Study Finds That Opioids May Interfere with Parenting Instincts
The brains of opioid addicts responded less strongly to pictures of babies than those of healthy people
New research from the Perelman School of Medicine at the University of Pennsylvania shows that opioid drugs may blunt people's natural parenting instincts.
Scientists scanned the brains of 47 people, both men and women, before and after they received treatment for opioid addiction. While being scanned, the subjects participating in the study looked at images of babies while the researchers measured the response of their brains. The scans were then compared with the brain responses of 25 healthy individuals.
The study participants were unaware that the images had been altered to adjust the "baby schema," the set of facial and other features that make the human brain register infants as irresistible and kickstarts the instinct to care for them. Examples of these features include round faces, big eyes, and chubby cheeks. Sometimes the images were altered to make the babies appear even more adorable, while others reduced the chubby cheeks and big eyes to make the infants' faces less appealing. Studies have shown that a higher baby schema activates the ventral striatum, a key part of the human brain's reward pathway.
When compared with the brains of the healthy individuals, it was found that the brains of the participants addicted to opioids did not produce strong responses to the appealing images. However, when these people were given a drug known as naltrexone—which blocks the effects of opioids—their brains experienced a more normal response to the pictures.
"When the participants were given an opioid blocker, their baby schema became more similar to that of healthy people," said Dr. Daniel D. Langleben, one of the researchers. "The data also raised in question whether opioid medications may affect social cognition in general."
This study is one of the first to examine the effects of dependence on opioids and how treatment of that dependence affects social cognition. Although it was small in scope, dependence researchers say that the study provides insights into addicts' parenting behavior.
There have been a number of startling images circulating the Internet recently that show opioid addicts putting children in danger. The police in East Liverpool, Ohio, posted a photo of two parents who were passed out in the front seats of a car while their four-year-old sat in the back seat. A video showed a young mother in Lawrence, Massachusetts, who had overdosed as she lay unconscious on the floor of a store while her two-year-old cried and pulled at her arm.
Kimberly Renk is a psychologist and the director of the University of Central Florida's Understanding Young Children and Families laboratory and clinic. Renk, who was not involved in the study, said that both this study as well as other research address whether or not the pathways in the brain that are responsible for a parent's attachment to a child are the same ones that are involved when the parent uses an opioid.
"There are definitely competing interests going on," said Renk. "This finding lends credence that the neurocircuitry is overlapping when it comes to parenting and opioid dependence. That's an important piece of information."
Dr. Sharon Levy, who directs the Adolescent Substance Abuse Program at Boston Children's Hospital, described the study as a "brick in the wall of continuing efforts to understand the brain and the impacts of drug use on the brain. It makes a contribution to refine our understanding."
According to Tracey Helton Mitchell, a recovering addict and author of The Big Fix: Hope After Heroin, the drugs have an effects on the attachment that a parent feels to a child.
"Being on opioids makes you feel disconnected not only from children but all people," she said. "I just felt disconnected to them, as if the opioids had built a wall between me and them."
Helton Mitchell has been drug-free for 18 years and often gives talks on her experiences with addiction and how it can affect parenting.
"When I talk to parents, there is a certain amount of caution about opioids and parenting, but part of the reason for seeking out opioids is to provide relief to their painful connection to the world around them," she said. "Even when you factor kids in, it's hard to turn on and off the need to find a way to deal with the emotional distress."
A report issued in 2009 by the Substance Abuse and Mental Health Services Administration estimated that approximately nine million American children had resided with at least one parent addicted to or abusing alcohol or an illegal drug during the year before. Statistics provided in 2014 by the National Child Abuse and Neglect Data System indicate that 29 states had reported an average of 17.9 percent of child fatalities associated with a caregiver who was at risk of abusing drugs.
Renk and Levy both emphasize that addiction is extremely difficult to overcome and that both public empathy and help for addicted parents are needed.
"Mistreatment of drugs and other substances is probably one of the most difficult things people face," Renk said. "The addiction is just so great it drives everything else out. Most people don't understand the struggle of dealing with addiction and people lose sight that the people who have these issues are still human."
Levy notes that, although the U.S. has faced drug epidemics in the past, this is the first time that addiction has been perceived as a medical problem that can and should be treated in a medical care setting.
"Someone who is not getting high on opioids and has not lost control of behaviors is going to do a better job parenting her child," she said.