美国国家公共电台 NPR For Newborns Exposed To Opioids, Health Issues May Be The Least Of Their Problems

 

ROBERT SIEGEL, HOST:

At a Steubenville, Ohio, hospital the other week, I heard about the expense of running an obstetrics department, including this troubling fact. One newborn in 5 there is born having been exposed in the womb to opioids. That figure certainly shows how pervasive¹ opioid abuse is among young women there of childbearing age. But what does it say about the health and developmental prospects² for the babies? Well, from Dr. Joshua Sharfstein, the former health commissioner³ of Baltimore, comes this surprising answer. In terms of physical consequences, it may say a lot less than you think.

Dr. Sharfstein, who is a pediatrician and a professor at the Johns Hopkins Bloomberg School of Public Health, joins us now. Welcome to the program.

JOSHUA SHARFSTEIN: Thanks for having me.

SIEGEL: So one baby is born having been exposed in utero to heroin⁴ or Oxycontin. Another is born not having been exposed. What does that say about what lies ahead for those two babies?

SHARFSTEIN: Well, it's terrible news for the first baby, particularly if there is an addiction⁵ in the parents because when parents are addicted⁶, the home life is chaotic⁷. There's an increased risk of abuse and neglect. And all of those factors conspire⁸ against the child. It's really a very difficult start to life.

SIEGEL: But you're not talking about a baby whose nervous system or whose neural⁹ development is being greatly damaged by that exposure.

SHARFSTEIN: Right. It's not so much a chemical problem. It's a social problem. When it reflects an addiction, an out-of-control home life, that's the problem. And the reason to put it that way is when we think of solutions, the solutions are to help the parents, to help the mom, particularly, out of her addiction, to get her into effective treatment. And when you do that, then the prospects for the child really improve.

SIEGEL: What is neonatal abstinence syndrome¹⁰?

SHARFSTEIN: It's a collection of symptoms that babies can have as they're withdrawing from the opioids that they were exposed to in utero. Those symptoms can include tremors¹¹, increased muscle tone, excessive sucking, poor feeding. And what you do is you treat that with an opioid that is slowly weaned off.

SIEGEL: You've cited as precedent¹² for what you say is an alarmist, exaggerated fear of prenatal exposure to opioids the widespread concern in the 1990s about crack babies, what prenatal exposure to cocaine¹³ can do to a child. What does the latest research say about babies who were exposed prenatally to cocaine?

SHARFSTEIN: We certainly should learn the lessons of what I would call maybe the crack baby panic. There were magazine covers, newspaper stories. What was happening to the brains of these babies, and would they be permanently¹⁴ scarred? The long-term evidence of that is that it really doesn't look like there's much of anything from cocaine in terms of the chemical impact on the brain.

The real harm is if the baby is going home into an environment that's unsafe. There are all kinds of problems. And the reason this is important is, for crack babies, people sort of saw the mom as the enemy, right? The baby was viewed as separate from the mom, and the mom could get punished and all sorts of things. And when that happened, the baby wound up doing worse. A better way of thinking about it is, what can we do to help the mom? There's nothing more important for the baby than that the mom is healthy.

SIEGEL: It sounds to me that as someone in public health, having been a Baltimore health commissioner, you're concerned about a kind of shaming of the mother here, that that's the wrong way to go.

SHARFSTEIN: Absolutely. And this is the tragedy that just absolutely drove me crazy - is, you'd have a mother who maybe got methadone during pregnancy¹⁵, was actually finally starting to put the pieces of her life back together. And then when the baby comes out a little jittery¹⁶ with the symptoms, she's made to feel horrible. She's told it's 'cause she was on methadone. And then what happens is she goes, well, I'm coming off. And the next thing you know, where she was getting her life back together, she's relapsed, Social Services involved. She lose custody¹⁷ of the baby. The baby is off to a terrible start in life. That's just a terrible outcome. And we have to be able to see this issue of neonatal abstinence syndrome in a little more complexity¹⁸ to be able to prevent those bad outcomes.

SIEGEL: And that story that you just related to me - that's not a rare hypothetical from your experience in Baltimore.

SHARFSTEIN: Absolutely not. Actually, my wife is an addiction medicine doctor, so some of these people wind up her patients.

SIEGEL: Well, Dr. Sharfstein, thank you very much for talking with us today.

SHARFSTEIN: My pleasure.

SIEGEL: That's Dr. Joshua Sharfstein, who's a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health. He used to be health commissioner of Baltimore, Md.

1 pervasive   

adj.普遍的；遍布的，(到处)弥漫的；渗透性的

参考例句：

• It is the most pervasive compound on earth.它是地球上最普遍的化合物。
• The adverse health effects of car exhaust are pervasive and difficult to measure.汽车尾气对人类健康所构成的有害影响是普遍的，并且难以估算。

2 prospects   

n.希望，前途(恒为复数)

参考例句：

• There is a mood of pessimism in the company about future job prospects. 公司中有一种对工作前景悲观的情绪。
• They are less sanguine about the company's long-term prospects. 他们对公司的远景不那么乐观。

3 commissioner   

n.（政府厅、局、处等部门）专员，长官，委员

参考例句：

• The commissioner has issued a warrant for her arrest.专员发出了对她的逮捕令。
• He was tapped for police commissioner.他被任命为警务处长。

4 heroin   

n.海洛因

参考例句：

• Customs have made their biggest ever seizure of heroin.海关查获了有史以来最大的一批海洛因。
• Heroin has been smuggled out by sea.海洛因已从海上偷运出境。

5 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

6 addicted   

adj.沉溺于....的，对...上瘾的

参考例句：

• He was addicted to heroin at the age of 17.他17岁的时候对海洛因上了瘾。
• She's become addicted to love stories.她迷上了爱情小说。

7 chaotic   

adj.混沌的，一片混乱的，一团糟的

参考例句：

• Things have been getting chaotic in the office recently.最近办公室的情况越来越乱了。
• The traffic in the city was chaotic.这城市的交通糟透了。

8 conspire   

v.密谋，（事件等）巧合，共同导致

参考例句：

• They'd conspired to overthrow the government.他们曾经密谋推翻政府。
• History and geography have conspired to bring Greece to a moment of decision.历史和地理因素共同将希腊推至作出抉择的紧要关头。

9 neural   

adj.神经的，神经系统的

参考例句：

• The neural network can preferably solve the non- linear problem.利用神经网络建模可以较好地解决非线性问题。
• The information transmission in neural system depends on neurotransmitters.信息传递的神经途径有赖于神经递质。

10 syndrome   

n.综合病症；并存特性

参考例句：

• The Institute says that an unidentified virus is to blame for the syndrome. 该研究所表示,引起这种综合症的是一种尚未确认的病毒。
• Results indicated that 11 fetuses had Down syndrome. 结果表明有11个胎儿患有唐氏综合征。

11 tremors   

震颤( tremor的名词复数 )； 战栗； 震颤声； 大地的轻微震动

参考例句：

• The story was so terrible that It'sent tremors down my spine. 这故事太可怕，它使我不寒而栗。
• The story was so terrible that it sent tremors down my spine. 这故事太可怕，它使我不寒而栗。

12 precedent   

n.先例，前例；惯例；adj.在前的，在先的

参考例句：

• Is there a precedent for what you want me to do?你要我做的事有前例可援吗？
• This is a wonderful achievement without precedent in Chinese history.这是中国历史上亘古未有的奇绩。

13 cocaine   

n.可卡因，古柯碱（用作局部麻醉剂）

参考例句：

• That young man is a cocaine addict.那个年轻人吸食可卡因成瘾。
• Don't have cocaine abusively.不可滥服古柯碱。

14 permanently   

adv.永恒地，永久地，固定不变地

参考例句：

• The accident left him permanently scarred.那次事故给他留下了永久的伤疤。
• The ship is now permanently moored on the Thames in London.该船现在永久地停泊在伦敦泰晤士河边。

15 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

16 jittery   

adj. 神经过敏的, 战战兢兢的

参考例句：

• However, nothing happened though he continued to feel jittery. 可是，自从拉上这辆车，并没有出什么错儿，虽然他心中嘀嘀咕咕的不安。 来自汉英文学 - 骆驼祥子
• The thirty-six Enterprise divebombers were being squandered in a jittery shot from the hip. 这三十六架“企业号”上的俯冲轰炸机正被孤注一掷。

17 custody   

n.监护，照看，羁押，拘留

参考例句：

• He spent a week in custody on remand awaiting sentence.等候判决期间他被还押候审一个星期。
• He was taken into custody immediately after the robbery.抢劫案发生后，他立即被押了起来。

18 complexity   

n.复杂(性)，复杂的事物

参考例句：

• Only now did he understand the full complexity of the problem.直到现在他才明白这一问题的全部复杂性。
• The complexity of the road map puzzled me.错综复杂的公路图把我搞糊涂了。