Pubdate: Sun, 27 Jul 2003
Source: Courier-Journal, The (KY)
Copyright: 2003 The Courier-Journal
Author: Javacia N. Harris, Associated Press


Prescription-Drug Abuse Takes Wider Toll in E. Kentucky

WHITESBURG, Ky. - As a nurse in Eastern Kentucky, Diane Watts is all
too familiar with the ear-piercing screams of drug addicts suffering
through withdrawal.

Comforting them through the pain and tremors has become a regular part
of her job in the obstetrics unit at Whitesburg Appalachian Regional

The number of infants born addicted to prescription drugs such as
OxyContin and methadone has sharply increased over the past year. In
the newest twist to the prescription-drug epidemic in the mountain
region, hospitals have found themselves doubling as detoxification
centers for babies hooked on powerful narcotics.

"From May 1998 to May 2002 we delivered three babies that were born
addicted," Watts said. "But from May 2002 to May 2003, we saw 24
babies born addicted."

The increase in addicted babies is part of the legacy of adults' abuse
of OxyContin and other prescription drugs. Scores have been jailed for
trafficking in painkillers, and several physicians have been indicted
on charges of allegedly overprescribing drugs.

Watts, the hospital's nurse manager of obstetrics and pediatrics, said
her staff began to notice an increase in the number of babies born
addicted to narcotics in November 2002, and began testing all
expectant mothers for drugs.

Doctors at the University of Kentucky Family Practice Center in Hazard
also started screening more of the center's obstetrics patients for
drug abuse after four drug-addicted babies were born in February, said
Dr. Chandramohan Batra, who worked at the center until last month.
Physicians at the Family Practice Center, a division of UK's Center
for Rural Health, deliver only about eight babies each month, he said.

Doctors at the UK Medical Center in Lexington also have seen an
increase in babies born addicted to opiates. Dr. Henrietta Bada, chief
of the division of neonatology, said in 1997 the neonatal intensive
care unit reported two babies exposed to opiates. From 2001 to 2002
that number increased to 20.

At Pikeville Methodist Hospital, the percentage of addicted babies
jumped from 3 percent of the 200 treated each year in the neonatal
intensive care unit to 6 percent in the past year, said Dr. Ruth Ann
Shepherd, a neonatologist.

Watts said caring for drug-addicted babies can be physically and
emotionally draining.

"You have to hold them a lot," she said. "Babies experiencing drug
withdrawal are very irritable and hard to comfort. They have this
high-pitched cry and they're very jittery."

Drug-addicted babies also have trouble sleeping, eating and even
breathing, Watts said.

"You can hear this unusual snoring sound when they breathe," she

Nurses comfort the infants as much as possible and keep them in a
quiet place, Watts said.

"Most drug-addicted moms are in denial, and they think that if they go
to a clinic it will be OK," Watts said. "The parents don't think the
effects are that serious."

But withdrawal symptoms can be severe, including tremors and seizures,
she said. Doctors have also seen an increased incidence of sudden
infant death syndrome in babies addicted to methadone - which is the
drug most commonly seen at the Whitesburg hospital, Watts said.

Babies suffering from severe withdrawal symptoms are placed on
phenobarbital, Watts said. The drug can help the babies eat and sleep
better and reduce the excessive sweating that is another withdrawal

Improvements can be seen within 24 hours of the first dose, but the
recovery process is long for infants. The babies are given the
medication for at least a month.

"The parents think the withdrawal will last only a few weeks and then
everything will be fine," Watts said. "But it's not over in two to
three weeks."

Compounding the problem, Shepherd said, is that some mothers don't
seek prenatal care because they don't want doctors to know they abuse

"If they admit that they're taking drugs, they feel like they're
threatened and the baby may be taken away," she said.

Rachel Breeding, a caseworker at the Whitesburg hospital who is
responsible for placing drug-addicted babies in safe homes, said
drug-addicted mothers and their babies are referred to social workers
at the Kentucky Cabinet for Families and Children to determine if it
is safe for the child to go home.

Breeding said most infants go home with a close family member, which
allows the mother to have an active role in the child's life while she
gets treatment for her own addiction.

"If the mother is seeking help, she will get it," Breeding

Glenda Banks, a state welfare worker, said counseling and other
services are provided to mothers trying to rid themselves of drug
addiction. The home will be monitored closely to make sure the child
is safe, but the goal is not to take the child away from the mother,
she said.

Watts said the hospital's main goal is to help the baby get well.
"Nothing we do here is meant to take that child away from that
mother," she said. 
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