Pubdate: Sun, 27 Jul 2003
Source: Lexington Herald-Leader (KY)
Copyright: 2003 Lexington Herald-Leader
Author: Javacia N. Harris, Associated Press


Units Have Become Detox Centers for Newborns Exposed to Narcotics

WHITESBURG - 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 like
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 detox 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 abuse by
adults of OxyContin and other prescription drugs in the mountain
region. Scores have been jailed for black-market trafficking in
painkillers, and several physicians have been indicted for
over-prescribing drugs.

Watts, the nurse manager of obstetrics and pediatrics at the
Whitesburg hospital, 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 its obstetrics patients for drug abuse
after four drug-addicted babies were born in February, said Dr.
Chandramohan Batra, who worked at the center until June. Physicians at
the Family Practice Center, a division of the University of Kentucky's
Center for Rural Health, deliver only about eight babies each month,
he said.

Doctors at the University of Kentucky Chandler 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 that in 1997 the neonatal intensive care unit saw 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 hospital's
neonatal intensive care 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 working with these babies 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 Whitesburg ARH 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 help reduce the excessive sweating that is another
withdrawal symptom.

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

"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 Whitesburg Appalachian Regional
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 whether 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.

"We try our best to keep families together," Banks

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. "The intent is to treat them."
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