Pubdate: Sat, 14 Jan 2017
Source: Courier-Journal, The (Louisville, KY)
Copyright: 2017 The Courier-Journal
Author: Laura Ungar


The days-old newborn shook and screamed, his tiny chest fluttering with
rapid breaths. Even his mother's arms couldn't soothe him.

Withdrawal from heroin was Jordan Barkley's first experience of the world.

His mom, Amy Kalber, shot up every day for most of her pregnancy. The
drugs coursing through her body sickened Jordan, who spent seven weeks in
neonatal intensive care, suffering from diarrhea and tremors, sucking on
morphine as he weaned off the heroin.

"It breaks my heart. It really does," said Kalber, 33, who is now in
recovery. "I just couldn't stop. With heroin, you have to do it. You have
to get it. It doesn't stop."

Kalber's story is all too common in Kentucky.

A recent research letter in the journal JAMA Pediatrics says the state had
more than twice the national rate of drug-dependent babies in 2013, the
most recent comparable year - 15.1 cases per 1,000 live births when the
U.S. rate was 7.3.

Both were up substantially from five years earlier, and Kentucky's rate
jumped another 40 percent the following year.

"We have mothers who are addicted throughout pregnancy and their addiction
is more or less passed down to their babies," said Joshua Brown of the
Institute for Pharmaceutical Outcomes and Policy at the University of
Kentucky, one of the authors of the research. "The trend just keeps going
up and up and up."

In 2012, The Courier-Journal broke the story of a 2,400 percent, 11-year
rise in Kentucky hospitalizations for drug-dependent newborns, becoming
one of the first media outlets in the nation to shine a spotlight on the
issue. And the numbers have just continued to skyrocket, with 1,234
drug-dependent infants reported to the state health department in the year
ending July 30, 2015.

"We've had one of the country's worst prescription drug problems," which
has spawned a burgeoning heroin epidemic, said researcher Jeffrey Talbert,
who directs the pharmaceutical institute. "We need more treatment
providers and more access to care."

A Courier-Journal analysis of U.S. Substance Abuse and Mental Health
Services Administration data shows only 30 of the 123 substance abuse
treatment facilities in Kentucky accept pregnant or post-partum women.
Only eight are long-term residential programs.

Kalber landed a coveted treatment spot shortly after Jordan's birth in
2011 and spent nine months getting clean through a Volunteers of America
program for pregnant and postpartum addicts called Grace House.

She said that's what saved her and her family -- a sanctuary and God's grace.

Growing up in Virginia with an alcoholic single mom, Kalber smoked her
first joint at age 11.

She did it to fit in with older, popular girls, and still recalls the
escape, the feeling "everything was better."

She quickly began popping pills that she'd find in friends' medicine
cabinets. By 13, she was drinking and using crack cocaine, getting high in
school bathrooms. At 14, she stole a car with a friend and drove it to
Georgia. By 19, she was pregnant by a boy she met in a school for troubled

Kalber cut back on the drugs during that pregnancy but admits using the
anti-anxiety medicine Xanax two or three times and drinking a handful of
times. She said her daughter, Luca, probably had drugs in her system but
wasn't tested and seemed fine.

Within a couple months of the birth, Kalber was using all sorts of drugs
again -- including, for the first time, cheap and available heroin.
Sometimes she dragged Luca along as she wandered from place to place, she
said, and sometimes the baby lived with her grandparents.

Kalber's addiction raged for five years, and in 2009, a friend brought her
to the doors of the Healing Place in Louisville in the hopes she would get
sober. She didn't. She met fellow addict Chad Barkley there and eventually
became pregnant with Jordan. Pregnancy didn't stop them from shooting up
heroin every day. They often downed Beam's Eight Star 80-proof whiskey,

Drunk and high much of the time, the couple got evicted from two places
and wound up in a threadbare shack behind an abandoned apartment complex
with no water or electricity. Knowing she was hurting her unborn baby,
Kalber tried three times to get clean at JADAC, now Centerstone Addiction
Recovery Center. She left each time.

One February morning, she woke up in the cold shack, her water breaking.
She knew she should get to the hospital, but didn't go right away.

She needed a hit of heroin first.

At University of Louisville Hospital, Kalber tested positive for drugs.
And when Jordan was born at 11:30 that night, the nurses and doctors only
let her hold him for a few minutes.

"We're sending him off," she recalls one of them telling her. "He's sick."

An emergency custody hearing was held at the hospital, and Jordan was
assigned to a foster family. Kalber took a few trash bags of clothes --
all her belongings -- and went to The Healing Place to detox. But before
going in, she sat in the parking lot and "just drank and drank."

Exhausted after the detox program, Kalber made a desperate call to
Volunteers of America, telling them: "My son needs help. I need help."
VOA's program often has a waiting list 20 to more than 30 names long, but
luckily had a bed.

"It was like a home" that also offered recovery meetings, parenting
classes, and relapse prevention, she said. "It was so clean and safe and I
slept in a clean bed."

Researchers and experts say the only real way to bring down the numbers of
drug-dependent babies - aside from reducing Kentucky's overall drug
problem -- is to provide more care for moms like Kalber.

"Let's get people drug treatment," said Jefferson Family Court Chief Judge
Paula Sherlock. "We may need to get them help with housing as well."

There are signs of progress.VOA has closed Grace House but runs a 20-bed
facility called Freedom House and plans to break ground in March on a new
facility on Second Street that will open in the summer and serve 16 more

In 2015, Kentucky became one of 11 states to receive up to $3 million in
federal grants to provide expanded treatment to pregnant addicts. That was
in addition to $1 million in state funds for transitional care and other
services that came from an appropriation in the anti-heroin bill passed
that year. And on Wednesday, state officials announced they will apply for
up to $10 million in federal SAMHSA funding to fight the opioid epidemic,
and one of their priorities if they get it will be to help pregnant

On a federal level, the Protecting Our Infants Act of 2015, co-sponsored
by Sen. Mitch McConnell, R-Kentucky, calls for, among other things,
spreading proven practices to prevent and treat maternal opioid abuse and
recommendations for treating drug-dependent infants.

But researchers said far more drug treatment is needed in Kentucky, as
well as more research and help for babies. Long-term effects remain
largely unknown, although some research has linked drug-dependence at
birth to Attention Deficit and Hyperactivity Disorder.

Jordan, now a 5-year-old kindergartener at the Brown School, has ADHD but
is in therapy. He's rambunctious, intelligent and loves indoor sports and
fishing with his dad.

Kalber said she's worked hard to give him a stable life since those early,
chaotic days. She and Barkley, who is also in recovery, are still together
and envision getting married someday. She's a case manager at Choices, a
program for homeless women and families, and he installs floors. They live
in a small rental house near Churchill Downs, and both are now studying at
U of L's Kent School of Social Work. They go to 12-step programs and help
other addicts.

Since Jordan was born, they've had two more children, both born healthy.
On a recent evening, Kalber cuddled baby Marty in her arms as 3-year-old
Rori played with a cell phone on the couch.

"These two have never seen a drink or a drug," she said.

And she's determined they never will.
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