Should We Adopt a Baby Exposed to Opioids?

When beginning the adoption process, one of the questions hopeful adoptive parents are asked by their adoption agency is if they are open to a baby whose birth mother has used drugs during her pregnancy. While there exist many different substances that an expectant mother might abuse, opioids are one of the most common.
 
Most of us are aware that the US is experiencing an opioid epidemic. So, what exactly are opioids? Prescription opioids include OxyContin, Vicodin, Morphine, and Methadone. Doctors prescribe these to treat pain and, in the case of Methadone, to treat opioid addiction.
 
Fentanyl is a synthetic opioid that is often made illegally, and finally, heroin which is an illegal drug. Unfortunately, many pregnant women are addicted to these opioids, both legal and illegal. The result is one baby is born every 15 minutes experiencing withdrawal symptoms called neonatal abstinence syndrome or NAS.
 

Effects of Prenatal Opioid Use

Before deciding whether you are open to a birth mother who has had opioid substance abuse, it is crucial to understand the effects the opioids have on the baby. What are the short-term and long-term effects?
 
The short-term effects of a baby born exposed to opioids will vary. The most common symptoms are:

• Tremors, convulsions, tight muscle tone, overactive reflexes, and tight muscle tone
• Sweating and fever
• Throwing up or diarrhea
• Trouble sleeping
• Congestion
• Increased and high-pitched crying
• Poor feeding or sucking, resulting in slow weight gain
• Breathing problems

These symptoms generally resolve themselves in five to 30 days. The recommended care to soothe and comfort these babies include:

• Skin-to-skin contact. Dress your baby in only a diaper and place your baby against your bare chest.
• Swaddle your baby.
• Keep your baby’s surroundings quiet with low lights.
• Gently rock your baby if she is fussy.
• Offer your baby a pacifier.

The long-term effects are a little more unclear. It wasn’t until 2017 that Health and Human Services declared the opioid crisis a public health emergency, so comprehensive studies are not available for the effects on children as they reach their teens and young adulthood.
 

Research on Prenatal Opioid Exposure

Dr. Joshua Sharfstein is a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health. He believes that “There’s no evidence of “huge, obvious differences” in children who were exposed to opioids in the womb, there is a lot of research showing that the social environment plays a critical role in determining a child’s future.”
 
He continues, “We certainly should learn the lessons of what I would call the “crack baby panic.” There were magazine covers, newspaper stories [about] what was happening to the brains of these babies. Would they be permanently scarred?”
 
“The long-term evidence is it really doesn’t look like there’s much of anything from cocaine in terms of chemical impact on the brain. The real harm is if the baby is going home into an environment that’s unsafe, there are all kinds of problems,” Dr. Sharfstein concludes.
 

The Benefits of a Loving, Safe, Supportive Home

While there is a chance that a baby born with NAS may experience some developmental delays as they grow, so far, they do not seem significant. And by school age, most of these children seem to be on track with their peers.
 
As you think about whether you should adopt a baby exposed to opioids, know that the environment these babies come home to seems to be of higher importance. Having a safe, loving, supportive home seems to make up for the tough start these babies have.
 
Even under ideal circumstances, any baby or child can experience developmental delays or other issues. No child comes with guarantees, and all children, adopted or not, will have some issue that a family needs to deal with because no one is perfect.
 
However, we love our children unconditionally, and our job as parents is to love them and help them grow and have the best chance for a successful and happy life.