Colleen Lopez
Mrs. Lee
Writing 10 Section 07
2 October 2014
Addiction for Two
There is an estimated 208 million individuals who suffer from drug addiction worldwide.
The gender gap of male to female drug abuse is slowly, yet surely, diminishing as women are
beginning to face more substance abuse opportunities. In the United States alone, 10.6% of
women addicts, ages ranging between 15-44 years, abuse opioids (Bandstra 1). As the gender
gap diminishes, a portion of opioid addicted women, as much as 4.4% (Bandstra 1), will not face
their drug use alone, but will instead share the illicit use with their unborn babies while
pregnant; as a mother’s actions are highly capable of affecting fetal development (Domenici et
al 786). As drug addiction amongst women rises, women who are pregnant face putting their
unborn babies in immediate health danger.
Women, whom battle opioid addiction, which includes but are not limited to heroin,
morphine, antidepressants, antipsychotics, and non-medical uses of prescription opioids
(Bandstra 1, Kaltenbach et al 48) while pregnant, run the potential risk of delivering babies
predisposed to health aliments. Such health risks include neonatal infections, low birth weight,
intrauterine growth restriction (IUGR), withdrawal symptoms, overdose, metabolic, infective
repercussions and decreased heart rate (Broscauncianu et al 1, Domenici et al 786, Schmid
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1267). Drug withdrawal symptoms, otherwise known as Neonatal Abstinence Syndrome (NAS),
range anywhere from tremors, irritability, hyperactivity, hypertonia, convulsions, fits of crying,
excessive sweating and salivation, high temperature, sneezes, yawns, nasal stuffiness, vomiting,
diarrhea, and eating to suction disorders (Domenici et al 786).
Infections amongst newborns with drug addicted mothers can also lead to serious
illness and or death (Broscauncianu et al 139). Neonates in this particular scenario are
substantially exposed to the micro-organisms within the vagina during birth and or throughout
the gestation period. Such micro-organisms include rubella, herpes, syphilis, and other
potentially life-threatening contagions (Broscauncianu et al 140). As many as 88% of the 25
babies with drug addicted mothers examined faced some type of neonatal sickness (142). A
plausible explanation as to why an opioid addicted mother contracts an infection and passes
aliment to offspring could in fact be stimulated by the possibility that the woman has had little
to no health screening while pregnant. Maternal check-ups during pregnancy could be affective
in detecting possible sexual and blood transmitted diseases. Doctors would also have the ability
of keeping tabs on an expectant mother’s nutrition; all of which are factors that could
potentially harm a fetus and ultimately led to passage of infections between mother and child.
A mother’s lifestyle might also increase her risk of catching aliments which then appear in her
baby (babies) as a congenital infection. There are potentially higher risks of infections if drug
addicted mothers are involved in risky lifestyles such as prostitution, criminal activity, etc.
When addiction surpasses the mother and affects the fetus, neonates face the
possibility of being diagnosed with Neonatal Abstinence Syndrome. NAS in newborns is
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equivalent to that of drug withdrawal in adults. In one particular study, 53% of the 131
neonates with opioid dependent mothers required treatment for NAS (Kaltenbach 47).
Treatment for NAS involves injecting the baby with doses of methadone, morphine, or
buprenorphine and slowly decreasing the dosages over time until the baby has been weaned
off of addiction. Such treatment has aroused controversy, particularly the buprenorphine
treatment because since its initial use in newborn babies, the Food and Drug Administration
have yet to approve drug usage in pregnant women (Bandstra 1). Despite lack of approval by
the FDA, babies treated with buprenorphine have experienced overall better outcomes to
treatment when compared to babies who were treated with methadone. Buprenorphinetreated babies spent significantly shorter durations of time in the hospital when compared to
methadone-treated babies (10.0 days compared to 17.5 days), ( Bandstra 1). Dosages of
morphine given to babies also varied greatly depending on treatment method. The
buprenorphine treatment required 1.1 mg of morphine which was significantly less than the
methadone treatment used in newborns which required 10.4mg (Bandstra 1, Kaltenbach et al
46). The overall treatment of addiction symptoms in neonates was shorter when babies were
given buprenorphine instead of methadone. On average, buprenorphine treatment lasted 4.1
days when compared to its medicine counterpart, methadone, which required 9.9 days of
treatment (Kaltenbach 48). In conclusion, buprenorphine seems to efficiently and swiftly treat
NAS neonates when compared to methadone. Perhaps buprenorphine particularly treats opioid
addiction bettered than methadone, and vice versa; methadone might perhaps treat other drug
addictions, such as marijuana, more efficiently than buprenorphine.
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The rise of opioid addiction and use during pregnancy can potentially lead to increase
opioid dependency in neonates. As cases continue to rise, treatments such as methadone and
buprenorphine will also be utilized in order to clear opioid addiction in newborn babies.
However, little is known about the effect of both treatments and repercussion both might have
on neonates. With this in mind, I plan to investigate the following questions:

Why does buprenorphine have better results when utilized to treat NAS in
neonates when compared to methadone? Is there an agent inside the
buprenorphine that deals with opioid dependency more efficiently than
methadone?

Are there any health repercussions a neonate might face in his/her future if
treated with buprenorphine since the drug has not been approved for usage in
pregnant women?

Are children treated for NAS as an infant in any way affected their future? In
other words, do NAS treated children experience more behavioral issues or
other similar matters when compared to children who were not congenitally
opioid dependent?

Why has buprenorphine not been approved by the FDA for usage in pregnant
women? What qualifications and or testing must be completed in order for the
FDA to approve such a treatment in pregnant women?
In order to address these questions, I plan on conducting extensive research. My
research will not only be based off of online articles and or books but will also focus on
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professional accounts and input. I believe that obstetricians and even pediatricians could have
potentially vital input regarding this particular, so I have decided that seeking out such opinions
would great benefit my research and research paper.
Works Cited
Bandstra, Emmalee S. "Maternal Opioid Treatment: Human Experimental Research ( MOTHER) Study:
Maternal, Fetal And Neonatal Outcomes From Secondary Analyses." Addiction (2012): 1-4.
Academic Search Complete. Web. 10 Oct. 2014.
Broscauncianu, Doina, et al. "Drug Addiction During Pregnancy -- Risk Factor For Perinatal Infections."
Romanian Journal of Rheumatology 23.2 (2014): 139-143. Academic Search Complete. Web. 10
Oct. 2014.
Domenici, Chiara, et al. "Drug Addiction During Pregnancy: Correlations Between The Placental Health
And The Newborn's Outcome – Elaboration Of A Predictive Score." Gynecological Endocrinology
25.12 (2009): 786-792. Academic Search Complete. Web. 10 Oct. 2014.
Kaltenbach, Karol, et al. "Predicting Treatment For Neonatal Abstinence Syndrome In Infants Born To
Women Maintained On Opioid Agonist Medication." Addiction (2012): 45-52. Academic Search
Complete. Web. 10 Oct. 2014.
Schmid, Maximilian, et al. "First-Trimester Fetal Heart Rate In Mothers With Opioid Addiction."
Addiction 105.7 (2010): 1265-1268. Academic Search Complete. Web. 10 Oct. 2014.
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Reflection
I believed that my research proposal changed drastically over time. At first I was planning on
focusing on addiction but I decided going a bit more specific would have been better as my teammates
encouraged me to be more specific about my topic because addiction can be a broad topic. I tried to stir
away from the laundry list approach and I think I have done so for most of the overview of my topic.
After the class session that taught me how to incorporate my research, I found that writing the research
portion of my proposal came easily. I found writing my assessment to be quite challenging. I am not
quite sure if the assessment I wrote is adequate enough. Perhaps I need to input more into the
assessment portion. I also tried to narrow down my research question as a part of the comments I
received that maybe my research questions were too broad. I would appreciate feedback most
particularly on my research questions and the procedure I would like to take in order to conduct my
research.