Medicine: Born Addicts

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Though U.S. narcotics addiction is rising, physicians are still often unprepared for one poignant aspect: the newborn babies of addicted women. If the mother's dosage has been recent, her baby suffers drastic toxic effects, and often dies. The infant's symptoms resemble those of agonized adult withdrawal: convulsions, no appetite, bluish pallor, heavy sweating, endless, high-pitched crying. Since a pregnant woman addict may look quite normal—and rarely reveals her habit—the doctor is likely at first to suspect other ailments with similar symptoms, e.g., calcium deficiency. Proper treatment may be too late to prevent fatal respiratory failure.

The problem is growing, says Manhattan Pediatrician Herman Schneck in the Journal of Pediatrics. But if physicians train themselves to look for the phenomenon and make an early diagnosis, the addict's child can be weaned away in time. Reason: the baby's "addiction" is physiological, not psychic, can be cured by sedative drugs. To prevent emotional ties that could make the "addiction" psychic, the first move is to take the child from its mother. Best treatment is administering opiates or tranquilizers (Thorazine and reserpine seem most effective) in gradually diminishing amounts over a period of days or weeks. This cuts the mortality rate to as little as 25% from up to 93% reported for untreated babies.

Pediatrician Schneck is less sure of what happens long after recovery. No study has been made, for example, of whether infant addicts suffer organic brain damage in their first weeks. Most are placed for adoption, and Dr. Schneck questions whether they are a good risk: "Could the mother's emotional instability which led her to resort to narcotics, foreshadow the neuro-hereditary pattern of her offspring? Or is the infants' ultimate emotional development primarily one of environment?" The problem's social and genetic aspects, concludes Dr. Schneck, need a lot more study.