“It used to be a very easy story,” Dr. Leslie Hulvershorn, a pediatric addictions specialist, told attendees at an addictions seminar Wednesday at the Allen County Public Library. “Drugs are bad; don't let moms use drugs.”
Research suggests that the problem isn't that simple, Hulvershorn said. Other factors in the mother's life may have more effect on a baby's health. “Drug abuse, whether it's nicotine or cannabis, may be less influential than a lot of other choices that mom is making ... during pregnancy and child care,” she said.
For instance, she said, mothers who smoke or use alcohol or drugs may also be exposing their children to abuse, domestic violence, poor nutrition or other problems that overshadow the effects of the substance use.
“If we have this idea that, oh, if we could only get moms to quit using drugs, then everything would be fine – that's probably not really what our data are telling us,” said Hulvershorn, a clinical psychiatrist for the Indiana University School of Medicine and head of the mood disorders clinic at the Riley Hospital for Children in Indianapolis.
“So, comprehensive support for moms who are using drugs is probably the best approach – including prenatal care, helping mothers obtain job and educational skills and training them on “things like relationship choices and how you interact with other people, so that we aren't having abusive boyfriends and dads surrounding these kids.”
Sponsored by the Allen Superior Court program Great Kids Make Great Communities, Hulvershorn's session offered social and medical workers insights about how drugs can imperil families and why the young are particularly at risk.
“About half of American teens have used illicit drugs by high school graduation,” she said. “Almost 8 percent have a serious problem.” Few teens actually seek and receive treatment, Hulvershorn said. That's particularly unfortunate because the young are particularly vulnerable.
“Of people who began drinking before age 14, half of those people later went on to have a serious alcohol problem,” she said. But only 10 percent of people who wait until they are 21 to drink have those problems.
Hulvershorn said she tells young patients, “Your brain acts completely differently on drugs and alcohol than mine would, because I'm older than you. I'd rather you not do it at all, but if I can get you to wait until you're 21, your brain can respond very differently.”
In Indiana, adolescents are particularly endangered by prescription pills, the cannabis in marijuana and the synthetic cannabinoids in “spice,” she said.
Marijuana use is dangerous, she stressed. For users with certain genetic predispositions, cannabis use can even cause lifelong psychotic disorders, such as schizophrenia.
“It's not a benign, no-big-deal kind of drug, and it's especially problematic for people who use very young,” she said.
Understanding the interplay between substance abuse and mental disorders is a key to getting young people help, Hulvershorn said. “You never want to treat substance abuse disorders in a place that only handles addiction.
You want to treat them in a place that can handle mental health ... all in one setting.
“Because if your depression's not getting better, your drug problem's not going to get better. If your drug problem's not better, your depression's not going to get better. So you have to treat both.”
Hulvershorn's talk was one of a series of training seminars Great Kids, the Fort Wayne-Allen County Department of Health and a coalition of other local organizations have presented on aspects of the drug epidemic.
Such efforts are crucial for this community to effectively address that crisis.