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Prenatal Substance Exposure

REALLY hard decision (pre-natal substance)

Hi, everyone -

My husband and I are desperately (and scared…) looking for any guidance on prenatally exposed newborns - - most especially *LONG TERM EFFECTS* (the peer-reviewed literature out there on long term for anything other than FASD is sparse and not conclusive).

We’ve been offered a likely placement from a self-identified depressed, anxiety-disorder, bi-polar first mom who has been a consistently crack, heroin, and methadone user.  We are really blessed with great insurance; the next 6-8 months completely off of work (we’re professors with the summer and fall off) so 24 hour NICU stays are no problem; and a facility with doing homework, advocating, and an open mind about mental illnessses (we drew the line at szchizophrenia b/c we didn’t think we’d be able to handle putting our child in full time residential care at 12, etc.). So we have a lot going for us and think we’re “equipped on paper” to handle a tough situation. But we’ve never been parents, we’re desperate to be parents, and we’re really scared, too. 

We are terrified of *long term* issues, not first-year-of-life issues (significant cognitive, especially - brain damage, mental retardation). We feel completely horrible caring about these issues, and with a biological birth that came from both of us, we also wouldn’t know (although we might have some warning…), but we just don’t know what we can handle…

Any moms or dads out there have any thoughts to share? Thanks so much.
Thanks from the bottom of my heart for your time and any wisdom you can share. Kindest,


We went through this with our son who is now 10. Would be glad to discuss with you. Karen at [**phone number deleted by an admin for privacy reasons; if original poster or others would like to contact this generous poster, please send her a private message]

Posted by Karen Warren on Jun 07, 2017 at 6:31pm

I have several documents on this but I don’t know how to get them to you on this forum.  There are facebook groups, Children Exposed to Drugs and raising drug exposed children.

Posted by starspangled on Jun 07, 2017 at 7:31pm

Thanks, Karen. You’re such a generous person to offer your phone number. I’m going to call (bother) you now. If I don’t reach you, please know we’re deeply grateful for your offer of any guidance. I love the adoptive parents community so much….

Thanks, Starspangled.  The most/substantive piece we’ve found is a 2013 piece from the journal _Pedicatrics_, a peer-reviewed source from the American Academy of Pediatrics.  It’s the 24-hour-care for the rest of the child’s life and adulthood that really scares us.  Would it be okay to send me a direct email message? My email is isabella underscore 2372 at yahoo dot come.  Your offer is as kind as it is appreciated. God bless you!

Posted by WhiteLakeMom on Jun 07, 2017 at 10:05pm

I would be concerned if there was alcohol use when drugs were not available. Many bipolar people self medicate with drugs and alcohol.

After birth they can probably tell you how baby is doing but cognitive issues? you can adopt or give birth to a child with no prenatal abuse and still have those.

Can you talk to a geneticist?

I don’t think there are studies with direct links. Some kids do fine with that beginning others not so well.

Posted by Regina on Jun 08, 2017 at 1:37am

not a whole lot of studies out there on long term effects, but generally with most substances there doesn’t seem to be a whole lot of long term effects (alcohol is the exception to this). some studies show increased risk of things like adhd and minor learning disorders, but it’s hard to tell how much of that might simply be hereditary. a child might be born with severe birth defects,including head/brain malformations,  but if emom is getting prenatal care then you should know about these before delivery. long term severe brain damage or cognitive delays that you wouldn’t know about at the time of birth are highly unliklely. you should also know that bipolar disorder occurs on a spectrum; on the mild end the individual can function normally on minimal medication, but on the severe end, it can be almost identical to schizophrenia with symptoms such as paranoia and hallucinations; i have a friend whose son is bipolar, and he was first hospitalized for it at age 8! on the other hand,  as you know, it can be a lengthy process to be matched; if you restrict yourself to matches that have no history of substance abuse or mental illness, you are really setting yourself up for a long wait.

Posted by rn4kidz on Jun 08, 2017 at 3:32am

Thanks so much Regina and m4kidz.  All is valuable information. The information you and everyone else has shared is greatly appreciated.  It’s 5am where I am and we still have 3 hours to decide (first mom is due any day, so we don’t have a lot of time).  Will continue to pray and try and “listen” for the right answer for this baby, my husband and I, and this expectant mom (but especially this baby). So hard.

Posted by WhiteLakeMom on Jun 08, 2017 at 9:15am

My daughter is 7 and was born addicted to benzodiazepines, and heroin.

I am actually the person who requested/started this group because I couldn’t find information about what to expect with my daughter.

She was in the hospital for 3 months to be weaned off the drugs. From day one she was always more calm when being held and to this day she likes to sit on my lap or be close to me.

she had some pretty severe delays the first few years of her life.  We got infant and toddlers program involved at 4 months… so she had Physical Therapy and occupational therapy and we worked on all the things they asked us to between sessions for 3 years… by the time they had to discharge her or transfer her to another program at age 3 she was “caught up”

She is finishing 1st grade and is on target.  She was falling behind earlier this year but we worked with her and made up some ground. She was officially diagnosed with ADHD about 3 months ago.We started her on medication and her teacher noticed immediately that she was able to stay in her chair…..

She also has high anxiety (which tends to come with ADHD) and sensory issues… if she doesn’t like the way something fits she won’t wear it. (also goes along with ADHD.)

There are times that are extraordinarily challenging but I wouldn’t change it or my decision to adopt her.

Follow your heart. Happy to answer any other questions.

Posted by JJ's Mommy on Jun 08, 2017 at 10:41am

Frankly, I think that you may be biting off more than you can chew.  I like the fact that you have attempted to understand the issues by doing research, but there is a big difference between understanding issues theoretically and dealing with a child with a lot of unknowns on a day to day basis.

First off, both drugs and alcohol damage the developing brain.  How much damage is done varies widely, however, depending on factors such as at what stage(s) of pregnancy the birthmother used the substances, how much she used, what substance or substances were used, and how resilient the child is.  Many children wind up with very small, almost unnoticeable effects, but some children are more seriously harmed, and predicting the outcome for any given child is not really possible.  There are children born addicted who go on to do well in all respects; there are others who have lifelong challenges. 

I would be much more willing to adopt a child who was drug-exposed than one who was alcohol-exposed.  Nonetheless, when you say that the expectant mother “consistently” used a variety of drugs, I’d be more worried than in the case of one who used occasionally or used only one drug.  And, as someone on this list mentioned, many expectant mothers who use drugs also self-medicate with alcohol, and may not report that use.  I’ve watched an internationally adopted school aged child with FASD-caused extreme impulsivity take off and run towards a busy street, with a bunch of adults rushing after her to try to divert her, and it scared the heck out of me.  This was a girl who might constantly put herself or others in danger, and who could either wind up in an institution or in constant trouble with law enforcement for such behaviors as stealing, assaulting people, behaving indecently in public, abusing drugs, and so on.

As to bipolar disorder, it often runs in families, but on the positive side, many people with it are intellectually above average.  On the other hand, some will never achieve their full potential because their mood swings limit their effectiveness in the workplace.and in social interactions.  I worked for a bipolar man, at one point.  He was absolutely brilliant, but I saw him totally turn off some important executives with whom he was meeting to discuss getting funds for a demonstration project.  A colleague and I also once were on the receiving end of a terrible, and totally unjustified, tongue-lashing from him, caused by his bipolar issues.  This man took his medicine as prescribed and was well informed about his disorder, but his wife must really have loved him to have put up with not only his moods, but also behaviors such as frequent infidelities; during the manic phases of bipolar disorder, some people tend to act out sexually.  Again, some people with bipolar disorder can function very well, some can have a certain degree of success but struggle with the effects of their disorder on their workplace and social interactions, and some may be seriously affected, to the point where they cannot function well, may turn to drugs or alcohol to self-medicate during periods of depression, and so on.

The questions you must ask yourself go beyond whether your child will ever be able to live on his/her own.  Because of your own educational levels, can you accept the fact that your child may never be able to reason quantitatively—a problem often associated with alcohol abuse—and thus, may not be able to graduate from high school, let alone from college?  Can you accept the fact that your child may behave badly or even have trouble with the law, and that your neighbors and friends may think that you are bad parents, rather than parents of a child with behaviors that he/she cannot control because of his/her disorders?  Do you have a strong family or social support network, as you may need an occasional shoulder to cry on, a person to laugh with you when things get totally bizarre, and a person to help out at times—for example, when you can’t take your child to the supermarket because of his/her behaviors.  Can you accept the fact that you may not be able to retire on schedule, and that your child may need either to live with you or to receive financial help from you, even after he/she reaches adulthood?  Can you accept being a “good enough” parent, instead of a perfect parent, because some children will make it difficult for their parents to be the kind of parents they’d like to be.

Think about your schedule during the times of year when you work.  If your drug-exposed child has anxieties that sometime make it hard for him/her to take less than two hours to get ready to go to school, can you take some extra time to help him/her, or are you rushing to get out of the house?  If your drug-exposed child can’t sit still long enough to do his/her homework, or can’t organize his/her thoughts into written paragraphs, can you avoid getting frustrated?  If your bipolar child becomes rather manic at school, can you “drop everything” when the principal asks you to pick him/her up?  If your bipolar teen is depressed and tries to kill himself/herself, can you take the time to spend with him/her at the hospital, going to family therapy and such?  Is your marriage strong enough to withstand the challenges of a child who seems to tax your patience every five minutes?

Adoptive parents often live by the mantra, “Hope for the best, but prepare for the worse.”  Can you accept that mantra as your own?  There are a lot of unknowns in any adoption, but especially in the case of the child matched with you.  You simply won’t know for certain what to expect.  Your child could turn out to be not much different from any other child—or could have a myriad of challenges.  And your child may seem fine soon after birth, but could be diagnosed with significant issues soon after he/she starts school or when he/she becomes a teen.  One thing I know is that many highly educated adults seek certainty—but certainty is the one thing that they won’t have when they adopt a child who is drug-exposed, possibly alcohol-exposed, and bipolar.


Posted by sak9645 on Jun 08, 2017 at 3:54pm

What did you end up deciding? I can imagine it was a tough decision.

Posted by momma21 on Jun 09, 2017 at 12:43am

Hi Bailey,

I’ve been thinking of you and apologize I haven’t posted yet. I agree to hope for the best and prepare for the worst, but I also don’t think we should catastrophize everything. As others have stated mental issues and behavioral problems can happen regardless of the child’s background, and some exposed children have little-to-no long-term effects. Not every child born from a parent with mental health disorders will have them, and some people will have them with no family history. With any adoption, no matter what the birth mother tells you, you really don’t know 100% what the mother did during their pregnancy.

I know you’re short on time, I think what is most important for you to consider is whether or not you have or could have access to the necessary resources should you need them. I think it’s a bit harsh for someone to say you are biting off more than you can chew solely for seeking input and support from others. At this moment in time, it may be true that you can’t take time off for said hypothetical child in the instance of a suicide attempt etc. However, I do feel, that if that was your reality, you do what you have to do. Your employer would do the same and no one can expect any parent not to do what necessary for their child in that situation. I also think as a parent pursuing adoption, being a parent obviously means a great deal to you and it’s not likely that you would give up a biological child should they have any of those issues. Is it hard? Yes. Stressful on personal and professional relationships? Absolutely. Does that mean you should not adopt the child? No, not unless you feel you shouldn’t deep down in your gut.

Adopting is scary (parenting in general is scary), there are so many unknowns. But if you are willing to do whatever necessary for your child, unless you have another reason not to, I say go for it. There are never any guarantees.

There are most certainly families that struggle and children with issues. The key is not to be afraid to reach out for any and all resources, know what to look for, and be an advocate for your child and family.

My husband’s mother is a recoverd alcoholic and drug addict. She drank throughout her entire pregnancy and did a plethora of hard drugs, including during labor. He was very, very ill at birth, was in the NICU, pre-term, low birthweight, they weren’t sure if he would make it. He’s extremely intelligent, has a masters degree, and aside from some stupid teenage behavior, has had no issues. His mother suffers from severe anxiety, depression, agoraphobia and more. He has no signs (and he’s 37) of any of these things.

Additionally, our daughter, whom was placed with us 2 years ago today, had a similar start to life. She was born addicted to methamphetamines and with amphetamines, THC and alcohol in her system. She was in the NICU for a month going through withdrawals. Thankfully she was never with her birth mother as she was taken into protective custody at birth and was released from the NICU to an amazing foster family. I truly believe her environment in her first months did have a positive effect on her. When we were preparing to adopt her, we were told she would be severely delayed developmentally and showed cognitive delays as well. She was several months behind in speech and was receiving OT for sensory processing and other basic skills. We brought her home at 15 months, in less than a year, not only did she catch up, she was ahead in all areas, significantly in fact, in many. She has no delays and is straight up brilliant. I understand she’s only 3 and there is a possibility for other issues to arise later for her, but we have educated ourselves, know what to look for, and are prepared to take advantage of any resources we need to. But all of the early things they told us would be struggles for her, have been non-issues. Some people tried to scare us away from taking her as a placement and we are so glad we didn’t listen. She is our everything.

This baby could be an amazing little child. Just gather as much information as you can before having to make a final decision.

I wish you luck! Please keep us posted!

Posted by thegoldings on Jun 09, 2017 at 2:32am

I asked what you ended up deciding because one thought I had is irrelevant if you have your sweet child home now.
But, I was thinking how it would be helpful for you and your husband to discuss ahead of time what you’re comfortable with. I know it sounded like you did that for the most part and I could tell you tried researching, researching, researching. It’s hard to say no when you’re presented with an actual situation and I know many people will try convincing themselves they can handle it (and honestly most probably could).
It’ll be much less stressful if you know ahead of time we are open to exposure of xyz but not open to exposure of abc. And of course you could modify that and look at each situation individually still but having a good basic idea of exactly what you’re comfortable with ahead of time could be helpful.

Also, I know you were probably looking for many positive success stories of kids with drug exposure. I’m sure there are thousands of kids who develop “typically”. But there are also kids who do end up needing extra support/services/care.

I believe you really can’t predict it, but would guess there’s a greater chance of seeing certain things later on with children exposed to certain drugs.

I also think in a lot of cases parents who find out a child has a certain diagnoses later on feel more ok with it than they would have prior to match.
Not saying you should willingly take on anything but there are many parents who still can’t imagine life without their sweet child even if things turn out different than expected.

Posted by momma21 on Jun 13, 2017 at 5:04pm

I am writing late to this thread because myself and my wife adopted two babies who were in the same situation (same or nearly same drug cocktail), with parents with mental disabilities confirmed in one daughter and only one in the other. I post this in case anyone else is thinking about adopting in this circumstance and finds this post. Heroine is a hard, hard thing to deal with. Unfortunately, one daughter was not diagnosed until six months later with heroine withdrawal. It’s possible had it been diagnosed, there could have been medicine given to her to help, but the way this child would scream - it was the most gut wrenching thing I have ever heard in my life and I have had six different babies in my house (two went home). And you couldn’t get away from it. And it was when she wasn’t sleeping, eating or drinking. A sign of withdrawal we learned was stiff limbs btw. All the doctors we took her to, said it was colic (and typically, we gave the child a bottle while at the docs to keep her calm - we should have just let her go). The worst was getting stuck in a car with her. I had to drive thirty minutes stuck in my Mustang with her while we went to look for a roomier car.

And this baby could eat. Your supposed to feed babies until they are full, but as an infant, she would eat 2-3 jars of baby food, likely as a method of coping with withdrawal (this child is the size of a 6 year old now at the age of 4).

Then and this could be unrelated, after she finally broke withdrawal, around the time she turned one, she started to have weekly seizures. It took a few years to finally get an epilepsy diagnosis. The ER always said she had febrile seizures. Finally, we were able to video a petite mal seizure so that the neurologist could help us.

The other daughter had problems with violent outbursts, probably related to her dad’s issues. We ended up being “ordered” to take her (by social services) for psychiatric help. So I would drive her on Wednesdays, as she would scream, kick the seats in the car, punch.

This one, I think we figured out. They say that sugar doesn’t trigger ADHD (it does in one child), but we realized anytime sugars spiked for these kids (one would be awful the day after holiday parties at schools, or going over to grandma and granpda’s - the other would sometime have seizures). The violent one would after coming home, get the stiff arms and legs like when her sister was going through heroin withdrawal. I did some research and found an article linking sugar spikes with withdrawal symptoms in heroin users. Heroin addicts drying out in jail the article added would do whatever they can to score sweets so they kind of stay afloat. But the crash allegedly could cause withdrawal symptoms because it affects the brain hormones.

I don’t know if the science was 100%, but when we made everyone (except grandma and grandpa who refuse to listen to us) stop giving them sugar, the violence in one subsided and the behavior in the other became a more moderate ADHD.

Fast forward to 4 and 5. One big thing what will be difficult if your child has behaviors is they may not act out around other people. People, particularly friends and family may treat you as kidding or stupid when you mention what needs to be done to take care of your special needs kids. It is cruel and lonely. It was explained to me that the children feel more comfortable with the parents they have so they don’t restrain their emotions where with others they aren’t comfortable enough to go wild. After spending the night at grandma and grandpa’s, my now non violent daughter was fine the first night (we had a treat in the evening the first night home because of a recent birthday), we had to deal with her for two weeks coming home from school, where she held everything in thing at school until she got home where she would tear loose with rage and have that withdrawal style tension I described (we found out grandma would sneak her sweets). It also didn’t help that food at school is very sugary (she’s been tested repeatedly for diabetes btw). She’s finally settled again but has these outbursts that we are still working with her on. honestly, the best thing is hugs, but it is hard to hug a child who just repeatedly struck you and screamed for two hours straight, throwing things and kicking the door, punching glass. And everyone will want to tell you how your child could benefit from medical marijuana even though you express repeatedly no interest.

But when these children are happy, they are the most wonderful,  joyful children in the world. And I’m glad we adopted them. But it has not been easy. One of the key things we tell ourselves is what kind of home could handle these two? I do not know of any. And I’m positive being passed around in the system would have destroyed them. But there is hope as they grow older in that medication may become an option. And with an opiod crisis in the US right now, new techniques for dealing with the fallout of heroine addiction will probably be developed.

Posted by cynicalcoder on Sep 23, 2017 at 1:57am

Hi, friends -

I didn’t reply before now because, well, my husband and I have a newborn at home! 

Our beautiful, now healthy, strong, so-far-on-target (if not a bit advanced, for now…) daughter was indeed born with the heavy anchor of heroin addiction and to make things even less fun, had some meconium aspiration to boot. (This in addition to the other substances during the nine months - crack, pot, cigarettes, benzos, and one month of methadone while birth mom had a brief stint in rehab - we did and do believe her when she says she never drank). Anyway, my daughter’s spirit is unmistakable. Literally, it’s unmistakable - you see it and sense it in her as soon as anyone meets her. This little girl is a warrior. 

Her NICU stay, which could have been as long as two months easily, was a very brief two weeks.  She was completely weaned off of the morphine in 12 days and was kept her there an extra two days to monitor - appropriately, she was discharged with 2 days of no drugs in her system on July 4. 

She had tubes going in and our of every orifice (and some man-made orifices) and was certainly in discomfort, but the blood curdling and heartbreaking screams of withdrawal, the violent back arching and not wanting to be touched that can accompany neonatal abstinence syndrome never manifested. THANK YOU GOD. She was from the start alert, really into being held, and a healthy eater.

After some unforeseen and horrible legal nightmares related to adoption (we were conspicuously and very painfully treated as “pretend,” not-real parents by nearly all staff at the hospital) and also after some equally painful, scary issues related birthmom’s legal troubles that were unrelated to the birth got settled, the mean-spirited and burnt out NICU staff (who I will curse until I die) had to allow us to spend the night with her in the hospital - that’s when she really took off in terms of recovery - this was about 5 days after she was born.  She was literally in my arms or my husband’s (even with tall the tubes) constantly.  We took shifts and she was never without us there and holding her. This was when her recovery really took off like gangbusters. Indeed, the prejudice and judgment of the NICU nurses, nurse practitioners, and a horrible and vindictive hospital social worker were the only extreme negatives - our daughter seemed only *mildly* uncomfortable thanks to a god-send of a neonatolgist and again, I believe our constant kangaroo care.

By the way - after the trauma of the NICU experience and we calmed down at home, we finally figured out, partially, why they treated us so badly, like we weren’t “real” parents - we really loved and love my daughter’s birth mom and sincerely don’t judge her - we did and do see her merely as a really, really sick woman with the brain-seizing disease of opiate addiction - her disease did this stuff to our daughter, not her, etc.); this absence of judgment to our daughter’s birthmom did NOT sit well with a NICU staff who visibly and consistently demonized this very sick woman who bravely decided not to terminate and to made an adoption plan. (Yes, she did things that will perhaps make my daughter’s life difficult in the future, and I hate her disease for that, but I can’t hate her and I refuse to judge her, for my daughter’s sake if for nothing else). We were in the delivery room with birthmom - going through withdrawal and delivery for 24 hours, all at the same time. MY GOD…. Anyway, we witnessed firsthand how horribly they all treated her (birthmom) and if weren’t there to advocate for her, I don’t know what would have happened.  It’s not a mystery to me why drug addicted birth moms don’t go to the hospital, I’ll say that.

Anyway, our open relationship with birth mom, our gratitude for her, our concern for her, us trying to help her get into a rehab, this all rubbed them the WRONG way. We were also (maybe b/c we’re professors?) “high maintenance parents” in that we had special requests, like donor breast milk that we’d purchased from a milk bank shipped to the NICU and the nurses had to do a little bit of extra work to handle this liquid gold that we purchased, etc. We brought i a special white noise machine that was supposed to help with neonatal abstinence syndrome, stuff like that. This one nurse practitioner was getting on us because she said “WE WERE HOLDING OUR DAUGHTER TOO MUCH?! Right? Anyway, daughter wonderful, NICU nurses and hospital social worker, evil.

Thanks to some great advice I received from someone on these boards, I got a nurse involved right away from our local “Early On” (early intervention) program; she comes to our house every 3 weeks or so and monitors things like gross and fine motor skills, weight, height, awareness, etc.  My beautiful warrior is on target or slightly ahead on all. This can change later, of course; we’re prepared for that.  We’re okay with that.  We know that no matter what the future holds, even if it’s really challenging, painful, lonely, we’ll get through it because (1) we’re extremely lucky in our class privilege (comfortably middle class with decent insurance, the time and wheherewithall to make phone calls and hustle some good support) and (2) we’re a really strong team, my husband and I.  We met later in life, a first marriage for both of us, and while it sucks that we’re older (49/51), we also at this point in our lives know what’s important, what’s not, who we are and who we aren’t, if that makes sense.

I’ll say this, too: I have been, from the start, the kind of wanna-be mom and now present-day mom who is prepared for the worst, despite hoping for the best.  I also (due to my love of homework and research) feel like forewarned is forearmed.  That’s how I deal with my own (sometimes generous doses of) anxiety - by “finding stuff out” - - especially in terms of worst case scenarios.  In my classes that I teach, I see soooo many undergraduates who are different learners, who struggle with ADHD, obvious depression and/or anxiety disorders, and also, what I suspect is addiction. Indeed, my husband and I have struggled with some of these on our own in our past.  Maybe for that reason, as well as seeing extended family members’ kids struggle with some of these, we feel like we can handle it. We also have great therapists of our own, I should mention!

Or maybe it’s that (painfully) corny thing that people say post-adoption, the thing that (while we were waiting to be matched) used to make me soooo frustrated and angry and “oh, please” myself - but it’s so frigging true: I feel like we got the baby we’re supposed to have. I don’t write this b/c her complications have been minimal so far.  Not at all - I say this /c the thought of her experiencing things like bi-polar disorder, depression, ADHD, LDs, racial conflicts (she bi-racial) inter or intrapersonally, perfectionism, any of these painful situations that could be lying in wait, the thought of her going through them with anyone other than us, it’s just unthinkable to me. I’d die for her, I’d kill for her (I would!) and no matter what’s in the future, she is exactly right. Does that make sense? I *am* extremely sleep deprived, I should mention that! But even in that, I’m able to see the gift that deep-in-your-muscles, never knew it existed like this before exhaustion brings: those moments every night at 3am when I look in to her beautiful face and she smiles at me (she smiles a lot), they make me feel like I can handle all kinds of crap that might be waiting for me! (Maybe I’ll have to re-read this in a few years, eh?!)

Posted by WhiteLakeMom on Oct 31, 2017 at 9:20pm


Posted by thegoldings on Oct 31, 2017 at 9:53pm

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