The Problem with "Addicted Babies"

By Elizabeth Brico 01/15/19

The "addicted baby" issue is not simply linguistic. You're not just contributing to stigma when you use this term, you're misrepresenting medical facts.

mother and newborn baby in hospital, opioid dependent, not "addicted baby"
When you make a mother feel like she is going to turn her child into a "drug addict" by taking these medicines, you scare her from seeking treatment.

"She was born addicted, but without methadone, she may never have been born at all."

That was the last sentence of my first published article with a major media outlet, Vox. The story was about giving birth to my elder daughter while on methadone. The "she" was my newborn daughter. I was terrified to "come out" as a methadone patient, something I'd hid from my family and friends even through my daughter's prolonged hospitalization and the child welfare investigation that was triggered by her neonatal abstinence syndrome (NAS), but I was also excited to be published by Vox — and rightfully so. This story would effectively launch my freelance writing and journalism career. What I didn't realize at the time was that my first big article was factually inaccurate.

It's embarrassing, now that I know better, to realize I contributed to a harmful, widespread misunderstanding of addiction as equivalent to dependency. My editor on that story and I have since agreed to a correction in the terminology — but this story garnered enough attention to end up in my then-treatment counselor's addiction newsletter and to land me a spot on the NPR podcast All Sides With Ann Fisher. Both appearances were well before that correction was made.

A story that once brought me immense pride now fills me with shame as I remember the stigmatizing mistake I made when I first wrote it, but I remind myself that it was a personal essay — my first major one — and I was simply echoing the language I'd heard over and over again everywhere, from the neonatal intensive care unit where my daughter was treated for NAS to NBC, and even former incarnations of the New York Times. What some of these outlets are finally realizing is that reporting infants as "born addicted to drugs" is, effectively, fake news.

Doctor Jana Burson, an opioid addiction treatment specialist and outspoken advocate for methadone and buprenorphine, summarizes the issue like this: "According to our definition of have to have the psychological component of craving or obsession. By definition infants are not able to experience addiction."

Have you ever seen a baby beg for more morphine from her crib, or crawl across the NICU to snatch a dose from another infant? Do you see evidence that they are ruminating over opioids, or that they even understand their discomfort is tied to opioids? Do any infants ever require methadone or buprenorphine maintenance once their physical dependency symptoms have declined, in order to manage psychological addiction and prevent harmful, compulsive drug use?

Of course, the answer to all of these questions is “No.” Infants born to mothers taking prescribed or non-prescribed opioids are sometimes born with a physical dependency on opioids. This means they will experience physical withdrawal, and may require extra comfort and possibly even titrated doses of opioids to wean them down. Their bodies will tense up, they’ll be extra cranky and have loose stools, and other symptoms of physical distress. It's a painful experience, and my heart broke watching my own daughter go through it, but the fact remains: neither my daughter nor any other infant is born with an addiction.

An infant capable of experiencing addiction would be remarkable for reasons far beyond the addiction; she would have capabilities of thought, expression, and action so far advanced beyond any infant born thus far that the government would probably snatch her up for extraterrestrial gene testing! In all seriousness, a baby who could ruminate about drugs, understand consequences, and then intentionally self-administer drugs despite those consequences would be a genius with super-strength. This baby is impossible outside of the X-Men Universe.

So why do so many media outlets, legal professionals, and even some treatment providers continue to use this incorrect language? In part, it’s probably due to the very thing that makes the language problematic: it’s highly stigmatizing. And stigmatizing, unfortunately, equals drama. Which headline grabs your attention more? "The Number of Babies Born Addicted to Drugs Skyrockets" or "Babies Born with Opioid Dependencies on the Rise." One is true, one is not, but the one that is not will probably get many more clicks. The consequences of this mischaracterization go beyond delivering incorrect information. "Any time you misstate facts or exaggerate, as many news outlets have, it increases the stigma and makes the problem worse because mothers feel more shame and they’re less likely to seek care...they'll get less prenatal care because of it," says Burson.

Sensationalizing a medical disorder to sell papers or clicks has other real world consequences. Many medications have the potential to cause dependency and for that dependency to transfer from a pregnant woman to her baby. But we don't say that babies born to moms taking anti-depressants are drug addicted, even though some of them will also experience a mild form of NAS. So why do we say it about babies born to moms who take methadone or buprenorphine, which are the gold standard of care for opioid use disorder for pregnant and non-pregnant patients?

When you make a mother feel like she is going to turn her child into a "drug addict" by taking these medicines, you scare her from seeking treatment. The problem with that, of course, is that she remains at high risk for illicit drug use, which may cause a dependency in her child but also has other complications, like a heightened risk of miscarriage or stillbirth.

Pregnant women aren’t the only ones who are harmed by the false equation of addiction with dependence. A lot of people think that people who take methadone or buprenorphine are just trading one addiction for another. In fact, methadone and buprenorphine will continue an opioid dependency, but are evidence-based treatments for opioid addiction approved by the World Health Organization and the FDA.

This misconception leaks into correctional facilities and drug courts. Most jails and prisons forcibly detox methadone and buprenorphine patients, and many drug court judges disallow their use, even going so far as to order patients to taper off their medication. The false equivalency also harms other opioid patients. Across the country, people who require opioids to manage pain are being taken off their medications as doctors scamper to avoid being labeled “pill mills” or enablers of addiction. In some cases, the pain and withdrawal are so unbearable, these patients commit suicide.

Because of this stigma, the debate about whether the press should use the term "addicted baby" has been lumped in with other language-centered debates, like whether or not the word "addict" is offensive. Personally, I think that news outlets should absolutely use person-first and medically-based language when talking about people who experience addiction. "Person with a substance use disorder" is a little clunkier than "addict," but it's worth it to relieve the sting and prejudice that’s associated with "addict." But the "addicted baby" issue is not simply linguistic. You're not just contributing to stigma when you use this term, you're misrepresenting medical facts.

It is the job of the press to disseminate the truth. Sometimes mistakes get made, like in my personal essay for Vox when I referred to my daughter as having been born addicted. That's why we have a process for submitting corrections. When news outlets use terms like "drug addicted babies" or "baby addicts," they're misrepresenting the truth, which means they’re not doing their job

If ever a "baby addict" comes into existence, there will be a far bigger story than the one about her addiction. Until we enter the age of superhumans, however, it is imperative that media outlets perform the most basic function of their job by delivering the actual facts. Babies born to mothers on methadone, buprenorphine, or other opioids may be born with a dependency on opioids. They are not born addicted.

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Elizabeth Brico is a writer from the Pacific Northwest. She got her MFA in Writing & Poetics from Naropa University, where she justified spending more time shooting dope than doing homework because William Burroughs once taught there. Now, she writes about trauma, addiction, and recovery on her blog Betty's Battleground. She's also a regular contributor to the PTSD blog on HealthyPlace, and freelances as much as she can for The Fix and Tonic/VICE. Her work has also appeared on VoxStatOzyTalk PovertyRacked, and The Establishment, among others. In her free time she can usually be found reading, writing, or watching speculative fiction. Find her portfolio and ramblings about writing on, or stalk her on Twitter: @elizabethbrico (if you're interesting, she might even stalk you back).