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To the Editor: In her Editorial about the possible causal mechanisms of drug addiction, Dr Kandel¹ did not discuss the risk associated with prenatal administration of opiates or sedatives. Several studies^2-4 have found that administration of these drugs during labor is a risk factor for later addiction in adolescence or adulthood. Not only have these studies found a dose-response relationship between drug exposure and subsequent risk of drug addiction, but also have the advantage that the perinatal drug exposure is limited to a few hours during birth. This restricts the range of confounding factors (eg, socioeconomic status or residential environment^5-6) that can possibly moderate this long-term effect. Since any drug administered prenatally would be expected to cross the placenta about equally to twin fetuses irrespective of whether they are monozygotic or dizygotic twins, such an explanation is consistent with the observation that no differences were found between these 2 . . . [Full Text of this Article]

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