Title: Opiate exposure in the developing brain and toxic stress in early childhood: How brain structure and function is altered and impacts life-long health

Mary Payne

Marshall University School of Medicine, USA


Mary Payne, MD graduated from medical school in 2002 from Louisiana State University. She then continued with a pediatric residency at Tulane University followed by a child neurology fellowship at Children’s Hospital of New Orleans. She has been faculty in the department of Neurology at Marshall School of Medicine since 2008. She treats patients with epilepsy, developmental delays, headaches as well as a myriad of pediatric neurology issues. Her research interests include neurodevelopment in infants born exposed to opiates and she coordinates multidisciplinary clinics for children born drug exposed. She also has a quality improvement study at her hospital reducing number of CT scans performed in children in the emergency room setting for mild brain injuries. Improving the developmental needs of children in the state is another area of interest for her, as she sits on the Early Childhood Advisory Council, appointed by the Governor. She has traveled with the CDC to study baby exposed to Zika in utero also.  She teaches students and residents in the departments of neurology and pediatrics and supervises students and residents in the outpatient and inpatient settings.


Toxins and stressful environments can alter brain structure and function. More importantly, the developing brain in utero is particularly susceptible to exposures to medications and substances of abuse. In my community in rural West Virginia, we have unfortunately experienced a dramatic increase in babies born exposed to opiates, among other drugs. We are approximately 20 times higher than the national average with these exposures. Prenatal brain development has been shown to be negatively affected by toxin exposure, however, many risks of polysubstance abuse are unknown. Furthermore, many of our children live in stressful home situations, whether it be drug use, poverty or inconsistent foster parenting. Persistent stress in early life also effects brain development and can alter long term functioning and adult health. This presentation will provide information on what is known about the developing brain and toxins during the prenatal period and early childhood and the long-term sequela.  Also discussed will be current observations from a multidisciplinary neurodevelopmental clinic in Huntington, WV and how the patient findings can be compared to what has been reported from past studies. Neonates, infants, toddlers and older children all have unique findings and issues related to in utero drug exposure and ongoing environmental stress.