BOSTON — Babies born to mothers who used heroin, fentanyl and other opioids during pregnancy can suffer from emotional and physical problems as they age, studies show.

But while children with disabilities as a result of exposure to alcohol during pregnancy can qualify for developmental services, those exposed to opioids do not.

Some lawmakers want to change that by expanding programs and services offered by the state Department of Developmental Services to children diagnosed with opioid-related systems from their mother’s drug use.

Senate Minority Leader Bruce Tarr, R-Gloucester, primary sponsor of a proposal to do that, said the disparity was brought to his attention by a constituent who adopted a child with developmental problems attributed to fetal opioid exposure. The family tried and failed to get help from the state with developmental services.

"We're trying to create fairness and parity for children born with opioid exposure," Tarr said. "As a state, we clearly recognize the challenges that parents face when it comes to fetal alcohol syndrome, so it only makes sense that we should recognize it with opioids."

The proposal goes before the Legislature's Committee on Mental Health, Substance Use and Recovery on Wednesday.

Tarr said there is a still-unknown cost for expanding developmental services for newborns, but early intervention will save the state money on longterm medical costs.

The proposal is one of several opioid-related bills to be heard Wednesday, but it’s the only one seeking to offer services to children exposed to drugs in utero.

Prenatal exposure

"We're living in a time where I think most people would agree that there's more of a chance of a fetus being exposed to opioids than alcohol," said Rep. Ann-Margaret Ferrante, D-Gloucester, a co-sponsor of the legislation. "We really need to have a discussion about what is happening to these pregnancies and what role the state should play."

Massachusetts is grappling with a deadly wave of opioid addiction that claimed nearly 2,000 lives last year from overdoses. Fentanyl, a synthetic opioid, was present in a majority of the deaths, according to health officials.

A legislative task force that looked at the issue two years ago noted gaps in health care services for newborns exposed to opioids and recommended legislation to plug the deficiencies.

The number of babies born to opioid addicted mothers in the U.S. more than quadrupled from 1999 to 2014, according to the Centers for Disease Control and Prevention.

The rate of prenatal opiate exposure reported in Massachusetts increased from 2.6 per 1,000 hospital births in 2004 to 14.7 in 2013 — an increase of more than 500%

Nationally the figure is five babies out of every 1,000 births.

Thousands of children are born in the U.S. each year with what's called newborn abstinence syndrome — a combination of symptoms caused by withdrawal from their pregnant mother's use of prescription painkillers, heroin or fentanyl. The drugs can pass through the placenta into a baby's developing nervous system.

A 2018 study published in the Journal of Pediatrics found that learning disabilities and other special education needs are common in children born with opioid-related symptoms. About 1 in 7 affected children required special classroom services for developmental delays, speech issues and other difficulties.

Other states' take

Massachusetts is one of 25 states that require health care providers report to child welfare agencies whenever a baby is born dependent on drugs.

Some states have expanded child welfare laws to include prenatal substance use.

Twenty-three states and Washington, D.C., consider substance use during pregnancy to be child abuse under their civil statutes, according to the nonprofit Guttmacher Institute.

In Alabama, the state Supreme Court recently determined that drug use while pregnant is considered endangerment of a child, ruling that a viable fetus is a person and "maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus" is child abuse.

At least three states — Minnesota, Wisconsin and South Dakota — allow for civil commitment of women suspected of using illegal drugs during pregnancy.

Dr. Mishka Terplan, a member of the American College of Obstetricians and Gynecologists’ addiction expert group, called the punitive approach misguided. He said it is reminiscent of the failed anti-drug policies of the 1980s and ‘90s, which were driven by hysteria over dubious studies that linked smoking crack cocaine while pregnant to health effects on infants.

"Almost none of that proved to be correct, and it turned out to be harmful to mothers and children," he said. "Those kids developed like everyone else, no better and no worse."

Terplan said Massachusetts policymakers are right to focus on early intervention and supportive care for children.

"Early intervention is crucial," he said. "We need to treat people with addiction, but we also need to make sure we provide resources for children and their families."

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at


Recommended for you