RE: Overdoses in pregnancy as risk factor

["J. Randall Webber" <rwebber@xxxxxxxxxxxx>]

Heroin addicts are at high risk of neglecting their children when they are
high, and at risk of abusing them when in withdrawal.  However, the use of
heroin by the pregnant woman you refer to could actually be seen as a way of
protecting the fetus.  Withdrawal from opiates is not recommended during
pregnancy, because of the possibility of abruptio placentae or miscarriage
resulting in fetal death.  This is as a result of central nervous system
hyperstimulation (heroin is a depressant, and withdrawal from that drug is
the opposite.)  Women who are addicted to heroin or other opiates are
generally switched to methadone until the child is born in order to avoid
these outcomes.  When the baby is born, s/he (the baby) is withdrawn from
the methadone, generally without much risk. The real problem is getting into
a methadone program.  In many areas, there is a waiting list, even for
pregnant addicts.  Given these facts, what choice does a pregnant opiate
addict have when she goes into withdrawal?

-Randy Webber

J. Randall (Randy) Webber, M.P.H. rwebber@chestnut.org
Director of Training and Publications
Chestnut Health Systems
Lighthouse Institute
720 W. Chestnut Street
Bloomington, IL  61701
(309) 829-1058 Ext 3411
<http://www.chestnut.org/li/>

"All people are equal, it is not birth, it is virtue alone that makes
the difference. "
- Voltaire



-----Original Message-----
From: owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu
[mailto:owner-CHILD-MALTREATMENT-RESEARCH-L@cornell.edu]On Behalf Of
Peter Dale
Sent: Tuesday, May 01, 2001 1:51 PM
To: Child Maltreatment Researchers
Subject: Overdoses in pregnancy as risk factor


Colleagues,

I'm involved in a fatal case review where it appears that a baby of a few
weeks old may have been fatally poisoned by parents with heroin (the
forensics of this have yet to be tested in the criminal trial).

However, a view has been expressed that an overdose in pregnancy by a
substance abusing woman should be seen as a high indicator of risk of later
maltreatment to the child once born.

Does anyone know of any research that substantiates this view?

TIA


Dr Peter Dale
work: mailto:pdale@nspcc.org.uk
home: mailto:pdale@kiama.freeserve.co.uk