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Babies born addicted to opiates find help in Indiana County

Written by Jason L. Levan/Indiana Gazette | Jul 8, 2018 7:00 AM
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Newsrooms across the commonwealth have spent years documenting the opioid crisis in their own communities. But now, in the special project State of Emergency: Searching for Solutions to Pennsylvania's Opioids Crisis, we are marshalling resources to spotlight what Pennsylvanians are doing to try to reverse the soaring number of overdose deaths.

WITF is releasing more than 60 stories, videos and photos throughout July. This week, you will find stories about initial response and how addition affects families.

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A week old baby with newborn abstinence syndrome lies in one of the ICU bays at one of the Norton Children's Hospital neonatal intensive care units Feb. 13, 2018, in Louisville, Ky. (AP Photo/Timothy D. Easley)

They are the youngest victims of the nation's opioid epidemic.

Statewide, nearly 2,000 children -- 15 out of every 1,000 -- are born each year with neonatal abstinence syndrome (NAS). The frequency has increased more than 1,000 percent in less than 17 years, according to a report from the Pennsylvania Health Care Cost Containment Council.

And the numbers are even higher in Indiana County, where roughly 1 in 50 babies were born with NAS during the last fiscal year.

NAS refers to the problems that develop after birth in newborns exposed to addictive drugs, most often opiates, while in the womb.

Caring for these babies is putting a real strain on Sarah Ross and the staff at Indiana County's Children and Youth Services office. As director of CYS for the last two years, Ross has been contending with a growing number of cases involving mothers who, at least for a period of time, cannot safely care for their newborn.

In most cases, the baby is placed with a responsible family member.

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Sarah Ross, the director of the county's Children and Youth Services office, said her staff has to handle an increase in cases every year. (Michelle Raymond/Gazette)

"The way that it works is if a child is delivered, and the hospital has a concern regarding drug use or addiction, they call in a report to ChildLine. We then would be responsible for going out and assessing the situation, doing an initial assessment to see if the child is safe in the parent's custody," Ross said.

"In almost all of our cases, when a child is born addicted, we can resolve it with the help of family members. So we will have situations where we will have an aunt or uncle, a grandparent, who's willing to accept responsibility for the safety of the child," said Ross, an attorney since 2008.

"As long as the parent that's addicted does not have unsupervised visits with the child, there aren't any issues. That's our ideal situation; obviously we want to keep children with their family as much as possible. We don't want to remove them unless it's absolutely necessary."

But increasingly, it is necessary.

"There are situations where we can't find a safe family option. One of the biggest problems that we've seen, especially recently, is you have multi-generational drug use," Ross said. "So people that typically we have considered a safe option in the past, those people are also using."

Even in cases where the mother was trying to stop using opioids with the help of a legal drug such as methadone or buprenorphine, the baby can still experience NAS.

"You can't leave babies unsupervised with addicted parents. The risk is just way too high.

"So it's getting more and more common for us to actually have to remove the child from the family's care because we can't find a sober individual who's willing to accept the child. It's become a huge problem for us.

"What happens in that case is we go to court and we ask the judge to place the child in the agency's legal custody and then look for appropriate foster parents."

Like Josh and Stephanie Rosenberger.

The Rosenbergers.jpgJosh and Stephanie Rosenberger, of White Township, have adopted three children in the past few years, including one who was born to an addicted mother. (Kevin G. Stiffler/Gazette)

The White Township couple has now adopted three children -- one of whom was born addicted at Indiana Regional Medical Center. A test of the cord blood showed he had prescription drugs, suboxone, marijuana, alcohol and tobacco in his system.

"That's why I think his recovery took longer," Stephanie Rosenberger said. The mother "did drugs through the whole pregnancy."

Newborns with NAS can suffer from tremors, rigidity, digestive issues, low birth weight, sleep problems, premature delivery, poor feeding and sucking, and often a distinct, high-pitch cry.

And babies that suffer from NAS often require a longer stay in the hospital -- an average of 17 days, compared to 3.5 for other newborns, according to the Cost Containment Council.

"The first couple of weeks were really tough," Stephanie Rosenberger said. "He wouldn't sleep -- at all. He had tremors, we couldn't find a formula that worked because his digestive tract was underdeveloped. Part of it was because he was premature when he was born. Everything was a concern. When we first got him, we didn't know if he could see or hear. He didn't really respond to sound until eight weeks old."

While a family is adjusting to life with a foster child, the CYS staff is concurrently planning for two different scenarios. While the agency's primary goal is to reunify the child with the family, plans may also be in the works for a permanent adoption. Relapse rates are very high, Ross said.

"This job is all about balancing out our desire to have families be successful on their own with children having an absolute right to be safe," Ross said.

And CYS is always working with a ticking clock. The federal Adoption and Safe Families Act dictates that if a child is not in the parents' custody for 15 of the previous 22 months, CYS must move toward termination. But "that 15 months doesn't usually match up with an addiction recovery timeline," Ross said.

The growing caseload and cost of in-home services for addicted mothers has caused the agency's budget to climb from $7.5 million in 2017-18 to a projected $9 million in 2018-19.  

"Because of the increased reporting, I have to have more staff available," Ross said.

Still, James Carmella, the solicitor for CYS, said many of these tragic situations have a happy ending.

"Adoptions are the best days for CYS and court," Carmella said. "At that point, all of the issues that got us to that point are gone and there's just simply the joy of that moment. I had a professor in law school that told me to never turn down an adoption case because it's the only time where everyone's going to leave the courtroom happy."

It's an experience the Rosenbergers have gotten to enjoy three times.

"It's overwhelmingly emotional," Josh said. "It is by far the most difficult thing I've ever done, but it's also the most rewarding thing I've ever done."

"We have really good foster homes; we just need more," Ross said.

To that end, the Rosenbergers have been counseling other local couples who are deciding whether or not to become foster parents, and they'd like to see the formation of a mentorship program.

"It's unbelievably rewarding to watch (other couples) follow in the same footsteps that we did, and we're watching them on that same journey," Josh said. "There are people of all walks of life who are interested. but they don't know where to turn. There's not a lot of awareness."

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