DRUG DEPENDENCY, ADDICTION NOT THE SAME

The Associated Press article about an increase of babies being born addicted
to pain medications did a disservice both to good medicine and to good
journalism.

It is, indeed, a tragedy that babies are born to drug-abusing mothers. It is
also a shame that the article focused on the sensational aspects of the
story, with less regard for an accurate medical portrayal, especially in its
imprecise terms.

Nevertheless, one would hope that this article can and should be a call for
more services directed to women with drug problems during pregnancy (such as
methadone maintenance) and other forms of addiction treatment that have been
shown to be helpful to the mother in dealing with her addiction, and safe
for the developing child.

However, the article misrepresents medical facts about drug dependency and
addiction. Despite what the nurse in the article was quoted as saying,
babies cannot be "born addicted" to drugs. When a woman abuses drugs while
pregnant, it is possible for her child to become physiologically dependent
on that substance. But dependency is treatable with proper care -- and is
not the same as addiction.

At birth, babies do not have the mental capacity to develop the
psychological syndrome of using drugs despite the harm, or to develop the
uncontrolled, compulsive use of substances -- conditions that separate
addiction from physiological dependence.

The alarming portrayal of newborns as "addicts" only perpetuates myths and
fears that surround the use of illicit drugs but also can bleed out and
affect the perceptions of the use of legal drugs such as pain medications.

Such sensationalized reports can make patients afraid to take the medicine
they need (if they, too, confuse dependence for addiction), or make doctors
hesitant to prescribe a necessary treatment for fear of prosecution.

And if one were to consider the problem of moderate to severe pain during
pregnancy, most physicians certainly agree that less is more. But many also
concur that opioids for moderate to severe pain in that context are about
the safest class of medications one can use. Opioids do not cause birth
defects, and the newborn can be safely tapered off of them without
withdrawal.

The effect of the stress of chronic pain on the mother has been poorly
studied, but one can imagine that pain could play a role in making the
intrauterine environment as inhospitable as opioids might ever have.

There are other questions:

. Shouldn't the article have explored why the infants were allowed to
needlessly suffer withdrawal? Those symptoms can and should be medically
managed.

. Why did the article characterize babies as "addicted" when the source of
the information provided the number of babies "exposed" to opiates?

. Shouldn't the article have stressed that under a doctor's care, chronic
pain during pregnancy can be safely treated?

. Why wasn't the abuse of alcohol versus other drugs described and stressed?

We cannot allow such media reports to skew the proper treatment of pain.