At this very moment, there’s an infant in Norfolk that’s being held close by his foster parent. He has likely been cuddled for several hours already today in an effort to not only soothe his restlessness, but to lessen the likelihood he will experience tremors or, even worse, another seizure.
In the baby boy’s few weeks alive, he’s struggled to learn the most basic human tasks — eating, breathing, sleeping.
But why is this newborn, who just months old, fighting to merely exist? His birth came with an addiction stemming from illegal substances his mother used while he was in utero.
He’s experiencing what thousands will grapple with this year across the Commonwealth — opioid withdrawals.
He is not alone. Many, like the baby now in foster care, will also experience these painful symptoms before they’re a month old.
Last year, more than 1,330 babies were reported to Child Protective Services across the state at the time of their birth, according to the state Department of Social Services. Each was born substance-exposed, meaning their mother used a controlled drug during pregnancy.
The actual number of babies born substance-exposed is expected to be much higher.
“Every year, about 100,000 babies are born in Virginia,” said Martha Kurgans, regional consultant and women’s services coordinator with the Virginia Department of Behavioral Health and Development Services. “About 10 percent, or 10,000, of those babies are born substance-exposed.”
This infant spent the first month of his life in a special care nursery at a Norfolk hospital before going home with his foster parents.
“The most difficult thing to see is this little baby shaking and struggling with tremors,” Angela Bell, a therapeutic foster care worker at the UpCenter, said about the infant. “His startle reflex is hypersensitive. He has to be in a dark, quiet space at all times.”
A five-minute car ride likely feels like hours to the infant, Bell said.
As a result, his foster parents have had to restructure their lives so that someone can be at home in a highly-controlled setting with him. Unlike other newborns, he isn’t easily calmed. Daycare isn’t an option. Skin-to-skin contact is one of few tactics that does the trick.
The baby has a team of doctors to aid his development as best as possible, Bell said, including therapeutic care, a neurologist, cardiologist and a developmental pediatrician. A spokesperson from Sentara Healthcare said that local hospitals are also seeing an increase in babies born substance-exposed.
He isn’t the only child that has entered local foster care programs this year due to parental opioid use, either, Bell said.
“I started keeping track of the number of cases this year,” Bell said. “We always had cases but not so regularly.”
In the last fiscal year, the center served five children who were submitted because of their parent’s substance abuse. In prior years, Bell said they would typically have one or two kids. While the number alone may not seem like much, it’s a 500 percent increase in just one of more than a dozen regional foster care programs.
Making the situation worse, there’s a shortage of foster care parents throughout the country, Bell said.
The center recently had two sibling groups enter their program under similar circumstances. One child witnessed their parent overdose and called the police for help.
“It’s hard enough to place groups of siblings,” Bell said, “but to then find a family who is able to meet the needs of a child who has experienced that is very difficult.”
How can this be prevented?
While many programs exist to help adults battling substance abuse problems, resources for pregnant women aren’t as abundant. Norfolk and Virginia Beach Community Service Boards offer programs and resources for this population but inpatient services are scarce.
“There aren’t any detox facilities in the Southside that are willing to take in a pregnant mother simply because of the liability,” Bell said. “Most would have to complete a medical detox at a local hospital.”
Bell said that while pregnant mothers in need of substance abuse treatment have been defined as a priority population by the state, there isn’t enough focus on services for these women.
Without a statewide protocol to identify the population, it’s nearly impossible to provide the services in a timely manner. Many of these women aren’t seeking medical care until the time of delivery, Bell said.
An organization in Hampton, the Southeastern Family Project, is one of few that provides inpatient services to pregnant women. Though she now works for the Hampton and Newport News Community Service Boards, Luxtracia Gregory previously worked at the peninsula organization as clinical service manager.
Gregory said SEFP has been operating for more than 15 years. On average, they house about 10 pregnant women at a time but are equipped to provide care for up to 16.
Many of their patients are opiate abusers, Gregory said, and come from all over the state.
“You can see the impact of the opioid crisis by looking at the population of women being served,” Gregory said. “Many have opiate dependence as their primary diagnosis.”
The soon-to-be mothers are linked to a variety of resources within hours of their intake. If needed, they’re put on a medication-assisted treatment program that provides the level of care that is needed for harm reduction. It also helps avoid any kind of withdrawal symptoms the unborn baby might experience.
“They’re also given medical treatment immediately,” Gregory said. “They receive substance abuse therapy, counseling and education, as well as nutrition and family services and insurance.”
Kurgans said about two years ago, Virginia’s Handle With C.A.R.E. Initiative was created in response to the increase in babies born substance-exposed. In the last seven years, the number reported to Child Protective Services has doubled.
Looking at the deaths of pregnant women throughout the state, Kurgans said about 10 percent died from accidental overdoses.
The initiative also investigated the number of sleep-related infant deaths — infants who died in their sleep — in 2014 and found that, similarly, many of those cases involved parental substance abuse.
“Maybe their parent was inebriated,” Kurgans said. “Of those children that died, 95 percent of them could have been prevented. These babies could have also been identified.”
New legislation aimed at identifying more high-risk patients
Only July 1, the Virginia General Assembly introduced new legislation aimed to more easily identify mothers with substance abuse issues and babies born substance-exposed. The legislation would also connect these at-risk populations with treatment and resources.
Carl Ayers, director of the division of family services for the state Department of Social Services, said the new laws would help to identify pregnant women battling substance abuse by screening all pregnant patients for the presence of substances. These screenings, Ayers said, would not be admissible in any criminal proceedings.
Safe care plans will be established by health care providers for pregnant women who test positive. The plans will address needs for both the mother and baby, as well as delivery, discharge and aftercare, including any substance abuse treatments.
Health care providers are now required to report babies born substance-exposed to Child Protective Services within six weeks of their birth. Additionally, if a provider suspects that a child has an illness, disease or condition stemming from their mother’s substance abuse during her pregnancy, CPS must give a family assessment and develop a plan of safe care.
Kurgans said a key change in legislation this year was that pregnant women who were using prescribed opioids were not previously identified.
“Previous legislation said that if a woman was using meds prescribed by her doctor, her provider didn’t need to report her,” Kurgans said. “So there were women that were using that we weren’t including.”
‘A vicious cycle’
Bell said the biggest worry now is that if Medicaid funding is cut, these much-needed programs will be even more scarce. If the services aren’t available, the foster care program she works for will undoubtedly see a larger increase in substance-exposed infants and children impacted by parental use.
“It’s just a lifelong crisis. The trauma of kid that found a parent who had overdosed — even with the child getting appropriate services, it’s something they will have to deal with for rest of their life,” Bell said.
Those adverse experiences as an infant or a child have repercussions that impact brain development, Bell said, which only sets these children back significantly. Children old enough to witness substance abuse are often at a higher risk of becoming addicts themselves.
But educating the community as a whole is a step in the right direction, Bell said. The foster care services ensure that, for even just a little while, the children are safe and getting treatment.
So, for Bell, it’s back to identifying the problem before it begins.
“If we can somehow reverse this, identify on the front end and provide service and support when they initially find out they are expecting, we’ll be putting the cart before the horse,” Bell said. “As it is now, the baby is here and going through withdrawals. It could have easily been prevented.”
Send news tips to Poulter at amy@localvoicemedia.com
This article was published in partnership with WYDaily’s sister publication, Southside Daily.
