Newborn has drugs in system...what now?

[cabanafrau]

The epidemic is growing at an absolutely ferocious rate at this point. That's why we're seeing so much pressure on prescriptions.

I heard something mentioned in the media and I thought it was pretty extreme until I actually heard we had some cases go through our court within the past few months -- HS and college kids who ended up hooked after the simple introduction of the prescription after wisdom teeth removal. Apparently we had a kid go through here who went from HS student and athlete with absolutely no psychological or legal issues to addicted with criminal charges for breaking and entering within two and a half months of having wisdom teeth surgery.

Absolutely normal HS teenager to facing a potential felony record in two and a half months? It could literally be anybody. My younger daughter had to have wisdom teeth surgery within the past month. You better believe I was paying careful attention. Her situation could have been much more painful, required her to take the narcotic meds prescribed and she could potentially be someone with a lower threshold for becoming addicted. She could be well on her way already towards a completely different path, leading to pregnancy and being so in the grips of addiction that even pregnancy couldn't stop her in another month or so.

 

[Colleen27]

I agree. There is help out there, even for those who can't afford it.

Frankly, only someone who has had little or no experience with the system would say that. The help that is available for those who cannot afford private treatment is largely a joke - without a court order waiting lists are absurdly long, and the fact that treatment is often ordered by the court means that a significant number of patients are there out of a desire to avoid jail rather than a desire to get clean, which fuels a brisk contraband trade. And that doesn't even touch the quality-of-care issues that exist with many sliding-scale or medicaid-eligible treatment centers.

 

[focusondisney]

I work maternity in an inner city hospital & have seen these situations for over 30 years. First off “drugs in her system”. What drugs? What is her history? In NY state, child protective services are run by counties. The procedure here: positive drug screens after delivery are reported to CPS. They will not take a report before delivery. You can not be jeopardizing the child until it is born. The CPS worker interviews the mother & determines the next action. For something like marijuana, they may go to the home & assess the situation there & let the baby go home with mom. Opiates or cocaine, they usually put a “hold” on the baby & prevent discharge to the mother. That is a very time limited event. Within 24 hours, they take the case to court. It is the court (a family court judge) that makes the ultimate decision on the child’s custody. The CPS department does not have that legal right. The mother has the option to go to the court hearing of course. Some do, some don’t.

If the baby is removed from mom, they may ask mom about family members, including the father, who would be willing to take the baby. But those family members will be “investigated” too. They will make sure the family member has a suitable home & is not an addict themselves etc. Most of our mom’s are not married, so the father is not an automatic legal option. There are certain legal documents to be filled out before the unmarried man is actually acknowledged as the father. If the baby can’t be placed with family, they will be placed in foster care. We have had out of county family take custody, but I can’t remember a case of an out of state family getting custody. Doesn’t mean it can’t happen, just that I have never experienced that. For out of county residents, our county works with the agency in the other county who does the in home investigation.

Depending on the type of drugs, mom’s history & willingness to get treatment, the baby is sometimes allowed to go home with mom. But CPS will put services in place & follow up closely to monitor the situation. If mom doesn’t follow the plan, the baby can still be removed.

So OP, there is no easy answer to your questions. There are many variables, including each county & states services & laws. Good luck to your friend.

 

[cabanafrau]

The bolded is very true. I was recently talking to an acquaintance that works with these kids throughout their adolescence and there are a lot of ongoing issues. It would be bad enough if the child just had to detox as a baby and they are free of side-effects for their live. Unfortunately they will have the physical symptoms of being born addicted to opioids (assuming that was the issue) for their life. Mothers really do set up their children for a rough life when they are born addicted. It is so sad to see someone do that to the person they should be willing to do anything for...even kick a hard habit.

I have no sympathy, absolutely zero, for drug users and that includes abuse of prescription drugs. I don't care about your story or justifications or whatever excuse you use.

While mothers using drugs while pregnant is definitely a tremendous hazard to the baby, many experts I've heard actually say Fetal Alcohol Syndrome is actually as damaging, if not more often more damaging to a baby than drugs. It's equally horrifying the damage a drinking mother can do to baby.

 

[GreatLakes]

While mothers using drugs while pregnant is definitely a tremendous hazard to the baby, many experts I've heard actually say Fetal Alcohol Syndrome is actually as damaging, if not more often more damaging to a baby than drugs. It's equally horrifying the damage a drinking mother can do to baby.

I agree. My wife didn't have a single drink while pregnant and stopped when we started trying, not only after finding out she was pregnant. Even though conventional wisdom is that you can drink a bit she said it just wasn't worth even the minuscule risk a single drink could do.

 

[Hisgirl]

I work maternity in an inner city hospital & have seen these situations for over 30 years. First off “drugs in her system”. What drugs? What is her history? In NY state, child protective services are run by counties. The procedure here: positive drug screens after delivery are reported to CPS. They will not take a report before delivery. You can not be jeopardizing the child until it is born. The CPS worker interviews the mother & determines the next action. For something like marijuana, they may go to the home & assess the situation there & let the baby go home with mom. Opiates or cocaine, they usually put a “hold” on the baby & prevent discharge to the mother. That is a very time limited event. Within 24 hours, they take the case to court. It is the court (a family court judge) that makes the ultimate decision on the child’s custody. The CPS department does not have that legal right. The mother has the option to go to the court hearing of course. Some do, some don’t.

If the baby is removed from mom, they may ask mom about family members, including the father, who would be willing to take the baby. But those family members will be “investigated” too. They will make sure the family member has a suitable home & is not an addict themselves etc. Most of our mom’s are not married, so the father is not an automatic legal option. Here are certain legal documents to be filled out before the unmarried man is actually acknowledged as the father. If the baby can’t be placed with family, they will be placed in foster care. We have had out of county family take custody, but I can’t remember a case of an out of state family getting custody. Doesn’t mean it can’t happen, just that I have never experienced that. For out of county residents, our county works with the agency in the other county who does the in home investigation.

Depending on the type of drugs, mom’s history & willingness to get treatment, the baby is sometimes allowed to go home with mom. But CPS will put services in place & follow up closely to monitor the situation. If mom doesn’t follow the plan, the baby can still be removed.

So OP, there is no easy answer to your questions. Here are many variables, including each county & states services & laws. Good luck to your friend.

I sure do appreciate your answer. Thank you.

 

[Hikergirl]

Frankly, only someone who has had little or no experience with the system would say that. The help that is available for those who cannot afford private treatment is largely a joke - without a court order waiting lists are absurdly long, and the fact that treatment is often ordered by the court means that a significant number of patients are there out of a desire to avoid jail rather than a desire to get clean, which fuels a brisk contraband trade. And that doesn't even touch the quality-of-care issues that exist with many sliding-scale or medicaid-eligible treatment centers.

Experience with the system, no. Experience with addicts who had help available to them but chose to make excuses why they couldn't use it, yes.

I understand what all of you are saying but it doesn't change my opinion that as a mother, if you don't do whatever it takes to stay clean while pregnant than you don't deserve the privilege of being in that baby's life as their mother. You already started off doing the worst for your baby. I put you up there with a child abuser or molester as far as second chances caring for your child.

 

[Hikergirl]

I understand what you're saying completely. I've sat in hearings where the arguments were being made for and against allowing more time, yet again, for a parent(s) to get it together and do it not say it and felt like standing up and telling everyone that enough was enough, pull the plug on the farce and give the kids a chance at a brighter future. I have actually had to bite my cheek bloody in the past to fight the urge. Don't get me wrong, there are plenty of cases where the best option is to terminate parental rights.

Then I see the sides of cases involving the kids, and only the kids. It's been very eye opening over the years that some of the things I was certain to be so simply didn't work out to be so true if I was only looking at what's good for the kids. I love and I hate when my job involves this type of work because it challenges my soul and hurts my heart.

In a case like this one I'd be pushing hard for mom to be getting treatment, entering into serious long-term counseling, eventually pushing toward her to find employment, housing, maybe pursue education, etc -- all while being monitored like a hawk in regard to usage and demonstrating extreme determination to love and learn how to care for that baby. I'm not looking to "reward" mom -- and definitely not for using while pregnant. Can I comprehend doing that? No. But then again I can't comprehend using drugs at all. Does she have untreated mental health issues that pushed her right in the path of drugs? Those kinds of things need to be considered -- for baby's sake.

As far as your wishful thinking, consider that the justice you're looking for only ups the odds that mom will continue using -- and very well may wind up pregnant again in very short order. There's a lot of upside to mom being on a court ordered treatment program. At this point it offers the greatest possibility for a win for baby, a win for mom, a win for potential future babies, a win for society in general.

I truly hope you have seen more of this than not, but the cynic in me says there is a lot worse going on out there with these babies and kids than we not working in the system, will ever know.

 

[MrsPete]

My daughter has a friend whose baby was born with drugs in his system (not a surprise to anyone). Nothing happened. Nothing. Maybe it was only a small amount? Maybe it was "only" marijuana? I don't know, but I was shocked. The child is now old enough to go to school, and it's quite clear that the child has not been provided with enriching activities to help him learn; for example, he speaks more like a 3-year old than a kindergarten student.

I think she made a choice to use drugs. Nobody has ever died from never trying drugs.

Makes sense to me. I mean, we all know drugs are additive -- why does anyone try them even once? I had an alcoholic father, so I feel sure I have a greater than average likelihood of becoming an addict, but I'll never be one. How can I be sure? Because I'm the boss of what goes into my body, and I can't become addicted to what I don't injest!

Someone'll say, Rx drugs gone wrong! Yeah, I know that happens, but two points: She has a boyfriend who's also a drug addict -- what are the chances that BOTH of them entered into this nightmare after taking legal drugs? Slim to none. And if she did begin with legal drugs and became addicted, there's help for that!

I agree. My wife didn't have a single drink while pregnant and stopped when we started trying, not only after finding out she was pregnant. Even though conventional wisdom is that you can drink a bit she said it just wasn't worth even the minuscule risk a single drink could do.

Bouncing off what another poster said, no mother's ever been sorry she took precautions and delivered a healthy child. Enough can go wrong -- why add to the possibilities?

 

[3 MEN AND A BOAT]

I had a cousin that had a daughter born with meth in her system, her mom, my aunt was allowed to bring the child home from the hospital and eventually given custody. The parents where completely useless, coming around all hours of the night, harassing babysitters that my aunt hired, even had my dad and SIL arrested after a violent confrontation one night. My aunt had a heart attack when the baby was 8 months old, I feel it was just to much stress placed on a 60 yr old woman. Her younger sister took the child and we told the parents they were not allowed around. This happened in Alabama, they had another child that became a ward of Mississippi because they thought CPS of Miss wouldn’t test for drugs since it was a different state.
Her baby daddy is currently serving 8 months for drugs, they are pieces of crap as far as I’m concerned.
The little girl is doing fine now, she turns 8 next week. We took her with us to WDW this past Dec and she had a blast at the Christmas party, she says her favorite was having breakfast with the princesses in Norway.
OP- I’ll be praying for your family.

 

[gotomu212]

People take those prescriptions every day without becoming drug addicts. After a few days of proper use, they decide they are ready to face the pain and bear it until they are healed. The ones who become addicts are the ones who use it differently than prescribed. 1-2 pills every 4 -6 hours as needed for pain does NOT mean "always take 2 pills every 4 hours, and really take it every 3.5 hours so it doesn't wear off" There has to be personal responsibility.

This is simply not true. They have tightened up opiate prescriptions greatly in the past several years, but for over a decade they were over prescribed without many doctors understanding their addictive nature and we’re seen as a wonder drug for pain management without the profession understanding that they contained far greater addictive properties. On top of that everyone’s physiology affects their addiction rates- the same way some genetic groups are more susceptible to alcoholism. Some patients were addicted to opiates after a few pills- pills they took on advise of doctors without ever thinking they were doing anything wrong.

Everyone in the medical professional has an obligation to recognize the risks of opioids as prescriptions.

 

[ronandannette]

Frankly, only someone who has had little or no experience with the system would say that. The help that is available for those who cannot afford private treatment is largely a joke - without a court order waiting lists are absurdly long, and the fact that treatment is often ordered by the court means that a significant number of patients are there out of a desire to avoid jail rather than a desire to get clean, which fuels a brisk contraband trade. And that doesn't even touch the quality-of-care issues that exist with many sliding-scale or medicaid-eligible treatment centers.

I couldn't agree more. Here in the utopian land of socialized medicine, meaningful, publically-funded inpatient drug treatment programs are largely a fantasy. Our resources are used instead for supervised injection sites and unlimited free noloxone kits. We've practically abandoned any pretense of curing addictions and have defaulted to "harm reduction" measures that certainly don't do anything to reduce harm to the innocent unborn.

While mothers using drugs while pregnant is definitely a tremendous hazard to the baby, many experts I've heard actually say Fetal Alcohol Syndrome is actually as damaging, if not more often more damaging to a baby than drugs. It's equally horrifying the damage a drinking mother can do to baby.

Interesting point. I'm not sure I know any families first-hand that are raising babies born drug-addicted, but I know a number with children affected by FAS. Those deficits are incurable and can result in quite profound disabilities.

 

[luvsJack]

Unless you have stepped into an addicts shoes, don’t judge. You don’t know what got this girl here. You don’t know what kept her here. Addiction is horrible.

I have witnessed someone turn to his friends and cry in their arms begging for help. He lost everything due to drugs his home, car, career and worse his kids because of his addiction. It starts as a choice, yes. It doesn’t stay there. And comparing it to what other can or can’t do isn’t fair.

As for the child, I have never been close enough to that exact situation to say. I do know a woman whose grandchild was taken from the parents for another reason. They lived in a different state than her and had no relatives in the state. She talked to a lawyer and he suggested she move out there. So she packed up and went to them. The courts put the child in her custody temporarily.

 

[Pea-n-Me]

Your have no idea how the addiction started, many times it starts with legal prescriptions. Thank goodness physicians are less like,y to prescribe opioids today, but at least two of my kids were given prescriptions (wisdom teeth and ankle surgery).

This is simply not true. They have tightened up opiate prescriptions greatly in the past several years, but for over a decade they were over prescribed without many doctors understanding their addictive nature and we’re seen as a wonder drug for pain management without the profession understanding that they contained far greater addictive properties. On top of that everyone’s physiology affects their addiction rates- the same way some genetic groups are more susceptible to alcoholism. Some patients were addicted to opiates after a few pills- pills they took on advise of doctors without ever thinking they were doing anything wrong.

Everyone in the medical professional has an obligation to recognize the risks of opioids as prescriptions.

It's not that children shouldn't ever be prescribed opioids. Or that providers don't understand addictions.

Health professionals and government officials have been studying medications in the pediatric population for decades, if not a century or more.

Even in 2018 there are times that, for acute pain, opiods are appropriate. However, there are a lot of other considerations that have to go into their use, such as length of time they're given, a small and finite number of pills, non-opioids pain relievers given in conjunction, education about pain and usage, and exact instructions about what to do with medication that is leftover, etc. These have been some of the factors which have been problematic. In the past, too many pills were prescribed and people took them for too long, they weren't well educated about pain and mobility, and opiods were left to linger in medicine cabinets and often fell into the wrong hands, among other things. Today, prescribers give very few, there are better instructions, and police stations have safe receptacles for leftover pills - they'll even come to your house to get them.

Here is a very good article written by a pediatric anesthesiologist about the realities of the treatment of pain today:

https://www.mayoclinic.org/medical-...esponsibly-in-the-midst-of-an-opioid-epidemic

 

[EMom]

While mothers using drugs while pregnant is definitely a tremendous hazard to the baby, many experts I've heard actually say Fetal Alcohol Syndrome is actually as damaging, if not more often more damaging to a baby than drugs. It's equally horrifying the damage a drinking mother can do to baby.

I believe this is accurate. Many doctors and NICU nurses have told me this, and my own research from when we were adopting indicated the same thing.

I have no patience for those who abuse drugs or alcohol while pregnant. None. Having worked with children in the care of the state, the things done to so many children by their parents is unforgivable.

 

[nkereina]

It being hard to find isn't an excuse when you are pregnant. I don't care if you have to tie yourself to a bed and quit cold turkey that is what you do for that child.

It's not that its hard to find. For some people, its simply not available no matter how badly they want it. You're not moved up on a waiting list for a bed solely because you are pregnant.

And as a PP has mentioned, quitting cold turkey is harmful to the baby and to oneself at that point. People die from withdrawal without a medical detox. And as I mentioned, finding a medical detox facility with availability can be impossible in certain areas. The suggestion of quitting cold turkey is speaking to your inexperience on the matter. Which is a good thing for you, because I would wish being a loved one of an addict on nobody.

Experience with addicts who had help available to them but chose to make excuses why they couldn't use it, yes.

I can understand your viewpoint considering this, but you have to understand the flipside - not every addict has help available to them that they are declining. Its not that simple.

I understand what all of you are saying but it doesn't change my opinion that as a mother, if you don't do whatever it takes to stay clean while pregnant than you don't deserve the privilege of being in that baby's life as their mother.

What do you suggest then? We know there are waiting lists for beds. We know quitting cold turkey can lead to death. So other than being added to a waiting list and taking the larger risk of risking both lives, what other option is there?

To be clear, I'm certainly not defending the actions of an addict. But having lived through this with relatives, I can understand why so many addicts have difficulty getting clean - the resources are abysmal at best.

 

[cabanafrau]

Experience with the system, no. Experience with addicts who had help available to them but chose to make excuses why they couldn't use it, yes.

I understand what all of you are saying but it doesn't change my opinion that as a mother, if you don't do whatever it takes to stay clean while pregnant than you don't deserve the privilege of being in that baby's life as their mother. You already started off doing the worst for your baby. I put you up there with a child abuser or molester as far as second chances caring for your child.

That's what I've been trying to express, this cannot be looked at solely via tunnel vision about the addict. It's easy to have zero patience or tolerance for an addict -- my experience is that they are lying liars who lie if their lips are moving.
What I know after all this time is that the most optimal outcome for a child in this situation is being able to reunite with a healthy and stable parent. It's also true that it's an incredibly difficult and incredibly slim chance it will be possible. I'm not suggesting reunification should be in the near future.

Based on the bare bones outline of what we have here my suggestion would look like this -- completion of 90 days inpatient with appropriate reports about compliance, cooperation and participation in the program from directors; participation in outpatient substance abuse treatment unless covered in dual diagnosis therapy with psychological treators; psychological evaluation followed with any recommended therapies and counseling with reports of compliance with and participation in all phases of treatment; random drug screens demonstrating sobriety and compliance with any med regimen for psychological treatment; demonstration of legal employment; obtaining safe and suitable housing; completion of parenting skills classes; participation in visitation with demonstration of skills attained in parenting classes.

If mom is competently juggling those balls in the air or well on her way after baby's first birthday, then we might start to look at expanding visitation to some unsupervised day visits, possibly beginning with a couple runthroughs with in home parent coaches. If all continues to go well, expand to some overnights. If all is well, start looking at reunification. What I would like to accompany this, and isn't provided for in the current system, would be a random drug screening component for a couple years, with number of screenings declining as years go on.

I truly hope you have seen more of this than not, but the cynic in me says there is a lot worse going on out there with these babies and kids than we not working in the system, will ever know.

What's happening with babies and kids in the system is overwhelming. I'm thankful what I'm doing is no longer concentrated so heavily in this area because it was wearing on me. I understand why PS and foster care workers burn out. Hopefully they both recognize it themselves and either find a way to reengage or find the drive and the means to get out of the field. Their workloads are unbelievably heavy and beyond emotionally draining. I would crumple like a tissue if I had their jobs. Ultimately what pulled them into the field and what pulls the lawyers who work in this area of family law and the judges and referees who hear these cases into this work is a desire to create order and stability for the kids so they have the best shot at a great future. As shocking as it may be to hear, as much as it goes against the grain of everything I thought I knew about parenting and what children need before I spent so much time around this crisis, it's not a slam dunk that the mother who gives birth to a baby with drugs in its system will not end up able to do a good job caring for her baby. Believe me I get why that seems ridiculous. I felt exactly the same way. It's the experience I've had with the kids themselves that pounded the message home for me.

 

[cabanafrau]

It's not that its hard to find. For some people, its simply not available no matter how badly they want it. You're not moved up on a waiting list for a bed solely because you are pregnant.

And as a PP has mentioned, quitting cold turkey is harmful to the baby and to oneself at that point. People die from withdrawal without a medical detox. And as I mentioned, finding a medical detox facility with availability can be impossible in certain areas. The suggestion of quitting cold turkey is speaking to your inexperience on the matter. Which is a good thing for you, because I would wish being a loved one of an addict on nobody.



I can understand your viewpoint considering this, but you have to understand the flipside - not every addict has help available to them that they are declining. Its not that simple.



What do you suggest then? We know there are waiting lists for beds. We know quitting cold turkey can lead to death. So other than being added to a waiting list and taking the larger risk of risking both lives, what other option is there?

To be clear, I'm certainly not defending the actions of an addict. But having lived through this with relatives, I can understand why so many addicts have difficulty getting clean - the resources are abysmal at best.

Actually, I do know of cases where women have been moved up on lists because they are pregnant. Not to suggest that getting space is easy by any means, but strings will definitely be pulled to place a pregnant mom beyond ASAP for obvious reasons.

 

[Boardwalk Jedi]

I think she made a choice to use drugs. Nobody has ever died from never trying drugs.

You make the choice to use drugs. You don't make the choice to be addicted. You don't have to have sympathy, no one is justifying. Just stating the facts. Simply blaming the addicted mother will not solve the problem.

 

[Boardwalk Jedi]

People take those prescriptions every day without becoming drug addicts. After a few days of proper use, they decide they are ready to face the pain and bear it until they are healed. The ones who become addicts are the ones who use it differently than prescribed. 1-2 pills every 4 -6 hours as needed for pain does NOT mean "always take 2 pills every 4 hours, and really take it every 3.5 hours so it doesn't wear off" There has to be personal responsibility.

If you are a nurse, you know that many of the addicted were in genuine pain and overprescribed highly addictive narcotics as a first line defense at one time.