Abstract
The purpose of this study is to single out the best way to address and treat the addicted children in a positive and effective manner. Approximately a 100 people including the mothers of addicted children and clinical professionals will be taking parting this project. They would be dealing with the various kinds of approaches, problems and methods they usually do. The process will show them to analyze what they other ways do in a multidimensional organized set up. Thus, the study will be making them a step closer to be objective. The data will be brought out in order to equip the world to face the regime of addiction in more practical and able manner.
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Table of content
Chapter 1
An Introduction to the treatment of addicted children 4
Chapter 2
The Existing literature on the medication of addicted children 5
Chapter 3
Methods 8
Discussion 9
Reference 10
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Chapter 1
An Introduction to the treatment of Addicted Babies.
The paper investigates deeply about the effective way of medication to the addicted children in the contemporary situations in the world. The author looks for a better understanding of the methods followed today and their efficacy. It is very much in consideration that the knowledge gathered through this study must help the professionals in the future to practically aid such children to a new life.
In 1988, it was estimated that drug addiction cost Americans at least $58.3 billion each year in health, social, lost productivity, and law enforcement costs. When costs associated with the care of infants born addicted or exposed to illicit drugs, the exacerbation of the AIDS epidemic, and other consequences are considered, the economic costs of drug abuse and addiction may have exceeded $100 billion in 1991 (Rice et al. 1991). Reports in the lay press based on anecdotal evidence resulted in a premature rush to judgment about the impact of in utero exposure to illicit drugs, particularly cocaine, upon the health, behavior, and development of children (Mayes et al. 1992). Children with a history of prenatal cocaine exposure, labeled “crack kids,” were portrayed in the media as inevitably and permanently damaged. An article in The New York Times reported that “parents and researchers say a vast majority of children exposed to significant amounts of drugs in the womb appear to have suffered brain damage which cuts into their ability to make friends, know right from wrong, control their impulses, gain insight, concentrate on tasks, and feel and return love” (Blockner 1990, p. 14). Another article stated that these babies are “like no
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others, brain damaged in ways yet unknown, oblivious to any affection” (Hopkins 1990, p. 1). The ability to structure a successful prenatal program for substance abusing women is within the domain of most community health organizations. Accomplishing this goal, however, requires coordination of many health care systems that may, under most situations, function independently of one another. It is this coordination of services, the creation of formal ties, that is the very foundation of a community-wide prenatal substance abuse program (DeLeon and Jainchill 1991; Giles et al. 1989) In light of the above described situation it is always crucial to develop a completely tied and tested method of medication to bring the addicted children back to normal life styles.
Chapter 2
The Existing literature on the medication of addicted children.
In order to achieve and maintain a drug concentration within the therapeutically effective range required, it is often necessary to administer the drug several times. In some cases, this results in a peaks-and-valleys profile of drug concentration in the blood and tissues (Zaffaroni 1991). Reports in the lay press based on anecdotal evidence resulted in a premature rush to judgment about the impact of in utero exposure to illicit drugs, particularly cocaine, upon the health, behavior, and development of children (Mayes et al. 1992). Children with a history of prenatal cocaine exposure, labeled “crack kids,” were portrayed in the media as inevitably and permanently damaged. An article in The New York Times reported that “parents and researchers say a vast majority of children exposed to significant amounts of drugs in the womb appear to have suffered brain damage which cuts into their ability to make friends, know right from wrong, control their impulses, gain insight, concentrate on tasks, and feel and return love” (Blockner
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1990, p. 14). Another article stated that these babies are “like no others, brain damaged in ways yet unknown, oblivious to any affection” (Hopkins 1990, p. 1). These statements are made in spite of the absence of any credible scientific evidence regarding the sequelae of prenatal cocaine exposure beyond the newborn period.
Transdermal delivery appears to be especially useful for administering drugs with poor oral bioavailability and short half-lives. Transdermal drug delivery systems have several components in common. The two basic types of passive transdermal delivery systems currently on the market are matrix systems and membrane-controlled systems (Chien 1987; Ledger and Nichols 1989).
It was estimated that 30,000 to 45,000 drug-affected infants were born in 1987. Premature births, low birth weights, pregnancy complications, and neurobehavioral abnormalities have been associated with in utero drug exposure. Neonatal withdrawal syndrome often occurs in neonates born to opiate-abusing mothers. Infants born to cocaine-abusing mothers do not go through withdrawal, but often show signs of neurotoxicity such as irritability. Serious complications such as seizures also occur in both cocaine- and opiate-affected infants (Dicker and Leighton 1991).
Data gathering on this subject should include a comprehensive interview with the mother, reports from drug treatment facilities and social service agencies, and more objective measures such as urine toxicology assays for drugs and their metabolites. Recognizing the limitations of urine testing, it is now known that drug exposure may be detected over a wider gestational period by assay of infant meconium samples or infant and maternal hair samples (Callahan et al. 1992; Ostrea et al. 1992).
Similar to treatment for exposure to opiates, treatment of the cocaine exposed neonate rests on an objective assessment of the impact of intrauterine drug exposure. But unlike opiate-exposed
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infants, cocaine exposed infants do not undergo a physical abstinence or withdrawal. These infants do, however, show signs of neurotoxicity such as transient irritability and tremulousness (Chasnoff et al. 1985; Doberczak et al. 1988b). Following this period of CNS irritability, cocaine-exposed infants tend to experience a period of hypo reactivity, lethargy, and poor interaction with caretakers. In addition, specific neurobehavioral testing has led to a general agreement that these infants evidence liability of state, with wide swings from hyper alertness to reduced reactivity, decreased habituation, and visual tracking difficulties (Chasnoff et al. 1989; Eisen et al. 1991; Mayes et al. 1993). Cocaine-exposed infants show a very wide spectrum of effects ranging from a lack of obvious symptoms, to neurobehavioral dysfunction (described above), to more dramatic complications such as seizures (Kramer et al. 1990) and cerebro vascular accidents (CVAs) (Chasnoff et al. 1986). These serious complications may be due either to an ischemic insult secondary to vasoconstriction or to hemorrhage from acute hypertension. EEG abnormalities have been reported in as many as 50 percent of cocaine exposed infants in one study (Doberczak et al. 1988b), In addition, echo encephalographic (ECHO) abnormalities have been reported in 35 percent of infants exposed to either cocaine or methamphetamines (Dixon and Bejar 1989). These abnormalities include ischemic injury with cavitary lesions (8 percent), intraventricular hemorrhage (12 percent), subependymal hemorrhage (11 percent), subarachnoid hemorrhage (14 percent), and ventricular dilatation (10 percent). In another study of infants with birth weights less than 1,500 grams, however, cocaine exposure did not increase the incidence of intraventricular hemorrhage or per ventricular leukomalacia compared with controls (Dusick et al. 1993).
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Chapter 3
Methods
Participants
The in depth Data collection of this study will include 50 health care professionals and 50 mothers who were ones bore the addicted children themselves. We will choose participants of deferent living conditions of bringing up the affected children and sample them with demographical interviews. We will provide the participants with a purposeful approach of a sample with little bit of work experience as we will be in need of learning more about these tow group before we will go in to detailed data collection. Regular interviews will occur every other month beginning from the first session. The professionals will be enquired about their usual approaches and will be confronted with the pros and cons of such practices.
Procedure
The participants will be participating in at least five interviews in a period of ten months which will be duration to observe some kind of a change in their subject’s situation. There will be a protocol developed for each section to cover such a broad areas like their children’s welfare, The medicines administered to the children, The time and quantity it is given and the basic change in the symptoms of addiction. In the first section itself a list of specific points to be observed will be handed over to the participants, so that they will know what to expect for the sessions to follow. All the participants’ queries about the purpose of the study will be answered at any time of the process. Our findings will provide valuable lights into the lives of millions children as well as the professionals.
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The findings will be thoroughly assessed in the light of simple and normal behavioral patterns and, at the same time, clinical support and demographic data of the varying life styles. Clearly the transition from the situation to welfare will be the tenure in which we need to observe the effect of best approaches. Thus analyzing it would be the real time study one would make with this project. Descriptive data will be collected for demographic characteristics, such as age, race ethnic background, etc and reported. Here, based on what we heard from the clients, we provide programmatic and policy recommendations to continue to serve this group and help these families in their transition to work and greater self-sufficiency.
Discussion
Clearly, the transition from welfare to normalcy is complex, compounded by the many challenges children face. How successful respondents were in this transition and in the progress they made depended partly on the extent of personal challenges they faced. The professionals or the parents who may have still been addicted would not clearly dictate these challenges always. Due to the fact that the study is a quasi-experimental design, one cannot infer causes. The largest threat to external validity or generalizability in this study comes from the small sample size. Prenatal narcotic exposure may impair specific learning functions. Autonomic system regulating mechanisms also may be impaired, but may be difficult to identify until school age. Alternatively, childrearing by addicted or recovering mothers may be more dysfunctional than that of matched mothers; over time, this may lead to the problems described above. It is also possible that both mechanisms play a role, illustrating the potential double jeopardy experienced
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by drug-exposed infants. A study of such a limited period may not bring all the needed data on this particular issue.
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References
Rice, D.P, Kelman, S, and Miller, L.S (1991). Economic costs of drug abuse. In: Cartwright, W.S., and Kaple, J.M., eds. Economic Costs, Cost- Effectiveness, Financing, and Community-Based Drug Treatment. NIDA Research Monograph No. 113. DHHS Pub. No. (ADM)91- 1823. Washington, DC: Supt. of Docs., U.S. Govt. Print. Off.
Mayes, L.C. Granger, R.H. Bornstein, M.H. and Zuckerman, B.S (1992). The problem of prenatal cocaine exposure: A rush to judgment. JAMA 267:406-408, 1992.
Blockner, S (1990). “Crack Babies.” The New York Times, August 19, p.14.
Hopkins, E (1990). Childhood’s End. Rolling Stone, October 18, p. 1.
DeLeon, G., and Jainchill, N (1991). Residential therapeutic communities for female substance abusers. Bull NY Acad Med 67:277-290.
Giles, W. Patterson, T. Sanders, R.N. Batey, R. & Thomas, D (1989). Outpatient methadone program for pregnant heroin using woman. Aust NZ J Obstet Gynaecol 29:225-229,
Zaffaroni, A(1991). Overview and evolution of therapeutic systems. Ann N Y Acad Sci 618:405-421.
Chien, Y.W (1987). Transdermal rate-controlled drug delivery: Theory and practice. Drugs Today 23:625-646,
Ledger, P.W., and Nichols, K.C (1989). Transdermal drug delivery devices. Clin Dermat 7:25-31.
Dicker, M., and Leighton, E.A (1991). Trends in diagnosed drug problems among newborns: United States, 1979-1987. Drug Alcohol Depend 28:151-165.
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Mayes, L.C.: Granger, R.H.; Frank, M.A.; Schottenfeld, R.; and Bomstein, M.H(1993). Neurobehavioral profiles of neonates exposed to cocaine prenatally. Pediatrics 91:778-783, Blockner, S (1990). “Crack Babies.” The New York Times, August 19, p.14.
Hopkins, E (1990). Childhood’s End. Rolling Stone, October 18.
Callahan, C.M.; Grant, T.M.; Phipps, P.; Clark, G.; Novack, A.H.; Streissguth, A.P.; and Raisys, V.A (1992). Measurement of gestational cocaine exposure: Sensitivity of infants’ hair, meconium, and urine. J Pediatr 120:763-768.
Ostrea, E.M.; Chavez, C.J.; and Strauss, M.E (1992). A study of factors that influence the severity of neonatal narcotic withdrawal. J Pediatr 88:642-645, 197
Chasnoff, I.J. Bussey, M.E. Savich, R. and Stack, C.M (1985). Perinatal cerebral infarction and maternal cocaine use. J Pediatr 108:456-459.
Doberczak, T.M. Shanzer, S. Cutler, R. Senie, R. Loucopoulos, J. and Kandall, S.R (1988). One-year follow-up of infants with abstinence associated seizures. Arch Neurol 45:649-653.
Dixon, S.D., and Bejar, R (1989). Echo encephalographic findings in neonates associated with maternal cocaine and methamphetamine use: Incidence and clinical correlates. J Pediatr 115:770-778.
Dusick, A.M.; Covert, R.F.; Schreiber, M.D.; Yee, G.T.; Browne, S.P. Moore, C.M.; and Tebbett, I.R (1993). Risk of intracranial hemorrhage and other adverse outcomes after cocaine exposure in a cohort of 323 very low birth weight infants. J Pediatr 122:438-445.