A baby is born addicted to heroin, must he be off opiates for the rest of his life?

Factual Questions
1

On a TV show I watch, the main character has adopted her grandson, who was born addicted to opiates thanks to his mother’s addiction. He’s a teen now and is fine, being raised in a loving home where his guardians speak openly about these matters.

I know that best practice for a recovering addict is to avoid the addictive substance completely. But what does that mean for our teenager? If he were to suffer some calamity that required analgesics, could he be put on opiates or would he have to tough it out on OTC pain relief?

2

There are two components of opiate addiction: physical and psychological. The baby is only going to have the physical addiction and this will be gone within a couple weeks or so of birth. So there won’t be a problem for him in later life because of this. The recovering addict of course also has psychological addiction–and this is what is extremely difficult to break.

3

If the mother was a recreational opiate addict, chances are, she has passed the genes on to her child, so they need to be careful about this.

More than once, I was involved in the care of a newborn who was born physically addicted to opiates, because the mother was using them for legitimate pain during pregnancy. It was less dangerous to do this, than to take the mother off her pain meds during the pregnancy, mainly because of QOL issues.

4

Addiction doesn’t change genes. It might be that the mother had genes that made her more susceptible to addiction, but there are a lot of things that determine whether someone ends up as an addict, and I’d expect that most of them would be environmental, not genetic.

5

Yes, although genetics plays a role in susceptibility to addiction, it’s outweighed by other factors.

https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2864

Without any specific genetic profile determined to reliably present a high risk of opiate addiction, it’s extremely unlikely that docs would hesitate to prescribe opiates for severe pain, just because addiction “ran in the family”.

6

There are, however, epigenetic modifications that occur due to exposure to environmental toxins (including narcotics) that impact addictive behaviors as well as responses from chronic stress, anxiety, depression, et cetera which can be conferred to offspring. There is a complex interplay of genetics, epigenetic factors, the physical and social environment, and experience (particularly trauma) that contribute to tendencies toward additive behaviors and chemical dependency.

However, a knowledge of family history for addition to opiates would indicate a need to be attentive to addition and regulate opiate dosage. For that matter, opiates for pain management can be prescribed for someone with a prior opioid addiction with controlled monitoring and dosage (usually by a family member) along with a plan for managed withdrawal.

Stranger

7

Unless you’re living on an island, the likelihood of social drinking to excess is ever present. I would say that greatly increases the probability of using opioids even if they have different genetic susceptibilities.

I imagine a lot of kids become addicted from using opioids to help with a painful injury.

8

That opiate addiction, like, as you put it, “social drinking to excess”, is presented by the media as something that’s cool and fun, as long as you don’t eventually OD, doesn’t help matters.

People who say that they became opiate-addicted after being prescribed a dozen Percocet after their wisdom teeth were removed were probably going to become addicted to something anyway.

9

Drinking, sure, but what media has ever portrayed opiate addiction as “cool and fun”?

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12

This kind of thing is why I am convinced that the fashion industry actively hates women, if they found it necessary to “react AGAINST” (emphasis added) women looking/being healthy.

13

Let me first say that I don’t drink, nor do I use any kind of intoxicants for fun (albeit, I think pot should be legal, and alcohol should remain so).

Second, I know I am going to get a lot of flak for this, but the idea that anyone who has been addicted to something and quit must never ever touch it again is entirely theory-based. That is to say, the goal of AA and the majority of rehab clinics being abstinence was based pretty much on the fact that the founder of AA thought it was the only thing that would work for him. There was never research into the idea for decades-- which was fine as long as AA was a personal choice, but people get court-ordered to it, and to rehabs that adopt its philosophies, while insurance pays for them.

A lot of alcoholics I know who treat AA like a religion have a “No true Scotsman” attitude toward any alcoholic who quits and then later becomes a moderate or “social” drinker. “They were never REALLY an alcoholic in the first place”-- never mind that a doctor diagnosed them as one according to whatever DSM was in use at the time, prescribed rehab, and insurance paid for it.

Last, when someone finally did get around to controlled studies of the question, it appeared to be a coin-toss whether a diagnosed alcoholic could ever become a moderate drinker.

I read about the study a good 20 years ago, so I’m assuming it sparked some research since, in trying to predict who could become a moderate drinker, and who could not, but I have never looked that up.

All that said, I am not postulating recreational opiate use for anyone, no matter what their history-- I am just suggesting that prior addiction is not as delicate a state as perhaps previously thought-- and certainly not so delicate that anyone should be expected to forgo pain relief after surgery or a broken bone.

But, even then, there has been and continues to be lots of research into opiate alternatives, and I don’t mean meditating or Mozart. I personally used a continuous-delivery local anesthetic system after abdominal surgery, and it was great. I didn’t have to deal with the side effects I get from opiates (constipation, but more awfully, migraines). With that system in place, I just needed a single dose of fentanyl right after the surgery, and then Tylenol.

Anyway, to answer the OP, No.

14

We really need some kind of upvote/thumbs up