THE AMPHETAMINE ADDICTED MOTHER AND HER CHILD
THE AMPHETAMINE ADDICTED MOTHER AND HER CHILD
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安非他明成瘾的母亲和她的孩子
DOI：
10.1111/j.1651-2227.1980.tb06197.x
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
G. Larsson
中科院分区：
文献类型：
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作者：
G. Larsson
在过去的几十年里，药物成瘾在瑞典被认为是一个日益严重的社会问题。育龄妇女在吸毒人口中占很大比例。孕妇在怀孕期间吸毒成瘾与医疗和社会并发症有关，因此受到深切关注。迄今为止，瑞典的毒品情况相当突出，因为主要是安非他明滥用（53）。在医学和社会专业人士中，越来越多的人担心瑞典安非他明成瘾母亲的孩子是处于危险之中的孩子。本研究开始于1976年，以确定这些儿童的后果后，母亲安非他明成瘾。在过去的十年中，severs 1研究报告了各种医疗和社会影响怀孕，分娩和新生儿后，母亲海洛因成瘾（19，57，69，74）。少数发表的关于海洛因依赖母亲所生婴儿的随访研究主要来自美国，其社会经济结构特殊。据报道，胎儿海洛因暴露会影响生长和行为以及感知和学习过程（43，72）。在丹麦的一项研究中，19名母亲对各种药物（包括安非他明和海洛因）上瘾的儿童的躯体生长以及粗和精细运动发育似乎是正常的（59）。与大量关于母亲海洛因成瘾影响的文献相反，很少有相应的研究描述怀孕期间母亲滥用安非他明的后果（41，44，69）。特别是，没有对这些婴儿进行后续研究，关于儿童长期预后的数据也很少。此外，还没有报告瑞典各当局在怀孕期间滥用药物方面取得的经验。然而，由吸毒成瘾的父母抚养的儿童似乎面临着被忽视和虐待的风险增加（9，38，40）。由于父母的无能，这些儿童中的一些被安置在寄养家庭（15，43，59）。除了撤销父母监护权之外，关于在多大程度上对这些家庭采取了社会措施的信息很少。当然，采取法律的措施的标准因国家而异。根据《瑞典儿童福利法》，社会福利机构有责任确保儿童的安全和福利。福利机构为消除不良状况而可能采取的法律的措施主要是预防性的。如果这些措施无效，父母对子女的监护权可能会被取消。由于没有对儿童的需要或环境的最低标准作出定义，法律提供了各种各样的个人解释。有必要分析产妇的社会风险因素，这在有关吸毒母亲所生婴儿监护权的决策过程中可能具有特别重要的意义。药物成瘾的过程已被描述在一个概念模型中，包括三个阶段（I）。即使是成瘾的终止-也被分为三个阶段（20）。在瑞典的一项研究中，吸毒成瘾者倾向于在吸毒2年或6年后放弃吸毒生涯（20）。在吸毒生涯的可比阶段，海洛因成瘾者和安非他明成瘾者的复吸频率似乎没有任何差别。概念模型可能
During the past few decades, drug addiction has been recognized In Sweden as a growing social problem of great importance (5). Women in the childbearing age group constitute a significant fraction of the addicted population. Maternal addiction during pregnancy is associated with medical and social complications and has therefore been viewed with deep concern. The Swedish drug scene has so far been rather distiwtive, since it is dominated by amphetamine abuse (53). Among medical and social professionals there has been a growing apprehension that chiidren of amphetamine-addicted mothers in Sweden are children at risk. The present study was started in 1976 to determine the consequences for these children following maternal amphetamine addiction. During the past decade, severs1 studies have reported a variety of medical and social effects on pregnancy, delivery and the newborn baby following maternal heroin addiction (19, 57, 69, 74). The few published follow-up studies on infants born to heroin-dependent mothers mainly originate from the USA, with its specific socio-economic structure. I t is reported that fetal heroin exposure can affect growth and behaviour as well as the perceptual and learning processes (43, 72). In a Danish study based on 19 children born to mothers addicted to a variety of drugs, including amphetamine and heroin, the somatic growth as well as gross and fine motor development appeared to be normal (59). In contrast to the vast documentation of the effects of maternal heroin addiction, there are few corresponding studies describing the consequences of maternal amphetamine abuse during pregnancy (41, 44, 69). In particular, there are no follow-up studies on these infants and few data on the long-term prognosis for the children. Moreover, the experience gained by the various authorities in Sweden concerning drug abuse during pregnancy have not been reported. Children raised by drug-addicted parents, however, appear to face an increased risk of neglect and abuse (9, 38, 40). Because of parental incapacity, some of these children are placed in foster homes (15, 43, 59). There is little information about the extent to which social measures, other than the revocation of parental custody, have been taken in relation to these families. Of course the criteria for taking legal measures varies in different countries. Under the Swedish Child Welfare Act, the social welfare agencies have the responsibility of ensuring the safety and wellbeing of children. The legal measures which the welfare agencies may take to eliminate unsatisfactory conditions are primarily of a preventive nature. If these prove ineffective, the parental right to custody of the child may be revoked. The law provides a wide range of individual interpretation as there is no definition of the child's needs or of a minimum standard for the environment. There is a need for an analysis of maternal social risk factors which might be of special importance in the decision-making process concerning the custody of infants born to drug-addicted mothers. The process of drug addiction has been described in a conceptual model including three stages ( I ) . Even the termination of addiction -the deaddiction process-has also been divided into three phases (20). In one Swedish study, drug addicts tended to abandon their drug career either before 2 years or after 6 years of addiction (20). There does not appear to be any difference between the populations of heroin and amphetamine addicts as regards relapse frequency in comparable stages of the drug career. The conceptual model might