1. Drug Use in Pregnancy: Mother and Child
Ira J. Chasnoff, MD

2. Children grow and develop in the context of…
Relationships
(C) NTI Upstream, 2018

3. Attachment: Basic Concept
Attachment is…
the interconnectedness between human beings.
Attachment requires…
reading each other’s cues
responding appropriately to each other’s cues.
Mother
Child
(C) NTI Upstream, 2018

4. Attachment: Where to Start?
Mother
Child
(C) NTI Upstream, 2018

5. When does risk happen? Embryonic Fetal Newborn Infant Toddler
Conception
Newborn
Infant
Toddler
Preschool
Early childhood
Primary grades
Middle School
Adolescence
Childhood
(C) NTI Upstream, 2018

6. Embryonic Period Embryonic Early gestational stress marks the genes
First 12 weeks after conception
Cells are “undedicated” (stem cells)
Cells become imprinted during this phase
Early gestational stress marks the genes
Adds a methyl group to the gene (methylation)
Becomes fixed as memory: epigenetic memory
(C) NTI Upstream, 2018

7. Fetal memory
(C) NTI Upstream, 2018

8. Attachment: Where to Start?
Mother
Child
(C) NTI Upstream, 2018

9. Two Essential Caregiver Qualities
Accessibility
Responsiveness
(C) NTI Upstream, 2018

10. Six Factors Affecting Relationships in Chemically Dependent Women
Negative heritage
Trauma history
Lack of social support
(C) NTI Upstream, 2018

11. Six Factors Affecting Relationships in Chemically Dependent Women
Negative heritage
Emotional instability
Lack of social support
Cognitive functioning
(C) NTI Upstream, 2018

12. Six Factors Affecting Relationships in Chemically Dependent Women
Negative heritage
Trauma history
Lack of social support
Cognitive functioning
Psychological functioning
(C) NTI Upstream, 2018

13. Six Factors Affecting Relationships in Chemically Dependent Women
Negative heritage
Emotional instability
Lack of social support
Cognitive functioning
Psychological functioning
Substance abuse
(C) NTI Upstream, 2018

14. * Strathearn, et al. Neuropsychopharmacology, 2009
(C) NTI Upstream, 2018
Strathearn, et al. Neuropsychopharmacology, 2009

15. * Strathearn, et al. Neuropsychopharmacology, 2009
(C) NTI Upstream, 2018
Strathearn, et al. Neuropsychopharmacology, 2009

16. Chronic administration of drugs of abuse, such as cocaine, substantially reduces oxytocin levels in the hypothalamus.
(C) NTI Upstream, 2018

17. Ox * Substance abuse Strathearn, et al. Neuropsychopharmacology, 2009
Oxytocin
Substance abuse
(C) NTI Upstream, 2018
Strathearn, et al. Neuropsychopharmacology, 2009

18. Just in case you didn’t get it…
Relationships
(C) NTI Upstream, 2018

19. Biological Basis of the Effects of Prenatal Drug Use: The Catecholamine System
(C) NTI Upstream, 2018

20. Biological Basis of the Effects of Prenatal Drug Use: Methamphetamines
Catecholamines
(C) NTI Upstream, 2018

21. Biological Basis of the Effects of Prenatal Drug Use: Cocaine
Catecholamines
Cocaine
(C) NTI Upstream, 2018

22. Neonatal Complications
SIDS
Dysmorphology
Prematurity
Low birth weight
Failure to thrive
(C) NTI Upstream, 2018

23. Neonatal Complications
SIDS
Dysmorphology
CNS damage
Low birth weight
Prematurity
Failure to thrive
(C) NTI Upstream, 2018

24. Neonatal Complications
SIDS
Dysmorphology
CNS damage
NAS
Low birth weight
Prematurity
Failure to thrive
(C) NTI Upstream, 2018

25. Attachment: The Infant’s Readiness for Attachment
Mother
Child
(C) NTI Upstream, 2018

26. Two Essential Infant Qualities
Accessibility
Responsiveness
(C) NTI Upstream, 2018

27. Newborn Neurobehavior
Orientation
State regulation
(C) NTI Upstream, 2018

28. Information Processing Model
Four domains of information processing
Input (recording information)
Integration (interpreting input)
Memory (storing input for later use)
Output (appropriate use of language and motor skills)
(C) NTI Upstream, 2018

29. (C) NTI Upstream, 2018

30. (C) NTI Upstream, 2018

31. (C) NTI Upstream, 2018

32. Biological Basis of the Effects of Prenatal Drug Use: The Catecholamine System
(C) NTI Upstream, 2018

33. Biological Basis of the Effects of Prenatal Drug Use: Methamphetamines
Catecholamines
(C) NTI Upstream, 2018

34. Biological Basis of the Effects of Prenatal Drug Use: Cocaine
Catecholamines
Cocaine
(C) NTI Upstream, 2018

35. ntiupstream.com
(C) NTI Upstream, 2018