A pregnant woman who is abusing opioid drugs is abusing her baby as well. This is seen when the baby is born in a constellation of symptoms referred to as Neonatal Abstinance Syndrome (NAS). NAS is associated with high pitched screaming as the baby is in pain, elevated core body temperature, occasionally seizure activity, diarrhea as they cannot fully digest food and other symptoms. Thus, NAS is a form of child abuse whether or not the mother understands what she is doing to her baby.
Babies with NAS need to be maintained in low light and sound conditions, swaddled and held close to a caregiver. One might question whether or not these conditions are met in NICUs that are set up for normal babies. Maternal drug abuse is a form of physical abuse and the mother can be returned to jail for such abuse. It may have been started by the use of opioids to relieve pain after surgery or other cicumstances. As she takes the opioid drug to fulfill her own drives, it passes through her vascular system into the babie’s brain via the umbilical cord.to its brain to a place termed the nucleus Accumbens. The red arrow marks the approximate location of this nucleus and above it part of the anterior cingulate cortex in a sonogram. This sets up the babie’s addiction to opioids and the NAS.
NAS is relevant to this discussion as the anterior cingulate cortex has high levels of opioid receptors and has motor outputs that drive pain responses including its high pitched screaming. This region also receives snsory inputs and is the rationale for reducing such activity.
These babies need special care in the NICU that can last weeks or longer. CNSI volunteers to help these babies to be weaned from their addiction. This is usually done with another opioid (methadone) that is administered in descending doses in the baby until they are weaned of their addiction and NAS disappears. The cost of this care is high (about $52.000 vs $2,500 for normal babies).