Mothers of Opioid-Exposed Newborns Find Treatment at Vermont Clinic

Two mothers trying to stay clean are coping with the consequences of drug addiction and its impact on their children.

For recovering addicts, it’s hard to stay clean. It’s even harder for single mothers living in Vermont – a state currently in the midst of a heroin and prescription drug abuse epidemic.

Ashley Blair, 32, is a single mother and recovering addict, who had a history of abusing prescription drugs, heroin and other opioids. Here she holds her youngest child, 3-month-old Xzavier. Xzavier was exposed to the addiction medication Buprenorphine during Blair’s pregnancy. She eventually switched to a safer medication, but even so, Xzavier was born with neonatal abstinence syndrome or NAS, a condition where a baby experiences symptoms of withdrawal. Newborns with NAS are monitored and, in some cases, treated with Methadone.

Adam Desiderio

Xzavier, now 3 months old, started showing signs of withdrawal just days after he was born. He was irritable, hard to console and was experiencing mild tremors.

Adam Desiderio

Kayana Pearson, 29, is a single mother and recovering addict who says she also abused prescription drugs, heroin and other opioids. Pearson takes methadone to stay clean. She gave birth to Ammanuell three months ago. Ammanuell has also been diagnosed with NAS. For the last eight years Pearson has been in recovery. She says she looks forward to a new start with Ammanuell. “I can’t picture that being my lifestyle,” Pearson said. “It’s not an option for me anymore. It’s not in my world.”

Adam Desiderio

Ammanuell, 3-months-old, is monitored by physicians and nurses every two weeks at the Neonatal Medical Follow-up Clinic at Fletcher Allen Healthcare in Burlington, Vt.

Adam Desiderio

Dr. Anne Johnston checks Ammanuell’s heart rate during a routine monitoring visit. Johnston is a neonatologist and medical director of the Neonatal Medical Follow-up Clinic at Fletcher Allen Healthcare in Burlington, Vt.

“We’ve had increasing number of opioid-exposed newborns into our clinic,” said Johnston, “and so we developed guidelines and protocols for caring for them and they’ve become a huge part of our clinic visits.”

The outpatient clinic requires bimonthly visits and close communication with home health nurses that monitor the opioid-exposed newborns’ development. Newborns who are diagnosed as opioid-exposed are scored for Neonatal Abstinence Syndrome when they are born.

Depending on the severity of their symptoms they are monitored by physicians and treated with maintenance medication for withdrawal.

Adam Desiderio

Pearson takes her 3-month-old boy to the Neonatal Medical Follow-up clinic for a checkup every two weeks where nurses and doctors monitor his development.

Adam Desiderio

Part of the treatment at the Neonatal Follow-up Clinic is showing mothers how to become good parents and to help them bond with their newborn to break the cycle of addiction.

“It’s a life full of hope as long as their mothers stay well,” Johnston said. “Treating the babies is pretty easy, but treating the mothers, that’s the complex thing.”

Adam Desiderio

Some babies diagnosed with NAS are required to take withdrawal maintenance medication. Healthcare professionals at the Neonatal Medical Follow-up clinic go over instructions for taking withdrawal maintenance medication with mothers at every visit.

Adam Desiderio

For his NAS, Xzavier was prescribed Methadone-- a drug addiction treatment medication given to recovery addicts and newborns exposed to opiates. Every morning at 10 a.m., Blair gives a very small dose of Methadone to Xzavier. The medication is kept under lock and key at her mother’s home nearby.

Blair says access to Methadone is helping her baby through withdrawal symptoms and urges other women to step forward and get help. “It’s a great thing for women out there who are using heroin, afraid that their children are going to be taken from them,” she said. “Well, there’s help.”

Blair takes Suboxone, an opioid addiction medication, to help reduce the side-effects of withdrawal. She says her life is more stable now. “I go to work. I do things as a normal parent,” Ashley said.

“I don’t want to take it forever,” she added. “But I’m afraid to get off of it now because it’s kept me together for so long.”

Suboxone is a medication for opioid dependence that is taken orally.

Ashley Blair was born in Rutland, Vt., and has lived here her whole life. She remembers a time when the town was much quieter and not plagued by drug addiction. “Rutland used to be safe. Rutland used to be this great community and I don’t know what happened,” she said.

Blair started using opioids like Oxycontin when she was 15 years old. She started using heroin a year later. “It was just cheaper, it was more readily available,” she said.

Blair says it hard to maintain her sobriety, but makes it her priority for her children. “I was always told that if you want to be clean and sober you have to put that above everything in your life or else your going to lose anything you put above it.”

Xzavier has been on methadone since he was just three days old. Doctors slowly weaned him off the drug over the past three months.

Tomorrow he will take his final dosage. “I’m worried that he may show some signs or symptoms, he may be a little irritable but I’m ready for it,” Blair said.

Blair sometimes thinks about the conversation she might have one day when Xzavier is old enough to understand her addiction.

“There’s bad things out there that you need to understand you could be more susceptible to becoming addicted to just because your mom’s in recovery,” she said. “I would sit then down and just tell them the truth.

For newborns exposed to heroin, the road to recovery has short and long-term successes, but if the mothers stay in treatment they have a healthy chance to break the cycle of addiction.

“My hope is that they graduate high school, they go on to do wonderful things, that they’re not caught up in addiction,” Blair said.