James Swain, MD, PhD, a clinician-scientist of the Department of Psychiatry and Behavioral Health and the Department of Psychology at Renaissance School of Medicine at Stony Brook University has received a $3.5 million federal grant to study how the brain governs maternal caregiving/behaviors for mothers undergoing buprenorphine treatment for opioid use disorder.
The grant, which began on September 30, 2019, is for five years and was awarded by the National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA). The research is titled, “Opioids and maternal brain-behavior adaptation during the early postpartum” (1R01 DA-047336-01).
The study will compare a group of postpartum women with opioid use disorder to a group of women who suffer matching levels of depression without opioid use disorder.
Opioid Use Disorder (OUD) is a fast-growing and devastating epidemic in the U.S., affecting a high proportion of child-bearing women, with many also suffering from mood disorders. The use of opioids (illegal or prescribed) during pregnancy may cause what’s known as neonatal abstinence syndrome (NAS) – a group of conditions caused when a baby is born and withdraws from certain drugs they are exposed to in the womb before birth. In addition to opioid use, NAS also can be caused by alcohol, stimulants, marijuana, nicotine, barbiturates or benzodiazepines (sleeping pills). When you take these drugs during pregnancy, they can pass through the placenta and cause serious problems for your baby --- including becoming dependent. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord. The untreated use of opioids and dependence on opioids involves repeated cycles of withdrawal for new mothers, and may impair mother-baby interactions.
“Opioid Use Disorder and related problems like postpartum depression are linked to higher risks of parenting problems, child abuse (physical and emotional), and the costly use of foster care,” said Dr. Swain, who is the principal investigator of the study. “Buprenorphine treatment reduces withdrawal symptoms and other adverse effects of illicit opioids for women in the later stages of their pregnancy and the postpartum. However, the effects of buprenorphine treatment on a new mother’s responses to and behavior towards their newborn infant in the context of opioid use disorder are unknown. “
The study will use structural and function MRI (magnetic resonance imaging) of the brain at different intervals during the first six months postpartum, coordinated with measures of mood and behavior. Dr. Swain's team includes co-investigators from Stony Brook's Department of Psychiatry and Behavioral Health (Helen Fox, PhD; Brittain Mahaffey, PhD; S Shaun Ho, PhD; and Joseph Schwartz, PhD); Stony Brook's Department of Obstetrics, Gynecology and Reproductive Medicine (David Garry, DO); and Tufts University Department of Biomedical Science (Elizabeth Byrnes, PhD).
Based on their preliminary research and preclinical models, Dr. Swain’s team hypothesizes that buprenorphine treatment in opioid use disorder may increase maternal brain circuit activity, yet also risk adverse side-effects on parenting.
If the hypothesis is proven to be accurate, it could lead to the establishment of a brain mechanism to validate beneficial and adverse effects of opioids and open the door to study and enhance current approaches to treat mothers with opioid use disorder with a specific brain mechanism, and ultimately offer recommendations on how to best manage a range of postpartum mental health issues and infant outcomes.
About Dr. Swain
As a clinician, Dr. Swain provides psychiatric care for children and families and families suffering mental health problems. As scientist, he studies the brain-basis of parent-infant bond formation and child outcome as a function of mental health problems and solutions for issues such as stress, depression, anxiety, poverty and substance use. Learn more about Dr. Swain's many research studies and lab activity.