Research
UNSW charts a brighter future for babies born with opioid addiction
Freya Lucas
Oct 10, 2024
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The use of opioids in Australia is of increasing concern for advocates, researchers and social commentators, with benzodiazepines and opioids remainung the largest contributors to drug-induced deaths in the nation.
Opioids are a class of drugs that includes prescription-only medicines such as oxycodone, fentanyl and tramadol. These are typically used for pain relief.They are addictive, and in high doses, fatal.Along with the increasing pattern of opioid use comes the inevitablity that women of a reproductive age are using opioids more, leading to a higher number of children being born after having exposure to opioids in the womb, meaning babies start facing withdrawal symptoms just moments after birth.
“The reasons for opioid use are complicated, political and social,” UNSW Sydney Associate Professor Kelly Clemens explained.
“There has been a 400 per cent increase in opioid use by women across the past 10 years,” she continued, “and this is a problem as everything that goes into the mum goes through to the baby.”
As a behavioural neuroscientist, her research extends to real-life cases in Sydney’s hospitals, where newborns are born with a deeper struggle of addiction, sometimes unbeknownst to medical staff.
Having exposure to opioids in the womb means babies start facing withdrawal symptoms just moments after birth, with opioid use changing how the brain of the baby grows across pregnancy.
The withdrawal symptoms in newborns can range from irritability and feeding difficulties to seizures and respiratory distress.
“When a baby is born with an opioid addiction and goes through withdrawal, they can be quite sick, which in turn requires replacements like methadone or morphine,” A/Prof. Clemens explained.
“So these kids can be exposed to drugs for quite some time both before and after birth.”
Half of the children affected are typically diagnosed with a mental health disorder such as attention deficit disorder and other conduct disorders by the age of five years, with the effects of in utero addiction lingering beyond infancy, shaping early childhood and beyond.
“At school, they do poorly, performing worse across NAPLAN,” A/Prof. Clemens continued. “Long-term, they are at high risk of drug addiction themselves, or death by suicide.”
Despite the grim findings, she has found that a simple dietary supplement could have a dramatic impact on the future lives of these infants. A seemingly small improvement early in life, she believes, could lead to a whole different future.
A/Prof. Clemens has been studying how in-utero exposure to these drugs affect the brain and behaviour of offspring. She found that opioids interact closely with our immune system—with neuroinflammation changing how the brain works and recovers.
“That also means they might have less resistance to viruses and bacteria,” A/Prof. Clemens explained.
Considering the microbiome of the gut is key to her findings, noting that a healthy gut is important for digesting r food and vitamins, as well as combating the ‘bad’ microbes.
A/Prof. Clemens believes the poorer brain outcome of children born with an opioid exposure may be linked to gut health.
“The gut becomes leaky, letting toxins and bad metabolites leak into the blood,” she explained. “Opioids also make the blood brain barrier leakier—so toxins reach the brain, and this might contribute to neuroinflammation.”
Her findings suggest that early intervention is crucial in moderating the effects, specifically, through targeting gut health.
Sodium butyrate is a compound produced naturally in the human body by digesting fibre. It has shown promise in animal studies for its ability to reverse some of the neurological effects of prenatal opioid exposure.
“It works by modifying gene expression and promoting healthy brain function, potentially offering a new avenue for treatment in affected infants,” A/Prof. Clemens said.
“When we gave sodium butyrate to our rats, it improved brain development and growth,” she continued. “It decreased indicators of inflammation. It improved the gut health of our pups by promoting good bacteria in their gut. And, it made them smarter.”
The pups exposed to opioids during pregnancy had significantly better long-term outcomes from taking sodium butyrate than the pups that didn’t.
In partnering with several local Sydney hospitals, affected infants could be monitored closely to understand the effectiveness of sodium butyrate in improving their developmental outcomes.
Senior Neonatologist Professor Ju Lee Oei is a clinical partner on the project, based at The Royal Hospital for Women. She says while her focus on clinical medicine uncovers the unmet need, the science is what helps to resolve the need.
“Our collaboration is built on a shared vision, to understand the mechanisms underlying the poor outcomes of children with prenatal drug exposure and to develop interventions to predict and prevent this harm,” Prof. Oei says.
With early detection and care, these children can receive the support they need to thrive despite the challenges they face from the very beginning of their lives,” A/Prof. Clemens added.
Learn more about the work here.
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