Prenatal Overdose Rejection Syndrome

A paper on how prenatal drug use and overdose traumatize a new life before birth

As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition second to his parents’ homelessness, felt the poisonous effects of multiple substance abuse, and was the victim of the subsequent, injurious, powerful negative stress hormones pulsing through his mother’s veins.

The Origin Of A New Trauma-related Diagnosis

Addiction and overdose result in deep shame, guilt, and fear for persons suffering from addiction.

Most addicts report a heavy burden of anger and disgust for themselves for their addicted state. Subsequently, they acknowledge an absence of self-worth, which perpetuates hopelessness, low initiative for self-care, and an outward disregard for their lives and health as a way to offset dealing with the deep trauma roots of addiction.

A drug-addicted lifestyle is harder on the soul and body of an addict than on the people who love them, although family and friends suffer inexplicably living with and observing a loved one’s addiction.

However, there is a significant other victim of addiction who is most often never even acknowledged until the damage done to them is permanent. This person receives every spiritual, psychological, and physical impairment that the person in addiction experiences in active addiction and overdoses, but is incapable of processing or recovering from the events.

These lives helplessly experience repetitive, excessive drug use, and very often, overdose, in their body and mind. They can not escape the experiences or the source of those experiences and are unable to tell anyone or ask for protection from the effects of another’s drug abuse.

This is because they are not yet born.

How Excessive Prenatal Exposure To Drugs and Overdose Physiologically Affect A Newborn:

An addict’s excessive drug use is an overt sign of self-rejection. The user may not perceive initially that this is an originating factor of their addiction because there are many other valid facets to addiction.

However, a tragic consequence of addiction-related self-rejection is the destruction of innocence, both of the using individual and of any child growing in the womb of a pregnant addict.

A fetus has every capability to perceive love, affection, and its hopeful birth as it does to receive the innate rejection, disregard, and neglectful abuse occurring in substance abuse overdoses and drug abuse during its womb experience.

What transpires physically to the child through the onslaught of poisonous substances in-utero creates the intrinsic knowledge or perception that it is unwanted, alienable, and dismissible as being worthy of concern and love.

This is how addictive drug use causes any addict to feel. This deep trauma belief is transferred to the unborn through brain synapses, hormones, and the connective spirituality between mother and child.

My own grandson has been born from a severely multi-substance exposed pregnancy. Once home from the NICU, this tiny human being wore the look of the sadness and devastation of his intra-uterine experience in his countenance. I had never seen anything like it. It scared me to the core.

My experience with the result of a loved one’s addiction leads me to educate readers on the tragedies of prenatal opioid and substance abuse.

In my work as a NICU nurse, what always struck me about our “drug babies” was their direct inability to readily accept the human touch. I recognized that although sensory and neurological issues were a major component of that born trait, the inability to want or accept human touch was also resultant of the prenatal rejection occurring through pregnancy drug use and overdose.

They would grimace from touch first, as it appeared to hurt. Watching a new child recoil from another human being’s affection is heartbreaking.

An initial diagnosis of NAS or NOWS is not the separative long-term condition that these children go home with. Most NAS symptoms, some of which initially coincide with PORS symptoms, dissipate after several few weeks.

Most times, these babies were discharged home screaming, red-faced, uncomfortable, and heavily medicated. Their parent(s) would never have the patience and wherewithal to care for them, while still in active addiction or early recovery.

These children begin their fragile lives with both a biological and physical understanding/belief that life is pain, an intrinsic search to end that pain (which becomes a future central focus of existence), an inability to independently stop the physical and emotional pain of rejection (which creates a subhuman existence) and a disconnect from intimacy and self that permanently alters their perspective on self-worth, purpose, and trust for humanity.

Why Medical Intervention is Imperative in PORS and Active Parental Addiction

There are now new trauma classes for foster families accepting children from homes of drug use and other abuses, but few are well versed, if at all, on the subject of prenatal exposure to excessive substance use and overdose-related PTSD or the resultant rejection component in the newborn.

This is because the conditions in this delicate population are not yet medically recognized, documented, and treatable pediatric diagnoses.

It is especially not yet widely recognized that these brand new lives have severe PTSD.

Few professionals have or seek research on this.

Even with today’s recent increased trauma research, both the medical community and society seem to pull a sheet over both the inevitable and unexplainable realities occurring to a human being from prenatal drug exposure.

When medical professionals happen to note both the discord in the addict’s parental dynamics and in how prenatal and postnatal drug addiction (at home) affects those babies conceived in addiction, it is common to see the multitudinous signs and symptoms in a child who is suffering from PORS, dismissed as non-related diagnoses.

CPS can and will not intervene in most cases where a mother does not show up positive for substances at birth or just before. Addicts know to circumvent the system. Who confirms that she is sober a few days prior to the test and several days or weeks after discharge?

For the most part, no one.

An addict traditionally does not get sober during pregnancy just because an innocent life is at stake during or after childbirth.

Overall, there is little intervention from the medical community to acknowledge the delicate situation these children are born into or to actually protect their vulnerable and damaged lives from further damage.

Many times, it seems that this lack of response may stem from willful and/or fearful ignorance to address addiction and an age-old stigma that since an “addict begats an addict,” why intervene?

Few medical providers understand the devastating and insidious nature of the addicted mind. Many do not comprehend the further and continuing damage that occurs to a child who goes home to addiction in a post-exposure crisis medically, emotionally, and physically.

As a result, the formation of special parenting techniques is not addressed through counseling/therapy and things such as specialist referrals are not made or followed through with, compromising the child’s health and safety further.

Persons with an addiction can get better and someday give good care to and parent their child well but, in my experience and opinion as a nurse and observant custodial grandmother, the formative years of the child should not be under the care of addicts (even “functioning” ones) or newly recovered ones.

When an addict is in recovery, they learn that they must focus on themselves and their sobriety first and always to keep themselves in check to stay sober. Decisions must be made that leave out other members of that addict’s family and other life priorities in lieu of the priority of sobriety.

Only time, maturity, and experience weaving the recovery program’s requirements into all aspects of the addict’s life will eventually allow for that addict to be able to properly care for others, and achieve the self-awareness and discipline to do so while maintaining sobriety.

My professional and personal experience so far is the observation of the passive omission of the medical community to take initiative to reach out and engage these parents in any appropriate discussion or intervention of the care of their PORS-affected newborn, or the desperate need for addiction services.

Addressing Latent Effects of PORS and An Addicted Parental Response

A healthy baby whose pregnancy is free of substance abuse requires full-time, attentive, round-the-clock care.

A newborn who is riddled with the physical, mental, and emotional after-effects of prenatal substance abuse requires scrutiny and intervention in every aspect of care and an intimate understanding that their responses to everything around them are woven with distrust, fear, and disconnect.

In most cases, the obvious emotional and physical problems cannot be handled safely or appropriately either by addicts who remain in their addiction or by recovering addicts who are less than 1–2 years stable into their sobriety.

Beginning in the early months after birth, it takes a gentle hand, a calm demeanor, an overly attentive approach, and an excess of undistracted care to settle and restructure these children’s spirit after their womb trauma.

Keep in mind, rejection is a foundational component of their physical, mental, and emotional makeup.

The latent effects of this condition pose further danger to a child as they grow and age as most parents in recovery or in active addiction, will not recognize or understand prevailing and insidious symptoms such as the presence of sensory deprivation/overload, general sensorial problems, neurological delays, night terrors, processing disorders, speech/choking swallowing disorders and other serious maladaptations resulting from prenatal drug use and overdose.

Some of these diagnoses could take months or a few years to become visibly evident, although many are present right after birth.

This places the child in yet another traumatic situation because the uneducated, (uneducated to the problems associated with the diagnosis) addicted or sober parent is again, not traditionally sought out by the baby’s or mother’s medical professionals as an interventional risk or for the teaching of the probable issues to come.

Addicted or recovering parents are prone to getting angry easily (which is a result of their complicated mental and emotional condition in addiction) at the distracting crying, incessant need to eat and be soothed, or the refusal to eat and be held, as well as frequent illnesses.

What commonly happens in the manifestation of symptoms, is the parent(s) will react to the “irrational,” confusing behavior and excessive needs of the child and not to the cause of either. Subsequently, several types of abuse are common to occur, as the baby or older child’s behavior is intrinsically misunderstood.

Parents in active addiction or early recovery will usually misunderstand telltale signs that the baby is in need of a different kind of intense and patient parenting. The parents also do not have the ability in their current state to process or act on the needs of their child.

In one particular NICU environment I was employed in, the staff would read the city’s newspaper weekly on the unit to note which of our discharged babies had died by abuse or neglect. It was that common.

Others ended up in our emergency room completely malnourished and in active severe dehydration. Some made it, some did not.

The medical community as a whole must urgently re-examine the entire and intricate phenom of addiction. We must seriously re-examine sending a drug and overdose-exposed infant home to the people who had damaged them in utero, despite their “cleaned up” appearance and promises, and even despite any recent positive recovery status.

The menace that is relapse is an overshadowing, lurking danger, historically, and must be monitored very closely for a newly sober parent.

Self-coined Prenatal Overdose Rejection Syndrome Diagnosis.

Separate from my extensive nursing experience, I have gathered an immense amount of professional and personal expertise in managing, caring for, and in raising a child born into a heroin and meth addiction.

I noticed the symptoms of PORS in my professional career, but it was not until Charlie, my own grandson, was born from severe addiction that I could pen an actual name for the postnatal (and beyond) symptoms that I was seeing.

I have had legal custody of him since his fifth month of life. Charlie grew in-utero in my home from 28 weeks, was born at 38 weeks, and subsequently endured a month-long NICU stay and then was discharged to my home under the care of his birth mother and my youngest son, his father.

Both Charlie’s parents continue to struggle today with their recovery from heroin and meth, but for all their positive efforts (five years later) neither are in any kind of emotional or physical condition to parent Charlie and will not be for a long time, if ever.

During the pregnancy, in a rescue attempt to get help for her and for Charlie, I insisted that my grandson’s birth mother inform all her doctors and prenatal specialists of her heroin and meth addiction.

However, her specialists were not concerned.

They did not intervene and did not question her or even address her obvious positive drug screens occurring before her 28th week.

Not only was she not flagged as a risk to the baby at and after the birth, but the delivering ob/gyn actually told her that heroin and meth were not known to hurt a baby, so he “should be fine.”

This ridiculous and irresponsible line of thinking and under-education on this doctor’s part is reprehensible and did prove to be tragically wrong. Charlie was born with Gastroschisis, requiring immediate surgery after birth, and was subsequently diagnosed with 12 independent diagnoses.

Now, Prenatal Overdose Rejection Syndrome is an additional, undocumented and unrecognized problem I manage in his care and a focal point of intervention in his life.


Charlie displays a constant need for reassurance of each family member’s role and connection with each other and to secure the idea that he and everyone “go together.” He continually looks for his proper place in the family, as it is clear he feels “out of place,” in general.

He is now almost five years old. Until very recently, he was inconsolable if I was not within sight and behaved as though he believed I was gone for good. This fear of abandonment began at birth. The few months his parents cared for him only cemented his fears as they did not know how and were not focused on meeting his needs…and they had both secretly returned to using just after he came home.

Charlie additionally had sudden, unexplained fevers, frequent illnesses (every 3 weeks almost on the dot) including pneumonia, RSV, strep, and other general maladies. He woke six to seven times a night, screaming inconsolably much of the time.

When a little older, he would hit himself when even gently corrected or if any situation seemed to place him in the spotlight for any reason. These issues are still present but improved now.

Charlie screams and talks angrily in his sleep often, now and seems to have dreams in which he is being threatened or attacked, as evidenced by this sleep speech and cries.

I sincerely believe this has to do with his prenatal and post-birth experiences with substance abuse, overdose, and the irresponsible, incomplete care he received from his parents in the first few months of his life.

For all the physical, neurological, and emotional difficulties (there are many more diagnoses), the most noted after effect of his prenatal exposure and trauma is his noticeable sense of rejection.

I am very careful in my one on one handling of his body when he walks and moves, as any accidental brush, scrape, or slight knock (think of getting a child into a car seat, dressing, or just moving about in general in the home) to his person sends him into a screaming fit, hitting himself.

The expectation of rejection and mistreatment is in his eyes, despite all my expressed care and love for him. I have also seen the same look in the eyes of other special needs children, both in my pediatric career and presently in other children attending therapy appointments at our therapy clinic.

Many things in a human being’s life can cause the rooted belief of unworthiness. It is incomprehensible that a developing fetus can be so poorly treated in the womb that this kind of root would begin before a first breath in the world, but it is an unfortunate reality.

Signs of PORS: (some can be characterized under other diagnoses as well)

If the caregiver/parent/grandparent of a child who suffered prenatal drug abuse and overdoses recognizes some or any of the following signs, immediate PCP’s therapy and developmental delay referrals needs to be made:

  • excessive separation anxiety
  • frequent night terrors
  • social distancing from peers (can be observed as early as 12–18 months)
  • delayed or difficult speech and conversation
  • frequent, unexplained illnesses
  • any purposeful self-injury
  • the appearance of being persistently sad, aloof, disengaged or if they appear overexcited, excessively talkative ie: like the Energizer bunny and they are in a noticeable state of stress)
  • anything else that appears to be “odd” or out of sorts with their communication methods, thought processes, and reactions to everyday activities and stressors.
  • subtle and overt signs of problems processing daily communication and information, discipline, and social expectations. *
  • Congenital mobility problems: weaknesses in various parts of the body showing as imbalance, toe-walking, odd gait, frequent falls, weak extremities, etc.

As a fetus, Charlie endured hearing his mother gasp for life during three heroin overdoses, heard the constant fighting and screaming between his birth mother and my son, endured severe malnutrition, felt the effects of multiple substance abuse, and was the victim of the negative stress hormones pulsing through his mother’s veins caused by the distinct chaos of another’s addiction.

Again, I continue to observe that the PORS phenomenon with all its nuances is not considered even when clinicians do work with addicts and their children. The effect of an addict’s life and abuse on the fetus is not addressed head-on.

Medical providers are bound to the search and research of best care and we are trained to unturn every stone for solutions and resolutions. If this is not accomplished, there are dire consequences for a patient who has experienced prenatal exposure to drugs, and especially, severe cases.

This type of unborn life, this type of prenatal rejection, affects the child’s whole physical, mental, emotional and spiritual makeup.

It is a permanent, invisible disfigurement.

Suggesting Further Solutions:

As with any health problem in our world, one effective and necessary solution is education, which is the purpose for my piece on this under-recognized and hugely epidemic medical and social problem.

Active and sober addicts, the parents and caregivers of the affected babies and children, and other involved (and medical) parties affected by Prenatal Overdose Rejection Syndrome need to be educated on the signs and symptoms of this not-yet-diagnosed condition.

Immediate, compassionate and consistent intervention should unequivocally begin at the positive test for pregnancy in an addict. As much as we, the medical community, can do to help that mother obtain permanent sobriety, we should do.

All parties affected by and involved in the care of Prenatal Overdose Rejection Syndrome also need a voice as a way to heal, educate, and be educated to implement treatments and cares and advocate for new research into this devastating issue. This begins by assessing, triaging, monitoring, and providing the utmost, loving and creative care are for these populations, as we are capable of.

This happens through the willful and purposeful engagement of physicians and other medical providers to swiftly address the symptoms of addiction in the parent and those of the child born out of that addiction. Researching and documenting these mental health and physical conditions and presentations is most imperative.

To summarize

Unborn babies in the womb of an active addict are the most at-risk type of patients in society and the medical community due to the inability of this type of patient to advocate for themselves and the inability of the addicted parent (s) to advocate appropriately for either of them.

The lives and health of these babies are severely compromised before birth. They are discarded and rejected prior to life outside the womb through the use and overdosing of substances, whether intentionally or neglectfully done.

Until research on the full psychosocial, psychological, and coinciding physical and emotional prenatal effects of drug use and overdose is addressed thoroughly, and protective measures for the unborn experiencing this abuse are put into effect, many an unborn child in the womb of an active addict will be plagued with a consciousness of intrinsic and lasting rejection before they are even seen or held.

This is unacceptable for our children and grandchildren and for any new human being.


Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Christina Vaughn
Christina Vaughn
Medicine, wellness, mental health, addiction, and parenting. See my blog Published Amazon author: Of Death and Brokenness. License number is 175694 with the Texas BON. Graduated from Austin Community College (ACC) in December 1999.
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