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Column originally published Jan 26, 2010

Newborns Can Develop Withdrawal From Methadone

Question: My niece was very rebellious since her teenage years. I remember my sister had such an awful time raising her. She started using drugs when she turned 14, and quit school at grade 10. She moved out west with her boyfriend shortly afterwards and we didnʼt hear much from her for years, until a few months ago. One day, she came back home and she was pregnant. She told my sister that she wanted to turn her life around and stop using drugs. She got into a methadone treatment program. Last week, she delivered a cute little girl. However, within a few days, this baby was started on morphine. I am skeptical about this methadone treatment. I heard it is just an excuse for addicts to get free drugs from the government. Now this baby is on morphine, which is the same drug that her mother was addicted to. I worry that this baby will turn into a drug addict also.

Answer:

You have asked a very important question: would a newborn baby given morphine develop drug addiction? The short answer is NO. You are a caring aunt, and you worry about your niece as well as her newborn baby. However, there is a lot of misunderstanding about drug addiction and methadone program that you need to know.

Drug addiction is a serious problem. Research has shown that the majority of people addicted to drugs have underlying psychiatric illnesses. Once they get addicted, it is very difficult for them to stop. Because of their addiction, they often cannot carry on their responsibilities at home, at work, or even looking after themselves. In order to pay for the addiction, many have to steal, rob, or involve in prostitution.

Methadone was invented about 70 years ago by German scientists. It has properties similar to morphine and heroine, but different from them in several important ways. It is very effective in controlling pain, and it works in the body for a long time. It does not produce the euphoria that drug addicts want when they use illegal drugs.

As a result, methadone has been used for several decades around the world to help drug addicts kick their habit. When a person is addicted to morphine or heroine, they develop withdrawal symptoms when they stop using them. Methadone controls these withdrawal symptoms without causing euphoria, and help these people lead a normal life and go to work (or look after their children at home) without the craving.

Methadone treatment programs are available in every province and territory in Canada. They are supervised by physicians who have special licenses to prescribe methadone. Those on methadone are regularly monitored to make sure that they are not using illegal drugs at the same time.

Pregnant women are at special risk because illegal drugs are most certainly harmful to their unborn fetuses. Use of methadone during pregnancy can help women stop using drugs and look after themselves. They have a much greater chance of giving birth to a healthy baby.

Unfortunately, methadone does pass through the placenta to the fetus. As a result, most of these babies will develop withdrawal symptoms within two to 14 days after birth. These babies are very irritable, with high-pitch cries. They are more stiff than other babies, and their hands and feet often have tremors. They have more difficulty coordinating sucking and swallowing, and they frequently have vomiting and diarrhea. Without treatment, some can develop convulsions.

Strangely, the best medicine to help them is morphine. Most hospitals with newborn care facilities are familiar with babies who have methadone withdrawal symptoms. They often use a scoring system to determine the severity of withdrawal, and to decide when and how much morphine to use. Every baby is different, but most babies would need several weeks before they can be weaned off morphine completely.

Once a baby is off morphine, she will not crave for this medicine. Therefore, use of morphine in newborn babies with methadone withdrawal symptoms does not lead to addiction. The environment where she lives in during her childhood and adolescence would be most critical to determine whether she may one day turn to illegal drugs or not. As I have mentioned earlier, it is important to remember that most drug addicts have underlying psychiatric conditions. Therefore, it is important to monitor these children for psychiatric conditions and to seek medical assistance as early as possible.

Although you are skeptical about methadone, I would suggest that you give your niece the benefit of the doubt and give her and your sister as much support as possible. There are many drug addicts who have successfully completed the methadone program and kicked their drug habit, although this usually takes many months to years.

In the meantime, you can go to the hospital and help to take care of your grand niece. Because she is more fussy, she would need someone to cuddle and rock her. She may need her diapers changed more often because she likely has loose stool. She may also need more patience with feeding, and you can help to give her the tender loving care.