Nathan Lepp, a neonatologist who works with ill and premature infants, leans over a white crib to check a monitor that hangs above on the wall of the neonatal unit at Maricopa Integrated Health Systems. The white crib is empty, but a tiny knit purple hat rests on the soft sheets along with a horseshoe shaped pillow.
The bed has been prepped for a baby girl who will use it after she’s born. But her bed is not where newborns are usually monitored – this bed is for babies who cry inconsolably as they withdraw from illicit substances their mothers used while pregnant.
“We see it on almost a daily basis,” Lepp said. “This is a burgeoning epidemic that really has just happened in the last five or eight years that those of us who take care of babies now really are dealing with everyday.”
The number of women nationwide who reported using heroin jumped from 83,000 in 2013 to 109,000 in 2014 – with 4,000 to 5,000 of them admitting to using while pregnant, according to the 2014 National Survey on Drug Use and Health prepared for the Substance Abuse and Mental Health Services Administration.
Babies exposed to narcotics while their mothers are pregnant experience vomiting, diarrhea, shaking and even seizures after birth, and they cry inconsolably as a result. These are the side effects of neonatal abstinence syndrome or NAS — the clinical term for an infant withdrawing from narcotic substances — which has increased by 235% from 2008 to 2014, and 27% since 2013, according to the Arizona Department of Health Services.
The long term side effects of NAS are not clear, Lepp said.
“We are just now starting to get some data on what these long term effects are, and it appears these children who are narcotics exposed are at increased risk for issues later in life.”
Experts say if a mother tries to quit cold turkey during her pregnancy, she risks miscarriage as a result. But using methadone, a pain reliever often used to detox addicts, will pass through her placenta and affect her baby just like the street drug or prescription drug she was using before.
“Moms who are in methadone treatment have thankfully made the choice to get treatment and be safe cause what’s less safe is out there taking street drugs and injecting heroin, so they made that really brave choice to get treatment,” said Lepp.
Today, heroin is the drug of choice and it’s increasing in use among those over 18, according to the survey. But back in 2006 when Christie Arthur was looking for treatment and pregnant with her sixth child, the more common substance was methamphetamine.
The Arizona Department of Child Services had taken Arthur’s four older children away, and she only had her two-year-old daughter Taylor, and her unborn baby in her custody. She worried about the health and wellbeing of her children. She had warrants out for her arrest.
“I just wanted a healthy baby, I didn’t want to have to worry about going to the hospital and having him taken from me, I didn’t want to have to go to the hospital and worry about my daughter who was just under two-years-old,” Arthur said. “I didn’t want to have to worry about any of that, I just wanted to be safe and stable. I wanted to know that I was going to come home.”
Arthur found Community Bridges Center for Hope in Mesa, and there she started trauma therapy sessions and talked about the abusive relationship she was in prior to her treatment. She participated in group and individual counseling sessions, and parenting and budgeting classes.
Center for Hope “…made me realize that there’s a better life out there. That I could stay sober; that I deserved to stay sober, and that I could be a good parent to my kids,” she said.
The Center for Hope still offers these resources to its patients, and has become an outpatient program with on campus housing to reach even more women.
There are other treatment centers for pregnant women in the Valley but they are limited. Center for Hope pulls pregnant women from shelters; its main priority is low-income, pregnant and homeless women, whose stay will be covered by the Arizona Health Care Cost Containment System, Angela Phillips, clinical program manager of the Center, said.
Dana Neves, a friend of Arthur’s who entered Center for Hope in December of 2005, said she struggled to find a place that would take her while she was pregnant.
“My biggest fear was that I was unemployable, that prior to coming here I didn’t know how to keep a job, I didn’t know how to maintain a schedule,” Neves said. “I always had the desire to be a better person, I always knew I was going to be somebody successful and it was that fear that my substance use had taken me to a place that I couldn’t get there.”
Phillips said many women worry about job placement but they also have issues finding reliable and affordable daycare.
“It’s very tough when you see parents making choices that affect babies,” said Lepp. “But you have to really try and understand the mom’s situation and where they are coming from and understanding that judging them isn’t going to improve their care or improve the babies outcome.”
Lepp, Neves and Arthur all advocate for more education around narcotic drug use. Neves tries to educate her children so they don’t make the same decisions that she did.
“I’m very open about my addiction. I’m very open about my past and I just let them know that this is a disease, a disease that kills, and that they have to be very careful if they ever make the decision to take a drug or drink, or to give into peer pressure, and that substances are dangerous,” she said.
Today, Neves has been sober for 10 years. She received her bachelor’s degree, cleaned up her credit, bought a home, got married and made amends to her children and family. She now works for Community Bridges as the director of system support.
Arthur stayed sober too. She and Neves remained friends, and Arthur said she owes her success to Center for Hope.
“I’m in a good place. I’ve been sober for nine years, January will be ten for me,” she said. “I have a really good job, I have a stable house, I’m married, my kids know that I’ll be home at night. I might be a little crazy, but for the most part I think I’m actually really normal, so I’m in a really good place.”
Graphic by Brooke Stobbe/Cronkite News