Brittany Smith, Northern Kentucky University – Saving Moms and Babies From the Opioid Crisis

On Northern Kentucky University Week: The opioid crisis is hitting mothers and infants too.

Brittany Smith, assistant professor in psychological sciences, examines ways to help.

Brittany Smith joined the Department of Psychological Science in 2022. She was previously at the University of Cincinnati for 11 years, where she completed her Ph.D. in neuroscience in 2016 and postdoctoral fellowship from 2016-2022. She teaches Biopsychology, Biopsychology Lab, and Research Methods. Her interests include behavioral neuroscience, neuroimmunology, molecular neurobiology, and translational research. Her research program is focused on understanding how prenatal substance exposure shapes behavioral function later in life.

Saving Moms and Babies From the Opioid Crisis

With the opioid epidemic continuing to surge, maternal overdose has become a leading cause of maternal mortality – and opioids are taking their toll on infants, too.

What treatment strategies might address these tragic consequences? My research on the use of low-dose buprenorphine suggests one possible path.

Buprenorphine is an opioid medication used to treat opioid use disorder. Taken during pregnancy, it prevents maternal withdrawal and reduces overdose risk. It also reduces the incidence and severity of neonatal opioid withdrawal and lowers preterm birth risk compared to alternate opioid medication, methadone.

Given those benefits, providers treating a pregnant patient for opioid use would likely prefer buprenorphine. But the same patient’s pediatric team might have concerns since existing research associates opioid medications during pregnancy with risks of a child having altered brain development, behavioral problems, and cognitive deficits.

This link remains associative because we cannot isolate other factors that may contribute to these outcomes, such as polysubstance use and unstable home environments. Regardless, cases emerge where a pregnant mother disclosing an opioid use disorder switches to taking opioid medication, and then sees her baby taken by well-meaning child welfare agencies shortly after birth because the baby tested positive for the opioid medication.

 I am an animal behavioral neuroscientist looking to connect the gap between pregnancy and pediatric care. I study long-term effects of prenatal opioid exposure in mice and find that exposure to morphine (a metabolite of heroin & codeine) causes adverse pregnancy outcomes while buprenorphine does not. Morphine causes offspring behavioral and cognitive problems.  Buprenorphine does not. Morphine causes signs of inflammation in the neonatal brain. Buprenorphine does not. Meanwhile, methadone has been reported to have adverse effects.

Our study used a low but clinically relevant buprenorphine dose, so higher doses may differ. Overall, this supports the use of low dose buprenorphine during pregnancy as a harm reduction strategy for pregnancy, neonatal, and pediatric outcomes.