Maternal/Child Exposure
PRENATAL EXPOSURE
Prenatal exposure to methamphetamine is a significant problem in the United
States and recent data confirms this. In 2003, of all persons admitted for methamphetamine abuse treatment, 45% were women. A study by the National Institute of Justice (1996) found that among arrestees age 21 - 35, females were more likely to test positive for meth. A study by Brecht (2004) found that female users were more likely to:
• use methamphetamine more days in a 30-day period
• smoke rather than snort or inject the drug
• be single parents who live alone with their children
• have worse medical, psychiatric, and employment profiles.
The negative consequences of intrauterine exposure have been demonstrated in numerous animal studies. These studies indicate: dose related reduction of uterine/placental perfusion, decreased fetal pO2, increased fetal blood pressure, increased rate of premature delivery and altered neonatal behavioral patterns, such as abnormal reflexes and extreme irritability.
The Infant Development, Environment And Lifestyle (2006) study, headed by Barry Lester, used meconium to verify fetal methamphetamine exposure in humans. This study found that 5.2% of women sampled used methamphetamine at some point during their pregnancy. They also found that the methamphetamine exposed neonate was 3.5 times more likely to be small for gestational age and have a lower birthweight than the unexposed group. A Thai study by Chomchai (2004) reported smaller gestational age head size. Another human study done by Forrester and Merz (2007) associates prenatal use of methamphetamine with increased risk of a variety of birth defects.
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CHILDREN
It is estimated that 9 percent of American children live with at least one adult who is a substance abuser. More than 1,100 children were injured at, killed at, or removed from methamphetamine laboratory sites from 2007 through September 2008.
The basic needs of children, including nutrition, supervision, and nurturing, often go unmet due to parental substance abuse, resulting in neglect. Maltreated children of substance abusing parents are more likely to have poorer physical, intellectual, social, and emotional outcomes. Children who have been abused or neglected are more likely to abuse substances as adults, and adults with substance use disorders are more likely to abuse or neglect their own children. A study by Brecht (2004), found that 33% of methamphetamine users had been sexually abused before the age of 15 and a similar percentage reported childhood physical abuse.
The Child Abuse Prevention and Treatment Act (CAPTA) is Federal legislation that requires the notification of Child Protective Services (CPS) if abuse or neglect are suspected. CAPTA defines child abuse as "Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse, or exploitation, or an act or failure to act which presents an imminent risk of serious harm".
As of 2003, to be eligible for Federal funding under CAPTA, States must also require the notification of Child Protective Services of “infants born and identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure.” CAPTA does not require reporting of legal substances like tobacco or alcohol exposure but it does not preclude their reporting. Health care workers must become familiar with their State laws to be compliant.
ADOLESCENT USE
Recent statistics provided by the Office of Drug Control Policy indicate that there has been a 50% reduction in methamphetamine use by teens since 2001. While this reported reduction may be an improvement for the nation it remains a devastating problem for the individual user and their families.
Families may need help to identify teenage emotional, behavioral or physical changes which are outside the norm. Signs which might indicate methamphetamine use or another serious condition could include:
Nurses familiar with local drug use patterns are well positioned to identify early signs of drug use and to direct families toward appropriate professional intervention. Nurses should remember that CAPTA applies to any child which has not attained the age of 18 years and pertains to any condition which presents an imminent serious risk of harm, sexual abuse or explotation. For more information regarding Child Abuse and Neglect Mandatory Reporting please visit the Child Welfare Information Gateway at http://www.childwelfare.gov/systemwide/laws_policies/state/
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