(FAS) is the most severe complication of maternal
alcohol use during pregnancy. FAS may involve
significant physical BIRTH DEFECTS, BRAINdamage,
developmental delays, LEARNING DISORDERS, and
psychologic conditions.
Infants of women who are addicted to drugs are
born addicted themselves, requiring intensive med-
ical care after birth to wean them from the drugs
and restore normal body functions. These infants
are also often born prematurely, further compro-
mising their health and well-being. Though the ter-
atogenic risks of drugs such as heroin and COCAINE
remain unclear, long-term health problems and
learning disabilities later in childhood are common.
Babies born to women who smoke cigarettes
are characteristically of small birth weight, which
researchers believe results from insufficient oxy-
gen in the mother’s BLOODcirculation. They also
have high risk for failure to thrive, a potentially
lethal health circumstance in which the infant
does not grow and develop normally but for no
discernible medical reasons. Such infants require
diligent care and frequent medical attention, and
are more vulnerable to infection and illness.
Advances in Knowledge and TreatmentDiscovery of opiate receptors in the early 1970s
was a huge leap forward in understanding how
narcotics work in the brain. Subsequent advances
allowed researchers to identify the roles of other
neuroreceptors and neurotransmitters and to dis-
cover alterations in brain function that occur with
specific drugs. Psychiatric disorders also play roles
in susceptibility to addiction.
Some research has shown that more than 80
percent of people diagnosed with SCHIZOPHRENIA
are also heavy cigarette smokers—addicted to
nicotine—have other substance abuse problems or
addictions. Researchers do not know whether the
addictions increase susceptibility for psychiatric ill-
ness or psychiatric illness increases vulnerability
for addictions.
The multiplicity of factors that contribute to
addiction make its treatment all the more difficult.
Of the 20 million Americans who have substance
abuse or addiction problems, fewer than 4 million
seek treatment. New medications that target spe-
cific neuroreceptors have vastly improved symp-
tom relief during DETOXIFICATIONand help maintain
SOBRIETYafter withdrawal for many people. Inte-
grated efforts to educate students and employees
about the dangers of substance abuse, coupled
with mandatory drug testing in a growing number
of environments, appear to have significantly
reduced substance abuse in certain settings.
Focused therapy that helps people learn new
behaviors (BEHAVIOR MODIFICATION THERAPY) and
gain insight into the reasons they abuse drugs and
alcohol (COGNITIVE THERAPY) seems to be improving
the success rate for maintaining sobriety. As well,
pharmacologic research is producing new kinds of
narcotics that can target specific neuroreceptors in
ways that provide therapeutic action (such as pain
relief) with low risk for addiction.Substance Abuse 313