Generation Rx: newborns increasingly affected by opiate, heroin use

Lance Lysowski

A few days after quitting heroin, Jeremy Taugner sat in a Robinson Memorial Hospital waiting room. It was April 1, 2010, and his first daughter was being born.

Taugner, 29 years old at the time, did not know what to expect once the nurse came out to talk to him. The child was five weeks premature. Having not been legally married to the then 21-year-old mother, who chose to remain anonymous for this article, he sat and waited as the birth took place.

A former drug dealer and chronic heroin user, Taugner was looking for a fresh start. The years leading up to that day had been filled with addiction. As a child, his parents’ issues with drugs and alcohol forced him to live with his grandmother. During his teenage years, he began smoking marijuana, snorting cocaine and abusing alcohol. Then came prescription painkillers such Vicodine and Percocet. Ultimately, Taugner turned to heroin.

A nurse approached Taugner and told him the news: his newborn daughter was born with heroin in her system, also known as Neonatal Abstinence Syndrome. She was immediately being transported and admitted to Akron Children’s Hospital’s Neonatal Intensive Care Unit with symptoms of apnea-difficulty breathing.

Taugner broke down.

“I was devastated,” Taugner said. “I realized at that moment that I became everything I hated. I didn’t want to grow up to be like my parents, but I ended up making their same mistakes.”

Neonatal Abstinence Syndrome

Jeremy’s daughter was treated for five days, as doctors monitored the newborn’s breathing, as well as withdrawal from the heroin in her system. As required by state law, when an infant is born with a drug in his or her system, the hospital is required to contact the Ohio Department of Job and Family Services.

Authorities arrived at Akron’s Children’s Hospital and once the infant was released from the hospital, she was taken into state custody and put into foster care immediately.

Neonatal Abstinence Syndrome is a combination of problems in a newborn who has been exposed to addictive drugs while in their mother’s womb. The baby may experience symptoms within one to three days after birth, which include blotchy skin, excessive or high-pitched crying, fever, irritability, rapid breathing, seizures, sweating and vomiting.

According to Stacey Frohnapfel-Hasson, communications chief at the Ohio Department of Alcohol and Drug Addiction Services, the state began researching NAS and its effects on infants after Gov. John Kasich’s declaration on April 5, 2011 to combat Ohio’s opiate epidemic.

Gov. Kasich’s announcement of $36 million in funding for prescription opiate treatment and other statewide opiate initiatives came on the heels of a 300 percent increase in overdose deaths in Ohio from 2000 to 2008, according to Ohio Drug Addiction Services.

The link between heroin and prescription opioids is becoming apparent. Users begin by taking prescription pain medications such as Vicodin, Percocet and Oxycodone. The active ingredients in these medications are structurally similar to heroin, as well as delivering a similar high. Once addicts can no longer afford pricy prescription pills, they turn to the cheaper alternative: heroin.

While the results of the Ohio’s NAS analysis are not due to be released for another month, Frohnapfel-Hasson said the state is not taking the issue lightly.

“[NAS] is not just the opiates in their system,” Frohnapfel-Hasson said. “It’s other drugs as well, which is one of the reasons the analysis is necessary. This is only one piece of us trying to combat the opiate epidemic and make Ohio a safer place.”

Treatment for newborns born with drugs in their system includes calming the distressed infants and on severe occasions, specific medications to combat the excruciating symptoms.

The state has yet to announce how many such cases occurred in 2012, but nationwide trends suggest more newborns are being affected by NAS. In a May 2012 study featured in the Journal of the American Medical Association titled, “Neonatal Abstinence Syndrome and Associated Health Care Expenditures,” Dr. Stephen Patrick stated that there were 3.9 NAS births per 1,000 hospital births in the U.S in 2009. In comparison, studies show only 1.2 cases per 1,000 births were seen in 2000.

Most cases of NAS lead to charges of child neglect against the child’s mother and the involvement of child protective services. And the odds are low that a child returns to their heroin-abusing parents.

“I think of all the drugs, [heroin] seems to be the hardest to overcome and have their children return to them,” said Tammy Devine, Children Services Administrator for Portage County Job & Family Services. “It seems to me that it is the one drug people don’t rebound from. They don’t come back. That’s what’s sad.”

Child Protective Services

Taugner’s first daughter was sent to live with her great-grandmother, while Taugner and his daughter’s mother followed a case plan with Portage County Job & Family Services. The mother was also charged on April 8, 2010 with endangering children, a misdemeanor of the first degree in Ohio, but the case was dismissed later that year.

When reflecting on her drug use during pregnancy, the mother found the addiction too strong to combat but made no excuses for it occurring.

“At that time, I think my addiction was so bad that I don’t think anything could have stopped it,” the mother said. “I knew what was going on, but I didn’t necessarily make the connection. The addiction is so strong that it kind of takes over you.”

According to Devine, each case plan is tailored specifically to the individuals involved, including previous drug history, employment and housing.

For Taugner and his girlfriend, the plan began with a required psychological evaluation followed by intensive outpatient treatment three days a week at Townhall II in downtown Kent. In addition to treatment, Taugner worked 30 hours a week and attended parenting classes for five months. He had quit all addicting substances after enrolling in a 12-step program for sobriety.

Without a driver’s license or transportation, Taugner and his girlfriend rode the bus each day to their job minimum wage jobs and to attend the various requirements of the case plan. According to Chris Bournea, a public information officer for the Ohio Department of Job & Family Services, these case plans identify services and activities that are designed to modify behavior or address conditions affecting the child.

The couple was also able to visit their daughter twice per week for one hour at a time.

The process of a child returning to their parents after being taken by the state takes an average of one year to complete, being much more difficult when substance abuse is involved. Taugner and the child’s mother completed the program’s requirements in four months.

“All day, every day, my life consisted of riding the bus and taking care of what I needed to take care of in order to get my daughter back,” Taugner said. “I did everything I could to get our daughter back as quickly as I could.”

Drugs are often the cause of child protective services being called on cases of reported neglect or abuse. According to a 2011 report by the U.S. Department of Health & Human Services, 29.6 percent of children who required child protective services in the state of Ohio had a caregiver listed as having a drug abuse risk factor.

The trend coincides with the clients that Portage County’s Job & Family Services have seen. According to Devine, 80 to 90 percent of the time children are removed from a home, drugs or alcohol are involved, as Portage County reported 10,626 substantiated cases of child abuse or neglect in 2012.

According to Job & Family Services policy, when a report is made involving suspected child abuse or neglect, a representative visits the home to assess if living conditions, food availability and the safety of the child are questionable. Child protective services attempts to mediate the situation if if they believe the child is in danger.

If the threat is high enough, a request will be made with the juvenile court for the removal of the child. The judge reviews the findings and makes the final decision. Police can be involved under circumstances where the child’s safety is in immediate danger, such as if drugs are being manufactured in the home.

The children of Portage County are being affected by a wave of narcotics that has hit the county over the past several years. According to Devine, the majority of cases in the county involving parents who can no longer take care of their children are the result of heroin, methamphetamine or bath salts abuse.

Methamphetamine, also known as the pleasure drug, enhances and destroys the human body’s personal pleasure system by releasing an excessive amount of dopamine. An excessive amount of dopamine can be toxic to the brain. The drug’s warm, fuzzy feeling is often followed by violent behavior. Bath salts have a similar chemical composition as amphetamines or cocaine, but can lead to heart palpitations, paranoia, hallucinations and violent behavior.

“As far as children go, I think the damage to children is astronomical,” Devine said. “These kids are educationally, physically and emotionally burdened. The cost to society to help these children after they’ve been raised in this kind of environment — we couldn’t even put a price tag on it.”

Narcotics are impacting the most vulnerable of children. According to the same study by the Dept. of Health & Human Services in 2011 on child maltreatment, there were a total 3,806 cases involving child protective services in the state of Ohio where the child was under one year old – 27.2 victims per 1,000 children in the state’s population. The prevalence of cases in Ohio involving infants is almost twice as frequent as any other age group under ten years old.

“It’s to the point where the kids are just living with it and having to deal with a parent whose not raising them well, or even worse, putting them at some risk,” said Joel Mowrey, Ph.D., associate director at the Mental Health & Recovery Board of Portage County.

Second Child

The days following the return of Taugner’s daughter were all but normal.

During their time in treatment, Taugner felt apprehension from his girlfriend. He did not feel she was serious about recovery.

Once their daughter returned, Taugner discovered the truth.

“The very next day, my kid’s mother was getting high,” Taugner said. “I just watched her closely and she was doing fine for a while.”

The mother, who is now 24, contradicted Taugner’s account of her drug use, saying it happened one year after their first daughter was returned to them and that the use was a ‘one time thing.’

The following months were improving for Taugner and his family. The news then came that she was pregnant with a second child, a daughter. He was working two jobs, his child’s mother was working and they were living with a family member. As the months went by, she suddenly became increasingly agitated.

Taugner suspected her of still using, but she shut the accusation down with anger. Her family supported her claims of sobriety and shunned Taugner for making that suggestion.

On July 20, 2011, the couple’s second daughter was born. As Taugner held his newborn daughter in the hospital room, he noticed she was shaking. The nurse suggested it could be a minor symptom and they would run further tests.

Taugner went to work and, a few hours in, received the phone call he dreaded. His second child was born addicted to heroin, his second child with Neonatal Abstinence Syndrome.

“I instantly became disgusted,” Taugner said. “It hurt. I finally understood what it felt like to hurt people because of my actions when I was using drugs. I have been on both sides now, and I understand because of the hurt I caused everyone.”

Being a former addict, Taugner was no stranger to hurting his loved ones. The now 32-year-old Ravenna native destroyed relationships with loved ones in the past through his drug abuse; causing irreparable harm to his son from a previous relationship, who witnessed Taugner as a heroin addict.

Taugner’s second daughter safely withdrew from the opiate, but was taken by the state and the mother was charged with child endangerment. Taugner’s progress in recovery, including success with his 12-step program and holding steady employment allowed him to file for custody of his daughters.

One month later, on Aug. 15, the mother of Taugner’s children was arrested for felony theft after stealing a credit card from her work. According to court documents, she pled guilty to the charge on Jan. 13, 2013 and received five years probation, along with mandatory inpatient treatment at Oriana House in Akron and eventually, employment and community service. Her relationship with Jeremy is over, while her children yearn for her presence.

According to court records, Jeremy was given full custody of both of his daughters in October 2011. He was now a recovering heroin addict working two jobs, and balancing the responsibilities of being a single father.

“She was a great mom, she loved her children, but being a mother requires more than just loving your children,” Taugner said. “It took me a while to realize that. It’s going to be rough for her and she’s got a lot of work to do.”

Today, Taugner holds a steady job and works as a co-founder of Portage County’s Citizens for Addiction Recovery and Education Inc., which advocates for addicts seeking treatment and is responsible for an upcoming all-male inpatient treatment facility in the county. Family members have stood behind Taugner as he balances his responsibilities as a father.

Although he has support, every night, Taugner hears the anguishing words come from his two, now-healthy daughters, asking the whereabouts of their absent mother.

As Taugner now reflects on the past, he has no regrets having his first daughter taken by the state. The event motivated him to quit his lifelong drug use and trouble with the law.

“It helped me realize what I needed to change in my life,” Taugner said. “I took it upon myself to make a promise that I would be there for my daughter because nobody else would be there. “

Today, the mother is close to completing her inpatient program at Oriana House, which included cognitive behavioral therapy and a continuation of her 12-step program. After several relapses during her recovery, she is confident in her sobriety.

“I’m getting the old me back and it’s really exciting. I’m able to open up to people now, I’m really busy and it’s exciting,” the mother said. “I’m finally figuring out a way to do thing for myself.”

As she searches for employment and braces for the next stage of her life, the 24-year-old hopes that support from her family and the lessons learned during recovery will allow her to reunite with her daughters. Legal troubles and her battle with heroin addiction have caused her to miss precious moments with her two healthy daughters.

“I’m anxious to get home to them,” the mother said, “They’re young and I’m kind of missing a lot. My youngest daughter is talking and my oldest is being potty-trained. I don’t know when that will be, but I hope it will be soon.”

Statistics

Number of substantiated cases of child neglect or abuse seen by Portage County Job & Family Services from 2009-2012, according to 2012 report by the county.

2009: 9,452

2010: 14,660

2011: 14,208

2012: 10,626

Children with Drug Abuse Caregiver Risk Factor, 2011; according to report on child maltreatment by U.S. Department of Health & Human Services (** counts a child only once regardless of the number of times he or she was found to be victim during the reporting year.)

Ohio Total Victims: 33,509

Ohio Victims with Drug Abuse Risk Factor: 9,931 (29.6% of cases)

According to same report by U.S. Department of Health & Human Services, victims by age in state of Ohio in 2011 that required child protective services & rate per 1,000 children in population

1: 1,978 (14.3 per 1,000 children)

2: 2,089 (14.8 per 1,000 children)

3: 2,092 (14.5 per 1,000 children)

4: 1,972 (13.4 per 1,000 children)

5: 1,823 (12.4 per 1,000 children)

Contact Lance Lysowski at [email protected].