Shame on Her

Understanding the Neurobiology of Parenting and Addiction

Heroin, cocaine, methamphetamines, opioids—addictive substances that destroy lives, but that danger is even more far-reaching when the addict is pregnant or a new mother. How could anyone do this to their baby?

As the mother of an adult child once caught in the claws of addiction, I’ve spent years educating myself about this disease. I’ve learned to erase the shame and reckon with the science that says this is an illness—not a choice. In co-founding LITT, I’ve made it my mission to help parents recognize and work with the abiding love at the core of a fractured relationship with their addicted child.

But I admit to a continued struggle with the reality of a pregnant or parenting addict and this is confounding to me given my understanding of this disease. The addicted mother’s parenting experience simply doesn’t line up with my own experience of falling madly in love with my newborn and being willing to make any sacrifice necessary to protect that child.

For some answers, I’ve turned to research regarding the neurobiology of parenting and

addiction. While extensive research has been done regarding the behavioral correlates of

parenting and addiction, more recent research is underway to understand the neurobiological aspects of parenting and the neural disruption that takes place in those with a chemical substance abuse disorder.

First, it’s important to understand that prolonged drug abuse damages the brain in such

a way that the brain can no longer regulate mood on its own and states of stress, panic, anxiety, and depression ensue when drugs are withheld. Even though the physical cravings for drugs may have passed during a course of medical detox or even a period of sobriety or abstinence, the resulting state for the addict is one of anhedonia. Even for addicts working hard in their recovery, anhedonia is a real and quantifiable state of mixed low mood that works against the addict’s best efforts to refrain from drug-seeking behavior.

Furthermore, drug abuse damages the prefrontal cortex and makes it difficult if not impossible for the recovering addict to recognize and respond appropriately to the emotions of others. Infant faces, according to the bulk of research in the field, elicit—in most healthy adults—a kind of neural stimulation and promote certain caregiving responses we associate with mothering.

The sleeping baby, the crying baby, the laughing baby, all draw us in awaken an urge to protect and nurture. For our addicted or recently recovered daughter, sister, friend, that response may be shut down.

There actually is something missing. What’s missing is the ability to feel all those magical/chemical responses to one’s own infant that inspire caregiving.

I’m familiar with far too many anecdotal stories of women who, finding themselves pregnant, manage to get themselves into a recovery program and subsequently give birth to a healthy non-addicted baby, only to find themselves back in the cycle of addiction again but now with a young helpless infant in their care.

Brain regions affected by addiction are sadly integral to parenting. The broken brain, and particularly the reward-stress neural circuitry, is excessively taxed in early parenting and the new mother finds herself less rewarded by parenting—less able or inclined to nurture—and more stressed by parenting. Couple a broken bonding experience with increased stressors that encourage drug-seeking behavior and you have a recipe for disaster. The question then remains, what can be done about it.

The good news is that the brain can heal, but it is not instantaneous upon the cessation of drug use. The anhedonia that kicks in with the removal of drugs lasts, on average, roughly a year, though figures vary widely based upon many factors. But the prefrontal cortex and the ability to regulate one’s mood can and does heal over time in almost all cases. The goal then is to provide mothers with as much support over the length of time necessary to resolve the healing.

We all know that isolation is especially difficult on new mothers and this is especially true if that new mother is relatively new to recovery. A strong support system with access to healthcare, addiction support services, healthy peers, and parenting education is crucial. In Baltimore, programs like the Helping Up Mission’s new Women’s Center and Johns Hopkins Center for Addiction and Pregnancy are pillars that support recovery and healthy families. Changing the way society looks at parenting and addiction also goes a long way in ending the shame and working toward recovery.

With an understanding as to just how the addicted brain is altered and damaged—and with the grateful knowledge that the addicted brain can heal—I’m also able to feel compassion and hope. Love In The Trenches is proud to be able to support programs that support women and their children and erase the shame. Please join us in educating yourself about the reality of this disease and the programs available to support both those afflicted with this disease and those families suffering the collateral damage of a loved one’s illness.

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