Drugs In Newborns: How Long Do They Stay?

how long does drugs stay in newborn system

The length of time that drugs remain in a newborn's system depends on various factors, including the type of drug, the mother's health, and the baby's gestational age. Traces of drugs can be detected in a newborn's system through urine, blood, meconium, hair, or umbilical cord blood or tissue samples. The detection window can vary from a few days to several months, depending on the drug's half-life and the newborn's metabolism. For example, drugs like amphetamines and cocaine may be detectable for a shorter period, while cannabis can stay in a baby's system for months. It is essential to seek medical advice and testing to determine the presence and duration of drugs in a newborn's system accurately.

Characteristics Values
Drug Amphetamine, Cannabis, Cocaine, Percocet, Opiates
Side Effects for Baby Low birth weight, Neonatal Abstinence Syndrome, Poor concentration, Delayed cognitive development, Abnormalities of the developing brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract
Detection Time Up to a week, 24-57 hours, 2-4 days, 48-72 hours, 2-4 days

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How long do drugs stay in a newborn's system?

The length of time that drugs remain in a newborn's system depends on various factors, including the type of drug, the amount ingested, the method of ingestion, and individual factors such as the mother's metabolism and the baby's gestational age. Here is a more detailed look at how long drugs may stay in a newborn's system:

Opioids

Opioids, including prescription opioids like oxycodone and hydrocodone, as well as illicit drugs like heroin, can cause neonatal abstinence syndrome (NAS) in newborns. NAS is a group of conditions caused by drug withdrawal, and it typically occurs when a pregnant woman takes opioids during pregnancy. The symptoms of NAS can vary but often include fussiness, excessive crying, poor feeding, breathing problems, and seizures. The treatment for NAS may include medications like morphine or methadone, which are gradually reduced over time to wean the baby off the substance. The duration of treatment for NAS can range from a few days to several months. According to one source, traces of opioids can be found in a newborn's system for 2-4 days.

Amphetamines

Amphetamines, also known as "speed" or "whizz," can have significant side effects on both the mother and the unborn baby. It can increase blood pressure and heart rate, which are already naturally elevated during pregnancy, potentially endangering both the mother and the baby. Doctors suggest that amphetamines can be detected in a newborn's system for up to a week after the drug was taken by the mother.

Cannabis

Cannabis exposure during pregnancy can have developmental impacts on the unborn baby and is associated with low birth weight. It can also lead to coordination difficulties, delayed reaction times, and altered heart rhythm in the mother. Cannabis exposure can stay in a baby's system for months after use, and it generally takes 24-57 hours just to eliminate half of the dose. THC, the active compound in cannabis, is stored in the body's tissues and released slowly over time.

Cocaine

Cocaine is a highly addictive stimulant that can cause serious health risks to both the mother and the unborn baby. It can lead to abnormalities in the developing fetus, including the brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract. Cocaine can be detected in a newborn's system for 2-4 days, while in the mother's system, it can be detected for up to 30 hours.

Percocet

Percocet is a combination drug used to treat moderate to severe pain, containing acetaminophen and oxycodone. While mild doses may have little to no side effects on the mother or the pregnancy, severe addiction can lead to detrimental effects on the fetus. Babies born to mothers with percocet addiction may experience withdrawal symptoms, including rapid breathing and seizures. The duration of treatment for withdrawal can range from one week to six months, depending on the severity of the addiction.

Opiates

Opiates, including prescription drugs like codeine and morphine, as well as illicit drugs like heroin, can be transferred to the fetus through the placenta and umbilical cord. While opiates are commonly prescribed to pregnant women and are generally considered safe when used under medical supervision, misuse or uncontrolled use can lead to major birth defects, including congenital heart defects. The duration of opiates in a baby's system depends on factors such as the type of opiate, the dosage, and the duration of use.

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What are the side effects for the baby?

The side effects for a baby exposed to drugs in utero can vary depending on the type of drug, the amount, and the length of exposure. Here are some general side effects that can occur:

  • Low birth weight
  • Neonatal Abstinence Syndrome (NAS), which includes symptoms such as crying, jitteriness, sleep/wake alterations, and feeding and breathing problems
  • Long-term cognitive and behavioural issues, including problems with learning, concentration, and impulse control
  • Physical abnormalities in the brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract
  • Placental abruption, which can be life-threatening for both mother and baby
  • Increased risk of Sudden Infant Death Syndrome (SIDS)

It is important to note that not all babies exposed to drugs in utero will experience these side effects, and the presence of a substance use disorder in the mother does not automatically indicate that the child will be abused or neglected. However, there are risks associated with substance use during pregnancy that can have short-term and long-term impacts on the baby's health and development.

Amphetamines (including methamphetamine and cocaine):

  • Low birth weight
  • CNS irritability/lability of state - crying, jitteriness, sleep/wake alterations
  • Continued exposure through breastfeeding
  • Neurodevelopmental alterations
  • Necrotizing enterocolitis
  • Long-term effects on growth, cognition, language, and behavioural self-regulation

Opiates (including heroin, morphine, codeine, oxycodone, and fentanyl):

  • Low birth weight
  • NAS, with symptoms such as CNS irritability, autonomic dysfunction, respiratory symptoms, and GI disturbances
  • Long-term problems with behavioural self-regulation
  • Congenital heart defects

Cannabis:

  • Low birth weight
  • Pale skin and decreased activity
  • Poor concentration and delayed cognitive development as the child grows older

Cocaine:

  • Abnormalities in the developing brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract
  • Low birth weight
  • Placental abruption

It is important to note that these lists are not comprehensive, and the effects of drug exposure can vary depending on many factors. If you or someone you know is pregnant and using drugs, it is crucial to seek medical advice and support.

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What are the withdrawal symptoms?

Withdrawal symptoms in newborns exposed to drugs in utero can vary depending on the type of drug, the amount of drug in the newborn's system, and the duration of exposure. Here are some common withdrawal symptoms:

  • Opioids: Opioid withdrawal in newborns, known as Neonatal Opioid Withdrawal Syndrome (NOWS) or Neonatal Abstinence Syndrome (NAS), can cause symptoms such as body shakes, seizures, overactive reflexes, high-pitched crying, fussiness, poor feeding, breathing problems, fever, sweating, blotchy skin, trouble sleeping, diarrhoea, vomiting, and stuffy nose. These symptoms can range from mild to severe and typically appear within the first few days after birth but can occur up to a week later.
  • Amphetamines: Exposure to amphetamines in utero can lead to withdrawal symptoms such as low birth weight, crying, irritability, sleep disturbances, and neurodevelopmental alterations. These symptoms can have long-term effects, including modest but measurable differences in growth, cognition, language, and behavioural self-regulation.
  • Cannabis: Cannabis exposure during pregnancy can result in developmental issues for the newborn, including low birth weight, pale skin, and reduced activity. As the child grows older, they may experience poor concentration and delayed cognitive development.
  • Cocaine: Cocaine misuse during pregnancy can have severe consequences for the unborn baby, including abnormalities in brain development, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract. It can also lead to placental abruption, which can be life-threatening for both the mother and the baby. Newborns exposed to cocaine may exhibit withdrawal symptoms such as rapid breathing or seizures, and treatment may be required to manage dehydration.
  • Percocet: Babies experiencing withdrawal from Percocet may present with symptoms such as rapid breathing or full-blown seizures. Treatment typically lasts from one week to six months, depending on the severity of the withdrawal.
  • Opiates: Opiate exposure during pregnancy can result in major birth defects, including congenital heart defects, spina bifida, and clubfoot. The duration of withdrawal symptoms in newborns exposed to opiates depends on factors such as the specific opiate used, the timing and duration of exposure, and the amount of drug in the newborn's system.

It is important to note that the presence of withdrawal symptoms and their severity can vary widely among newborns, and a detailed assessment by a healthcare professional is necessary to determine the appropriate treatment plan.

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What are the long-term problems?

The long-term problems of drug exposure in newborns are extensive and vary depending on the type of drug consumed. Here are some of the common issues:

  • Impaired growth and development: Drug exposure in the womb can lead to low birth weight, smaller body length, and smaller head circumference. This can have long-term consequences on the child's physical growth and development, including impaired growth, birth defects, and altered brain development.
  • Neonatal Abstinence Syndrome (NAS): Babies born to mothers who used opioids during pregnancy may experience withdrawal symptoms such as excessive crying, poor feeding, slow weight gain, stuffy nose, hyperactive reflexes, trembling, and seizures.
  • Fetal Alcohol Spectrum Disorder (FASD): Alcohol use during pregnancy can cause FASD, which includes physical and psychiatric problems such as abnormal facial features, problems with vision or hearing, shorter-than-average height, problems with sleep and sucking, and heart, kidney, or bone issues.
  • Sudden Infant Death Syndrome (SIDS): Babies exposed to drugs, alcohol, or tobacco in utero are at a higher risk of SIDS.
  • Neurobehavioral Effects: Drug exposure can have long-term effects on the child's neurobehavior, including attention, memory, language, and executive function. For example, cocaine exposure has been linked to abnormal infant behavior such as lower arousal, poorer quality of movement, higher excitability, jitteriness, and abnormal reflexes.
  • Mental Health Issues: Prenatal drug exposure has been associated with an increased risk of mental health disorders such as depression, anxiety, and aggression.
  • Learning Disabilities: Children exposed to drugs in utero may experience learning disabilities and difficulties in school.
  • Congenital Heart Defects: Opioid use during pregnancy has been linked to major birth defects, including congenital heart defects.
  • Long-Term Health Issues: Drug exposure in utero can have long-term health consequences, including respiratory problems, altered heart function, and increased risk of certain cancers.

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How can drugs be tested in newborns?

Testing for drugs in newborns can be performed on urine, blood, meconium, hair, or umbilical cord blood or tissue samples. Meconium is the traditional specimen for newborn drug testing, although its use may pose pre-analytic challenges (e.g., delayed or segmented collection). Umbilical cord tissue is easily collected at birth but has been found to contain lower drug concentrations than meconium. Urine, hair, and blood (including umbilical cord blood) tests offer different advantages, disadvantages, and windows of detection in newborn drug screening.

Meconium testing is the gold standard for drug testing in newborns. It is the first stool of a newborn, typically passed in the first few days of life, and contains metabolic waste products. Meconium usually begins to form at the beginning of the second trimester as the fetus's swallowing reflex begins, permitting the swallowing of amniotic fluid. Meconium is often considered the gold standard for drug testing in newborns because it has a long window of detection. It can be collected in a non-invasive manner, and it begins to form around 12 weeks into gestation, with an element of drug concentration in the meconium tissue. However, meconium can sometimes be passed in utero, and screening may show drugs administered during labour, potentially confounding results.

Neonatal hair growth begins in the third trimester. Hair drug testing may be helpful if meconium is not available due to the transition to neonatal stool or the clinical condition of the baby. Testing the hair can be useful if the mother has a history of drug use or is in an environment with others using drugs. While not all newborns will have sufficient hair growth to allow for adequate specimen collection, hair testing can detect drug use several months prior if the baby's hair is long enough.

Umbilical cord testing is an alternative to meconium collection. The umbilical cord is a part of the placenta that connects the developing foetus to the placenta. It is easily accessible and non-invasive and is available immediately after birth. It may reflect fetal exposure better than meconium, but drug levels in the umbilical cord have been shown to be lower than in matched meconium.

Blood and urine testing are also possible, but they have a short window of detection. Blood testing is rarely used clinically or in research for drug detection. Urine testing is the most commonly used matrix for drug screening in adults, including pregnant women, and is relatively easy and non-invasive to collect. However, it has a short window of detection, providing insight only into recent exposure, and may not be useful for detecting substance use disorders.

Frequently asked questions

Doctors suggest that amphetamine will stay in a newborn's system for as long as it is in the mother's system and can be detected for up to a week after the drug has been taken.

Cannabis exposure can stay in a newborn's system for months after use. It generally takes 24-57 hours to work half of the dose out.

Cocaine can be found in a mother's system for up to 30 hours after taking the drug but for newborns, it could be 2-4 days.

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