Drug Use During Pregnancy
Pregnant women, who want to deliver a healthy baby, need to avoid using most drugs while they are pregnant. Drugs have a direct impact on the fetus, whether they are illegal or over-the-counter pain or cold medication. Tobacco, alcohol, caffeine, cocaine, crystal meth and other legal and illegal drugs may not have much effect on the mother, but they can have a lasting effect on the baby.
How Does Crack Cocaine Reach the Fetus?
When the pregnant mother takes crack cocaine, it passes through the placenta and enters the baby’s circulation. It takes much more time for fetuses to eliminate the cocaine from their bodies than it does for the mother. This means it stays in the baby’s body much longer. It may directly affect the developing neural system in the fetal brain. It can have an adverse effect on the monoaminergic system development. This system plays an important role in the production and secretion of the chemical that maintains neuron integrity and gives them nutritional support. It can also indirectly affect the vascular constriction and subsequently decrease placental blood flow causing inadequate oxygenation of the blood.
What Are the Effects to an Unborn Baby?
Crack cocaine has been associated with ‘crack babies’ in the past. These are children born to mothers who used crack cocaine while they were pregnant, and the children were considered hopeless for good cognitive and life skills because of irreversible brain damage. While some researchers felt that these findings were exaggerated because in later findings these children appeared normal, today, it is considered by the National Institute on Drug Abuse that exposure to cocaine while in the womb can cause subtle deficits that are significant later in life such as cognitive performance, attention to tasks and information-processing.
The Organization of Teratology Information Services (OTIS) states that cocaine exposure during the first few months of pregnancy can increase the risk of miscarriage and cause placental abruption later. This can lead to severe bleeding, early birth and possible fetal death.
According to the American Congress of Obstetricians and Gynecology (ACOG), babies of mothers who used crack cocaine during pregnancy for prolonged periods of time also have a higher risk of birth defects including:
- A smaller than normal head
- Reduced growth potential
- Genital, kidney, and brain defects
Withdrawal symptoms have also been seen such as sleeplessness, feeding difficulties, muscle spasms and tremors.
For the person using crack, it can cause:
- Respiratory failure
- Heart attacks
These health issues are life-threatening and can be passed to the unborn baby. Another issue for the newborn is brain structure changes that affect their performance in school and social behavior in life and may persist into their early teenage years. For the user, the effects of cocaine may be immediate, the effects on the unborn baby may last their whole life.
Treatment for Pregnant Women
Inpatient treatment is considered the best way for a pregnant woman to get treatment for crack cocaine addiction. In many cases, pregnant women are caring for their other children. They may also need to be removed from an environment that supports drug addiction. Inpatient treatment can provide better care and offer:
- A welcoming setting that includes place for the patient’s children.
- Childcare options for patient’s children.
These treatments address a withdrawal period when the woman may experience depression, lethargy and anxiety for about a week. In a rare few cases, paranoid psychosis during withdrawal is seen if the woman took frequent, high doses of crack cocaine.
Medication is not usually used during withdrawal from crack cocaine in pregnant women because there is little or no data on the effect these drugs may have on the fetus. In some cases, antidepressants are prescribed for the first five days to reduce the depression that often causes a high dropout rate during this period. If a woman needs prolonged use of antidepressants or sedatives, there may be other psychological issues that are not related to crack cocaine addiction.
Inpatient treatment can also provide regular cognitive behavior therapy (CBT) that can help address the reasons the patient originally became addicted to drugs. It uses several goal-oriented systematic procedures to address dysfunctional emotions, cognitive processes and maladaptive behaviors. The therapist will try to help the patient find strategies to address these problems.