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The Springfield News-Sun digs into important stories about public health in Clark and Champaign counties, including recent stories about teen pregnancy and mumps outbreaks.
As illegal drug use has skyrocketed in Ohio and nationwide, Clark County has seen a growing number of babies who are born addicted.
Many have to be weaned off the drugs for weeks with doses of methadone, morphine or phenobarbital, and require extended hospital stays that drive up the cost of medical care.
Ashley Sherrock’s daughter was born six weeks early, she appeared drunk and screamed throughout the night at the hospital.
The infant was going through withdrawal from heroin, painkillers, crack and other drugs that Sherrock ingested throughout her pregnancy.
“It was horrible,” said Sherrock, 27. “She was always out of it. Normally, when you have a baby, you see their personalities right away. She came out and she was just not there.”
More than 5,100 newborns tested positive for illegal drugs in Ohio and were diagnosed with neonatal abstinence syndrome or NAS between 2004 and 2011, according to a survey recently released by the Ohio Department of Health and the Ohio Department of Mental Health & Addiction Services.
It is a syndrome that occurs in newborns exposed to opiates and other addictive drugs while in the mother’s womb.
In 2004, 199 babies were treated for NAS at Ohio hospitals. By 2011, the numbers ballooned to nearly 1,200.
The Springfield Regional Medical Center began drug screening for all mothers and babies in 2013 due to the increasing number of babies who tested positive for drugs.
In 2011 Clark County Children’s Services received 55 referrals after a positive test from area hospitals, including 13 babies who had been exposed to opiates.
Last year, 92 were referred to Children’s Services from local hospitals, including 18 cases with babies who tested positive for opiates.
Forgotten casualty of drugs
The cost of treatment for drug-exposed babies is typically five to seven times more than the care for all infants and has also taken a toll on the health care system, according to the survey.
Medical costs for NAS treatment accounted for more than $70 million in charges and 19,000 days in Ohio hospitals in 2011.
Medicaid was the primary payer for the medical bills.
Drug-addicted babies are often a forgotten casualty in the drug epidemic, said Dr. David Yohannan, of Pediatrix Medical Group at Springfield Regional Medical Center.
Many Ohio hospitals are increasingly screening all mothers because some drug-exposed babies have gone home, Yohannan said, delaying the treatment of withdrawal.
“Not all mothers will admit to taking medications of any kind and that means some of these babies were not observed close enough, only to be readmitted with more serious withdrawal symptoms,” Yohannan said.
Hospitals that care for drug-dependent newborns must adopt a screening tool, such as a Finnegan score sheet, a withdrawal scoring system that measures different symptoms such as tremors and high-pitched crying.
Dr. Yamini Teegala, medical director at Rocking Horse Community Health Center, said physicians develop a discharge care plan based on the baby’s score.
“The care plan depends on the substance used,” Teegala said. “It has been surveyed that possibly opioids and methadone and heroin are the top three (substances used) with … prescription opioids being the top one.”
Shelley Robbins, a Rocking Horse nurse coordinator for children in foster care, teaches caregivers how to comfort drug-exposed babies through a program at the health center.
Babies typically begin showing withdrawal symptoms between 24 hours and five days after birth. The symptoms include excessive high-pitched crying, tremors, rigid limbs, convulsions and seizures.
The babies can be inconsolable. They can suffer from sensitivity to light and sound, struggle to latch on to a bottle and they may draw their knees to their abdomen due to the pain, Robbins said.
“These babies struggle. They really struggle,” she said.
Infants can be weened off drugs with methadone or phenobarbital typically between eight and 16 weeks, Teegala said.
Rocking Horse tracks drug-dependent infants through their first year of life, she said, and the center is one of the limited resources available in the community to treat them.
“It is a high risk population. It takes time. It takes manpower. It takes a lot of research, knowledge and commitment to take care of any high risk population, let alone being a baby. It takes a commitment,” Teegala said.
Custody often lost
Mothers who are severely addicted to drugs and deemed unfit to care for an infant often lose custody of their children, said Denise Estep of Clark County Children’s Services.
“If they have a daily use (drug habit) that they’re trying to keep themselves from getting sick so they’re going to have to use, it’s a no go. The baby cannot go home with them,” Estep said.
Parents have 18 months to meet reunification standards before Children’s Services files for permanent custody.
Children’s Services filed for permanent custody of two babies born exposed to drugs last month, Estep said, and are working to place those babies with a family.
Melissa of Champaign County said she and her husband, Randy, have legal custody of their grandchildren, one of whom was born addicted to heroin. Melissa and Randy asked to withhold their last names.
She and her husband knew that her daughter had a drug problem in 2010, she said, but assumed her daughter would stop using when she became pregnant in 2011.
But when Melissa and Randy arrived at the hospital a half hour after the baby was born, her granddaughter was trembling.
“She looked like she was laying on a block of ice,” Melissa said. “Her little body just trembled. I didn’t know … I had no clue.”
Two days after the baby was born, her daughter told her she had used heroin between six to 10 times per day while she was pregnant. Her granddaughter had to be weaned off the drug with daily doses of methadone and spent 10 weeks in the hospital.
“I never left her,” Melissa said.
The baby had jaundice. During her sixth week at the hospital she had to be placed in an isolation room because she “just cried and cried and cried,” Melissa said.
“It was just heart-wrenching. We were just helpless. All I could do was hold her and try to spoil her and try to do what I can for her. That’s pretty much all you could do,” Melissa said.
Newborns are typically treated with doses of methadone in the hospital and then sent home with phenobarbital, Robbins said.
“ We try to get them off quickly, we don’t want them on it forever, but it’s better in my opinion than to see them suffer because they really do struggle,” Robbins said.
It’s unknown if these babies suffer long-term effects as studies have been inconclusive, Yohannan said.
Seeing babies go through withdrawal is hard on medical staff, he said.
“It is very difficult on nurses who take care of these babies day in and day out. It is tough … They constantly cry. They’re difficult to console. Definitely recognizing it early and treating them has made a difference in these babies,” Yohannan said.
Treating parents
It’s unfortunate that physicians have to treat babies born dependent on drugs, Yohannan said, and added that more awareness of addiction and treatment is needed nationwide.
“They’ve stopped all these pain medication clinics and reduced the prescriptions by the physicians. But without treating these people who are already addicted, there is some thinking that these persons are seeking heroin because its cheaper and easily available,” he said. “On one hand you have reduced the pill mill sector, but there’s an increase in heroin addiction. Sometimes some actions you take have bad side effects.”
Sherrock lost custody of her daughter for about a year.
Her daughter remained in the hospital for three weeks and she was weened off drugs with methadone.
Sherrock’s mother cared for the baby, Breannah, while Sherrock went to rehab a few months after she was born and completed drug court.
The former certified nursing assistant began using drugs at 13. She said she drank alcohol and smoked marijuana as a teen and progressed to heroin at the urging of a former boyfriend.
“I fell into that pattern of wanting to get high all the time (and) once I did it the first time,” Sherrock said she was hooked.
When she became pregnant, she said she was afraid to stop using drugs because she feared going through withdrawal would cause a miscarriage. She also said she wasn’t ready to quit.
“When I got pregnant, (a baby) that’s all I ever wanted. But I was already so far into the heroin, I even was doing crack with it,” Sherrock said.
She entered rehab when her daughter was a few months old, then relapsed after the first 60 days.
“When my daughter came home, I was still struggling with trying to stay clean at that point because I knew what my daughter went through in the hospital — the guilt,” Sherrock said.
Sherrock managed to kick her habit by focusing on Breannah. She’s been drug free, she said, since Dec. 29, 2012.
She is now pregnant with a boy.
“I’m excited. It feels so good to be back with your kids. It’s a different life. It’s hard, but you can do it. But you’ve got to want it,” she said.
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