Words matter. So when The Courier-Journal published Laura Ungar’s timely article on “addicted” babies, I seized the opportunity to clarify the terms: physical dependence and addiction. They are not interchangeable and the difference is important…

Letter to the editor, published in The Courier-Journal, March 19, 2014:

Every hour a baby is born in this country to a mother who is abusing drugs. Thank you, Laura Ungar, for shedding light on the problem in Sunday’s Courier-Journal. However, the word “addicted” in the title is misleading. Addiction is a chronic disorder involving the reward circuits of the brain, leading to: craving, emotional dysfunction, and continued use despite harm.

A fetus exposed to the mother’s drugs may be born “physically dependent,” which, while horrible, is temporary. Anyone can expect to become physically dependent on a drug they take for a long time.

And withdrawal can be severe, but when it is over it is over. In contrast, the disease of addiction is a chronic condition that, without treatment, is progressive and can result in lifelong disability or death.

Almost all addicts have been physically dependent on drugs, but vastly fewer people who find themselves “physically dependent” on drugs (i.e. pain patients) are addicts. None of the babies born physically dependent can be considered “addicted.”

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James Patrick Murphy, MD

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My letter was in response to this article:

Kentucky addicted babies increasing despite pain-pill crackdown

by Laura Ungar, lungar@courier-journal.com 9:02 p.m. EDT March 14, 2014