Debbie rocks her grandson, gently cradling the newborn in the specialized neonatal unit at Cabell Huntington Hospital.
When the boy was born in early June, he was going through opioid withdrawal.
He will be the fourth grandchild to fall into her care. Two experienced withdrawal, she says; her 19-month-old grandson would “scream all the time” and still reels from the effects of the drugs he was exposed to in utero.
At 56, having beaten cancer, Debbie never dreamed of this life for her golden years.
“It’s sad,” said Debbie, whom CNN agreed not to identify by her full name. “We just don’t know what the long term is going to be for these little guys.”
Debbie said she is representative of many grandparents in the region who have been forced to care for their grandchildren amid the growing opioid epidemic.
On this day, she tends to her grandson in the neonatal therapeutic unit of the West Virginia hospital, where one in 10 babies is born going through withdrawal from some type of drug: heroin or other opioids, meth, alcohol or a combination. That is about 15 times the national average, making the hospital the ground zero on how to deal with such babies.
The unit was formed a few years ago after babies going through withdrawal filled the neonatal intensive care unit. The infants shake, vomit and have diarrhea. They scream incessantly, and some experience seizures. “We recognized we had to do something different,” said Dr. Sean Loudin, the unit’s medical director.
The 36-bed NICU began to see a drain on resources. “When we had 20 babies in our NICU who were just going through withdrawal, that left only 16 beds for babies who were sick, premature, and who really needed intensive care therapy,” Loudin said.
Loudin created the unit to allow a quiet environment for the children away from the NICU. The wing is calm and low on light, with the serenity broken only by the cries of the infants suffering the effects of withdrawal. Most spend about 20 days in the hospital while being weaned off the drugs.
Loudin said that just like the drugs that have permeated the community, the treatment is ever-changing. “Babies, frankly, are exposed to more and more substances. It isn’t just about heroin. It isn’t just, you know, about methadone or the opiates. It’s about a multitude of things,” he said. “So we do have to keep up with that, and we have to individualize the therapy to the babies as well, but frankly, it is a challenge.”
Tucked into a pocket of West Virginia, the hospital also serves Ohio and Kentucky, neighboring states that have been decimated by economic hardships and the opioid epidemic. What’s happening in this community, Loudin said, is indicative of where the crisis is headed nationwide.
“We’re almost a barometer for what the rest of the country will see eventually,” he said.
He says a multipronged approach involving education, economic development, health care treatment and empathetic judicial reform is needed to help turn the tide. “Hitting this from all areas at once,” he said, “is what will make the biggest dent.”
“We have to recognize what the cycle of addiction does to people and their ability to comprehend, to understand and change,” he said. “You have to recognize that somebody who is in the throes of addiction, their ability to have rational thoughts is altered.”
Loudin said that he and his staff members do the best they can to get the babies in their care as healthy as possible and that they try to educate mothers or new caregivers about the resources available to them. But the question he can’t answer yet is “What is going to happen to these kids 20 years from now?”
A study released in Australia this year found that children born going through withdrawal performed progressively worse on testing as they got older. By seventh grade, nearly 38% did not meet minimum standards in at least one testing category.
Gordon Merry, director of the Huntington region’s emergency medical services, said his crews have responded to more than 1,000 overdoses this year alone, and he can’t help but wonder what the toll will be on the community.
“I think we’re losing a generation, maybe two generations,” he said. “The adults are having children, and the children, unfortunately, don’t have much of a chance because of the environment they’re growing up in. That’s probably the hardest thing to deal with.”
Debbie worries about the era her grandchildren — ages 11, 6, 19 months and the newborn — are entering. “I mean, are they going to be susceptible to being drug addicted also when they get older?” she wondered.
Trying to get her daughter off drugs, she said, has been “a neverending battle.” Her daughter has been addicted to methadone and methamphetamine, but says she’s never done heroin because of a fear of needles. Mom doesn’t know quite what to believe. Her daughter tried several stints in rehab, but she thinks she “doesn’t have a problem,” Debbie added.
Her daughter has lied and stolen from her, Debbie said, wrecking relationships with family members. Her three sisters no longer want anything to do with her. In retrospect, Debbie said, she wishes she’d called the police and had her daughter put in jail the first time she stole from her — something that she thinks might have prevented the hell that she’s wrought on the family ever since.
“My other girls have just washed their hands, saying, ‘Momma, we’re done. We just can’t give her everything she wants.’ ”
Her newest grandson, she said, was born addicted to Suboxone, a medical maintenance drug that can provide relief to opioid cravings. It’s as if her daughter and others, Debbie said, are “playing Russian roulette” with their addiction.
“It’s not going to get any better. It’s going to get worse. I mean, it just gets worse every day,” she said.
Loudin says it’s not fair to cast judgment on those suffering substance abuse disorder, because many are using “just to function.”
“The driving force behind the heroin epidemic is, frankly, people trying not to feel sick every day of their lives,” he said. “They’re trying to avoid withdrawal.”
But for people like Debbie, the effects are widespread and devastating. She loves her daughter, but it’s hard to look past the harm she’s caused. Her grandchildren don’t have a relationship with their mother, she says, and the only time her daughter visits is when she wants money. “Most of the time, it’s not really a conversation.”
Debbie is on a fixed income. She said she can’t take a break from raising her grandchildren because she can’t afford a babysitter. With another grandchild to raise now, she worries about having a vehicle big enough to get them around.
“I said, if she don’t quit having children, then I’m going to have to go get a bus,” she said.
Sitting in the rocker with her grandson, she added, “there are so many grandparents raising their children today, and I’ve even seen great-grandparents raising children.”
Does she see anything changing in the next few years?
“I’ll still be raising the children,” Debbie said. “I’ll probably raise them until the day I die. I want her to have them back, but I don’t see it.”