similar to cannabinoids that are naturally produced in the body) signaling may be involved in developmental processes such as cell proliferation and survival during the formation of the central nervous system, which would account for the age-dependent effect of the THC/ethanol combination seen in this study.
The authors acknowledge that the effect of cannabinoids on the neurotoxicity of ethanol on the developing brain requires further studies with longer survival periods. "With the use of behavioral and stereological techniques such studies would explore whether acute changes reflect permanent neuronal loss and lead to behavioural deficits," they conclude. "The results of the acute studies have interesting potential therapeutic implications including the use of CB1 receptor antagonists for preventing brain damage in fetuses and neonates exposed to ethanol, sedative and/or anticonvulsant drugs."
Journal article: "Cannabinoids Enhance Susceptibility of Immature Brain to Ethanol Neurotoxicity," Henrik Hansen, Birte Krutz, Marco Sifringer, Vanya Stefovska, Petra Bittigau, Fritz Pragst, Giovanni Marsicano, Beat Lutz, Chrysanthy Ikonomidou, Annals of Neurology.
Adapted from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS.
Fetal exposure to THC can also result in attention deficits, learning disabilities and behavioral problems. A new study using rats found that THC combined with mildly intoxicating doses of alcohol induced widespread nerve cell death in the brain.
Led by Henrik Hansen and Chrysanthy Ikonomidou, at the Neuroscience Research Center of the Humboldt University in Berlin and the Department of Pediatric Neurology, University of Technology Dresden, Germany, researchers administered THC, a synthetic form of THC, ethanol, MK-801 (an anticonvulsant) and phenobarbital by injection to rats between 1 and 14 days old. A previous study by the same group had shown that ethanol and drugs such as sedatives, anesthetics and anticonvulsants triggered widespread nerve cell death in the developing brain of immature rodents; the current study was conducted to determine if cannabinoids had the same effect.
The results showed that THC and its synthetic form did not cause neurodegeneration when administered alone but did cause cell death when given with lower than toxic amounts of ethanol. This combined effect increased according to the dose of THC that was administered and was strongest when the rats were 7 days old. THC also enhanced the neurotoxic effect of phenobarbital and MK-801 (ethanol combines the mechanism of action used by these two drugs). In addition, marijuana activates CB1 receptor levels, which causes the psychomotor, memory, cognition and pain perception changes seen with this substance in adult humans and animals.
In the current study, THC combined with ethanol increased these levels, and the CB1 receptor blocker Rimonabant, an anti-obesity drug that may be beneficial in treating addiction, reduced these levels. Mice that did not have functioning CB1 receptors (knockout mice) were less susceptible to the neurotoxic effects of ethanol.
"Neuronal degeneration became disseminated and very severe when THC was combined with a mildly toxic ethanol dose," the authors state, adding that since this effect was completely counteracted with the CB1 receptor blocker Rimonabant, the activation of these receptors is responsible for ethanol's increased toxicity. They note that experimental evidence suggests that endocannabinoid (compounds similar to cannabinoids that are naturally produced in the body) signaling may be involved in developmental processes such as cell proliferation and survival during the formation of the central nervous system, which would account for the age-dependent effect of the THC/ethanol combination seen in this study.
The authors acknowledge that the effect of cannabinoids on the neurotoxicity of ethanol on the developing brain requires further studies with longer survival periods. "With the use of behavioral and stereological techniques such studies would explore whether acute changes reflect permanent neuronal loss and lead to behavioural deficits," they conclude. "The results of the acute studies have interesting potential therapeutic implications including the use of CB1 receptor antagonists for preventing brain damage in fetuses and neonates exposed to ethanol, sedative and/or anticonvulsant drugs."
Journal article: "Cannabinoids Enhance Susceptibility of Immature Brain to Ethanol Neurotoxicity," Henrik Hansen, Birte Krutz, Marco Sifringer, Vanya Stefovska, Petra Bittigau, Fritz Pragst, Giovanni Marsicano, Beat Lutz, Chrysanthy Ikonomidou, Annals of Neurology.
Adapted from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS.
Drug addict babies: 140 in the Midlands
By Anuji Varma
MORE than 140 children were born with a drug-dependency in the Midlands last year.
Shock new Department of Health figures show that 146 junkie mums on crack cocaine and heroin passed on their addiction to their unborn babies.
And in the past six years the numbers of children born to mums addicted to some sort of drug, including tobacco and alcohol, has continued to rise.
Experts have warned drug use during pregnancy can leave children suffering crippling withdrawal symptoms and long-term health problems.
West Midland's Euro MP Liz Lynne said: "The figures for babies being born to drug dependent mothers in the West Midlands is the third highest in the country, which is extremely worrying.
"We must do more to provide adequate treatment and services for people addicted to drugs at local level.
"We need to treat addiction as a disease not as something that people can just stop without help.
"I know that we have some good services in the West Midlands already, but we must build on those.
"What we need is more funding to be earmarked for treatment of drug and other addictions. If we don't do this we will see a continuous rise in babies born to addicted mothers, as we have seen in the last few years."
She added: "There is much we can learn through the exchange of best practice from other EU countries.
"Poland for example has a legal obligation for the social reintegration of drug users, Belgium believes that poverty and addiction are inter-twined and Denmark requires all local authorities to provide a social action plan for all drug users.
"I am not saying that any of these are the right answer.
"But we do need to put our heads together so that not only those of us in this region can benefit. We can hopefully reach some sort of consensus by pooling expertise from across the EU to address the problem of addiction in a more successful way."
A spokesman for drug treatment agency, Addaction, said: "Drug use among parents is a big problem and it has been on the increase for some years.
"Pregnancy can be a catalyst for people to stop using drugs but, in some cases, that does not happen."
Symptoms in newborns where mothers have used hard drugs like heroin can include shivering and crippling stomach cramps.
Cocaine can cause irritability and feeding difficulties, while drugs like diazepam can lead to babies having fits.
Long-term drug use during preg-nancy can also lead to children being born at a low birth weight.
Several studies have shown that children born to mothers with a drug addiction can also lead to Sudden Infant Death.
The youngsters' development can also be badly affected, with many suffering from attention deficit hyperactivity disorder.
The statistics come after it was revealed that more and more children are being put into care because of their drug addicted mothers.
One Midland woman had all 15 of her children taken off her by social workers after she was unable to kick her habit.
MORE than 140 children were born with a drug-dependency in the Midlands last year.
Shock new Department of Health figures show that 146 junkie mums on crack cocaine and heroin passed on their addiction to their unborn babies.
And in the past six years the numbers of children born to mums addicted to some sort of drug, including tobacco and alcohol, has continued to rise.
Experts have warned drug use during pregnancy can leave children suffering crippling withdrawal symptoms and long-term health problems.
West Midland's Euro MP Liz Lynne said: "The figures for babies being born to drug dependent mothers in the West Midlands is the third highest in the country, which is extremely worrying.
"We must do more to provide adequate treatment and services for people addicted to drugs at local level.
"We need to treat addiction as a disease not as something that people can just stop without help.
"I know that we have some good services in the West Midlands already, but we must build on those.
"What we need is more funding to be earmarked for treatment of drug and other addictions. If we don't do this we will see a continuous rise in babies born to addicted mothers, as we have seen in the last few years."
She added: "There is much we can learn through the exchange of best practice from other EU countries.
"Poland for example has a legal obligation for the social reintegration of drug users, Belgium believes that poverty and addiction are inter-twined and Denmark requires all local authorities to provide a social action plan for all drug users.
"I am not saying that any of these are the right answer.
"But we do need to put our heads together so that not only those of us in this region can benefit. We can hopefully reach some sort of consensus by pooling expertise from across the EU to address the problem of addiction in a more successful way."
A spokesman for drug treatment agency, Addaction, said: "Drug use among parents is a big problem and it has been on the increase for some years.
"Pregnancy can be a catalyst for people to stop using drugs but, in some cases, that does not happen."
Symptoms in newborns where mothers have used hard drugs like heroin can include shivering and crippling stomach cramps.
Cocaine can cause irritability and feeding difficulties, while drugs like diazepam can lead to babies having fits.
Long-term drug use during preg-nancy can also lead to children being born at a low birth weight.
Several studies have shown that children born to mothers with a drug addiction can also lead to Sudden Infant Death.
The youngsters' development can also be badly affected, with many suffering from attention deficit hyperactivity disorder.
The statistics come after it was revealed that more and more children are being put into care because of their drug addicted mothers.
One Midland woman had all 15 of her children taken off her by social workers after she was unable to kick her habit.
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