Opioid Dependent Mothers

The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).

Opioid abuse in America is a current health issue, like any other, where we view the problem from an analytical standpoint. While the numbers are devastating my main motivation for choosing this study comes from an emotionally driven place. Personally, I’ve known people who have been sucked into the addictive effects of opioids and, for years, it has affected an entire family’s, that I am close to, life from one person’s abuse of opioids. An example that many don’t think of when they imagine opioid abuse is how a simple mother could go from being an ordinary housewife to an opioid abuser, where her children are too scared to bring friend’s back home due to their mother’s state, and how she’s devolved into a person who steals from her

Hogan, D. M. (2007). The impact of opiate dependence on parenting processes: Contextual, physiological and psychological factors. Addiction Research & Theory, 15(6), 617-635. doi:10.1080/16066350701663698

Through the years, substance misuse in the United States has turned into an industrious issue influencing numerous people. In 2008, it was assessed that 17.8 million Americans beyond 18 years old where substance subordinate. Women who use medications during pregnancy can have an enduring impact on fetal. Medications can have an impact of maternal and child wellbeing, yet there are a lot of different variables, which influence it, poor social environment, nourishment, cleanliness, and sexual abuse. Regenerative interruption connected with heroin utilization has been shown in both and women and even low dosages of opiates can impede ordinary ovarian capacity and ovulation. The harm that goes hand in hand with substance utilization comes either straightforwardly from the impact of the medication itself or from issues identified with development and/or unexpected labor. The entanglements of jumbling components clamorous way of life, poor nourishment, liquor utilization and cigarette smoking influence the appraisal of the impacts of cocaine in pregnancy. In obstetric practice, 100% of pregnant women utilizing cocaine or heroin are cigarette smokers. Cigarette smoking is presumably the most well known manifestation of substance utilizes and is noteworthy corresponding considering ladies who use unlawful medications. Babies whose moms smoked in pregnancy have a tendency to have lower conception weights and diminished length, cranial and thoracic

The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.

Growing up in the household under substances influence can cause severe damage to the child. Parental substance abuse has a significant impact on family function, and it may also contribute to child maltreatment. It heightens the risks to both of the physical and emotional safety of the children, and it generates children’s problematic outcomes. Children who grow up in such families may also experience mental health issues, social isolation, financial difficulties, and exposure to stressful life events and so on.

    The opioid and heroin addiction is affecting the upcoming generation drastically. There are babies being born with an addiction to alcohol, opiates, heroin, alcohol, or multiple different things. These drug addictions at a young age take a toll on the children 's bodies, they shake violently and cry uncontrollably. 1 in 10 children born in a hospital are addicted to one of the above mentioned drugs. The babies aren 't the only youth affected, there are also teens/young adults that who are addicted to these drugs. This

“Every 25 minutes, 1 baby is born suffering from opiate withdrawal. Newborns with neonatal abstinence syndrome (NAS) are more likely than other babies to also have low birth weight and respiratory complications” (Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome, 2015, Paragraph 2). To insure a better life for these babies, people are trying to create an Act called the Plan of Safe Care Improvement or otherwise known as the Infant Plan of Safe Care Improvement. This Act is meant to protect future babies from not only being born drug dependent because of their mothers, but also ensuring them a drug-free environment after birth. It will also “get help for the mothers and any other guardians involved in drug addiction”

The problem was discovered by Ashley Kilpatrick, NNP, Project Manager of this process improvement initiative. Ashley saw the opportunity to improve patient care by standardizing the care of the infants by decreasing the variation in care. I was made aware of the problem in weekly discharge rounds that occur every Tuesday in RNICU/CCN with the nurse managers, assistant nurse managers, social services, utilization management, UAB Police and the discharge coordinator to talk about any financial or social barriers to discharge. During discharge rounds, we discussed infants whose mother was addicted to drugs, whether prescription, illegal, or opioid substitutions. We also discuss whether the infants are having withdrawals and receiving Methadone. There would always be questions about weaning the Methadone, what day of weaning were the infants on so they could be discharged. There would be questions whether we were monitoring 3 -5-7 days off Methadone to send the infant home. This could ultimately be a safety and quality issue for the organization.

According to Lowe (2017), “…across the United States, a woman presents every 3 minutes to an emergency department for opioid misuse or abuse” (p.657). With the significant increase in the misuse of opioids over the last thirty years in the US, it has become a serious public health concern. With the most dramatic rise in opioid use being of childbearing age women, it is a very important issue in maternal health care (Keough & Fantasia, 2017). It is imperative that nurses are informed and have efficient knowledge of the potential risks, effects, treatment, and prevention of opioid dependence during pregnancy.

Although all sorts of families can be devastated by addiction, but single parent units (the most common lower class structure) are the most obscured. Behavioral Health of the Palm Beaches supports, “In every family unit, each person plays a role (or multiple roles) to help the family function better and to maintain a level of homeostasis, stability and balance. When substance abuse is added to this dynamic, the family roles naturally shift to adjust to the new behaviors associated with drug or alcohol use, and to continue maintaining order and balance.”4 In single parent units there is an inability of a second parent to fill the void role of the addicted parent. The National Center for Biotechnology Information states, “Frequently, children may act as surrogate spouses for the parent who abuses substances. For example, [young] children may develop elaborate systems of denial to protect themselves against that reality of the parent’s addiction. Because that option does not exist in a single‐parent household with a parent who abuses substances, children are likely to behave in a manner that is not age‐appropriate to compensate for the parental deficiency.”2 So a child growing up in a compromised family unit where addiction is present may develop altered norms and mature into an addict themselves.4

Opioid addiction rates are on rate s are on the rise and is creating a new sort of problems for children because when addicted parents are addicted, locked up, or going away for treatment. What happens to their children? This brings a whole new light to grandparents responsibilities and roles in a family. When children haven’t been formally removed from a home the grandparent who gets the call is left with two options come retrieve the child or they will go into foster care. Grandparents are faced with a difficult task, raising their grandchildren while their children are in jail, being treated, or dead from overdose. Grandparents are called upon to take care of their grandchildren with little resources, support, or warning. When the grandparent decides to take in their grandchild they become a different kind of caregiver neither parent nor grandparent it’s called kinship care. Formal kinship care provides legal guardianship, monetary government assistance, court appearances, visits from child protective services, or mandated caregiver training. That can be disrupting to a child and

Does anyone you know and or love currently struggle with opioid addiction? Have you witnessed the loss of a life due to opioid addiction? Opioid addiction is a major issue we are all facing the United States either directly or indirectly. The opioid epidemic has continued to grow yearly, and shows no real solutions in the trend of it slowing down or it coming to an end. Doctors are well aware of this information and are working to reduce the number of opioid abuse cases created at the source. There are options available to addicts including but not limited to inpatient rehabilitation programs, detoxification programs/facilities, and outpatient counseling support. These options cost a significant amount of money, unaffordable to most addicts,

(n.d.) also conducted a study focused on infants that were exposed to buprenorphine or methadone while in utero. Unlike MacMullen et al. (2014) their focus was on predicting how the symptoms of NAS might manifest in the exposed newborns. Since the 1970s (MacMullen et al., 2014) methadone has been the treatment of choice for mothers with opioid dependence during pregnancy, the use of this drug allows for a decrease in withdrawal symptoms for the child after birth. The main categories of symptoms include central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress and vague autonomic symptoms (MacMullen et al., 2014). Although methadone has been being used for many years buprenorphine has only been used since 2002 in the United States (MacMullen et al., 2014). Their research was consistent with Kaltenbach et al. (n.d.) in that infants born to buprenorphine-exposed mothers had lower scores for NAS than those born to methadone-exposed mothers, but still had varying severities of symptoms and scores across all infants. For at least 10 days after birth, an expert scored the newborns on a modified Finnegan scale every 4 hours. The results showed that high birth weight was often a predictor for high NAS scores, along with lower NAS scores for infants delivered by cesarean section. MacMullen et al. (2014) were unable to find any connection between the use of methadone and buprenorphine to indicators of symptoms of NAS. The main

Children can be subjected to the negative effects of parental substance use in a variety of different ways. For example, substance use during pregancy can cause detrimental outcomes for newborn infants by placing them at a higher risk of Sudden Infant Death Syndrome (SIDS), being born with birth defects, developing behavioral and developmental delays, being born premature, etc. Children with addicted parents, are placed at a higher risk of: lacking appropriate supervision; lacking basic needs such as: food, clothing, housing, and medical care; exposure to violence; developing substance abuse issues themselves.