Pubdate: Sun, 27 Jul 2003 Source: Courier-Journal, The (KY) Copyright: 2003 The Courier-Journal Contact: http://www.courier-journal.com/ Details: http://www.mapinc.org/media/97 Author: Javacia N. Harris, Associated Press HOSPITALS TREAT MORE DRUG-ADDICTED BABIES Prescription-Drug Abuse Takes Wider Toll in E. Kentucky WHITESBURG, Ky. - 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 Hospital. The number of infants born addicted to prescription drugs such as 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 detoxification 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 adults' abuse of OxyContin and other prescription drugs. Scores have been jailed for trafficking in painkillers, and several physicians have been indicted on charges of allegedly overprescribing drugs. Watts, the hospital's nurse manager of obstetrics and pediatrics, 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 the center's obstetrics patients for drug abuse after four drug-addicted babies were born in February, said Dr. Chandramohan Batra, who worked at the center until last month. Physicians at the Family Practice Center, a division of UK's Center for Rural Health, deliver only about eight babies each month, he said. Doctors at the UK 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 in 1997 the neonatal intensive care unit reported 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 neonatal intensive care unit 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 said. Nurses 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 the Whitesburg 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 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 are given the medication for at least a month. "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 drugs. "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 the Whitesburg 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 if 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 said. 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. 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. - --- MAP posted-by: Richard Lake