Substance abuse impact info

Hi All,

We are getting close to the point where we have to specify what situations we feel comfortable with and can accept. Our agency has a very specific questionnaire we have to fill out for each type of substance and for each trimester.

We are feeling really lost with this not knowing anything about how substance abuse impacts a newborn. We would love any advise on where we can look up reliable information and educate ourselves. We also asked our doctor and although he didn't know himself, he was very sweet and said he will give it some thought. 


Re: Substance abuse impact info

  • Our son was born addicted to subutex, which is the pregnancy-"safe" version of methadone.  He had to stay in the hospital for a week after birth for observation, and did have some mild withdrawal symptoms.  We were open to and knew about it ahead of time, and he has no long-term consequences.  

    I think the best stance to take if you're open-minded but not open to everything is to state just that.  We just said that we would decide on a situational basis and were open to mild to moderate exposure. 

  • In the book You Can Adopt there is a summary of the different exposures that I thought was helpful.

    As Pinkie mentioned alcohol is the worst with the most definite negative outcomes - FAS which includes a characteristic facial appearance and intellectual disability - which is most likely to occur with heavy use in the first trimester. Tobacco can lead to decreased birth weight secondary to intrauterine growth restriction. Other drugs have less obvious effects. Many are felt to be linked to some inattention and other psychiatric disturbances but it's unclear. Babies often experience withdrawal from regular opioid/heroin/methadone use that may require medication and longer hospitalization.

    Aside from illicit drug use there are also some prescription medications that can have harmful effects the fetus (depakote, lithium, warfarin being a few off the top of my head). Your best bet is that once a situation is identified that you're serious about find out everything the expectant Mom is taking and talk with a pediatrician if there's anything you're concerned about.
    Mostly things were already covered by other posters.
    We used the section of You Can Adopt to help.
    • Alcohol- Just like was mentioned- by far the worst. (lifelong effects)
    • Smoking- we were not allowed to include this in our key, but low birth rate is a risk
    • Methadone- my SW pointed out that, if they are on Methadone, they are usually under a doctor's care, which is something I hadn't considered.
    • Cocaine (crack) they will have withdraw symptoms. There was a recent publication of this 30 year study out of Philadelphia which showed that there were little to no long term effects of cocaine (and that poverty was much more powerful than drug exposure)


    "Even miracles take a little time"

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  • DH and I were in a class that talked about all types of chemical use and by far, alcohol was the worst. That being said, an EM drinking doesnt mean that it is 100% sure the child will have any issues. It also depends on at what stage of the pregnancy the alcohol was consumed - dont get me wrong, there is no safe period just as there is no same amount, but different stages of pregnancy does have different effects. 
  • Thanks for the info posted on this question. We will have our final Homestudy in the middle of Jan when we have to fill out the questionnaire stating what we are willing to accept.
  • The Infant Risk Center at Texas Tech University has a hotline you can call to inquire about specific exposures during whichever trimester, I believe!
  • We fostered a 5 year old who was born to an alcoholic mother and they were unsure what drugs she used during the pregnancy... But the mental delay was very apparent. He would ask questions repeatedly and never "got it." It may have just been him, but it was obvious that he was behind and would struggle in life.
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