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How the Opioid Epidemic is Literally Changing Kids’ Brains

Nadine Burke Harris - opioid epidemic
*Photo credit: The New Yorker

While working as a pediatrician in a poverty-stricken neighborhood in San Francisco, Dr. Nadine Burke Harris saw many patients who had experienced trauma such as witnessing violence and abuse, having incarcerated parents and having caregivers with mental illness. Her discovery of the Adverse Childhood Experience (ACE) Study was the key to explaining why many of these kids weren’t developing at a normal rate. Burke Harris has since become a leader in the movement to transform how we respond to, treat and prevent childhood adversity. She was recently interviewed by Mother Jones, a nonprofit news organization, to discuss the developmental and physiological effects that the opioid epidemic is having on children. Below are some important responses to note. (The questions have been modified to show highlights.)

Nadine Burke Harris

Dr. Nadine Burke Harris

How does parental drug use affect a child’s development?

Dr. Nadine Burke Harris: “One of the very most important foundations of brain development is a phenomenon of serve and return. Babies look at their parents’ faces, and they coo or they babble or they make facial expressions. When you have a healthy caregiver, the caregiver will return that. And that actually serves critical function for infant brain development. If it doesn’t happen, that really harms infant brain development. So you could imagine that a parent who is impaired or clouded or blunted by heroin is not going to be doing as much of that serve and return.

Every time a child gets into a scary or dangerous situation, it activates their stress response. The repeated activation of their stress response is what leads to the biological condition that we, in pediatrics, are now calling toxic stress. Toxic stress are the long-term changes to not only brain structure and function, but also to the hormonal system, immune system, and even all the way down to the way our DNA is read and transcribed. And these changes lead to increased risk for mental health and behavioral health consequences—increased risk of depression, increased risk of suicidality, increased risk of anxiety. But also increased risk of things like substance dependence.”

What would be some differences between a child’s brain who has experienced trauma vs. one who has not?

NBH: “What we could expect to see is the activity and possibly the size of the amygdala (the brain’s fear center) would be increased. We would also expect to see decreased functioning of the brain’s pleasure and reward center. We might see impaired executive functioning: difficulty with a lot of the things that kids need to be able to sit still in class and pay attention. Impulse control, judgment, the ability to weigh and balance a bunch of different inputs at a time—and then figure out which one you’re going to do and follow through on that. Those are all executive functioning tasks. And those reside in the prefrontal cortex, so we might see decreased prefrontal cortical activity.”

Are trauma and parental drug use linked?

NBH: “Often times, as a society, we look at the parent who is addicted and we say “Oh my goodness, how could you do this to your kid?” But if you go back far enough in time, you’re going to find that parent when they were a kid, they were experiencing all the same things. And we know that an individual with four or more adverse childhood experiences is ten times as likely to be an IV drug user as someone with zero adverse childhood experiences. When we look at the folks who are using, we have to understand that this is a cycle.”

Read the entire Mother Jones article here: The Opioid Epidemic is Literally Changing Kids’ Brains 


The good news is that the brain can change, and it’s never too late for change to occur. The human brain is developing every second of every day, long into adulthood. It has the ability to grow stronger, learn how to solve complex problems and develop resiliency to bounce back after difficult situations.

Many health, education and social work professionals are working to put science into action in order to change lives. We need to commit more resources towards treatment and prevention, which will require creating infrastructure and environments that give all people better, healthier options. Learn more about how KVC is using neuroscience research to influence practice, policy and public decisions in order to help children and families who have experienced trauma.

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