Article 1
Bringing Babies Back From The Brink
By Carl Hamilton
Drugs rip families apart. Mike and Nancy Duvall of North East know this well, having spent 12 years as foster parents who try to put some of those pieces back together.
�We�ve cared for about 20 children over the years, ranging from birth until 4 years old, and I would say that drugs were the problem in close to 80 to 90 percent (of the cases),� said Mike Duvall, 57.
�Some were born with drugs in their systems. Some were born into homes where drugs were so pervasive that the parents couldn�t care for them properly.�
Currently, the Duvalls are caring for two babies born into such drug environments.
Their 4-month-old foster daughter, Baby Beth, was born to a woman who apparently managed to keep her addiction in check during pregnancy. Otherwise, delivery room doctors would have contacted Social Services if they had observed telltale signs of drug addiction.
�The baby made it home, but then the mother went off and did her own thing.� Said Nancy Duvall, 59.
The mother left Baby Beth with her father and 6-year-old sister, who sometimes served as the infant�s caregiver.
Overwhelmed as a single Parent, the hard-working father did the best he could. Still, his shortcomings in child rearing caught the attention of a neighbor, who contacted Social Services.
The Duvalls, in turn, became Baby Beth�s foster parents when she was about 6 weeks old.
�The father told his 6-year-old, �If you don�t feed her, she will die� before leaving for work,� Nancy said, slowly shaking her head. �Can you imagine being a 6-year-old girl being in charge of a 1-month-old baby?�
Today, almost three months after joining the Duvall household, Baby Beth has good health and a wonderful disposition.
The Duvall�s other ward is Baby Brian- born with crack cocaine and methadone in his system, residuals from his pregnant mother�s addiction. Baby Brian is one of 16 drug-affected newborn cases recorded in Cecil County last year.
Alert delivery room doctors notified Social Services after detecting the dangerous narcotic and, in turn, caseworkers contacted the Duvalls. They received Baby Brian when he was 1 week old, as soon as hospital officials approved the ailing baby�s release.
He weighed 6 pounds at birth, not bad compared to the size of other drug-affected newborns for whom the Duvalls have cared.
�We had one baby who weighed 4 pounds. He was so tiny you were almost afraid to touch him,� Mike Duvall said. �His head fit in my hand. Preemie clothes were too big for him.�
When caring for a drug affected newborn, feeding and diaper changing go hand-in-hand with drug treatment.
Baby Brian�s addicted mother passed on the dangerous drugs to him during pregnancy and, as a result, the newborn exhibited signs of a crack cocaine addict.
Withdrawal symptoms can include nausea, cold chills, sweats and shakes, a common description by those who have gone through drug withdrawal.
Some drug-affected newborns need only a few days of intensive care. Some require prolonged hospitalization. And some die.
Within a month, the Duvalls had weaned Baby Brian off the anti-withdrawal medicine. Today, Baby Brian is a healthy, giggly 5-month-old who sleeps well through the night and his naps. He has not even had bouts with excessive crankiness, a common trait among drug-affected newborns.
�Because it�s six times a day, you usually have to wake up the baby to give him medicine,� Nancy Duvall said. �When you�re done, besides the fact that you don�t have to give the baby the medicine anymore, there�s a sigh of relief because the medicine did what it was supposed to, and the baby won�t have seizures and other withdrawal symptoms.�
Article 2
Born Addicted
Drug-Affected Baby Population Surges
By Carl Hamilton
Baby Brian entered this world with crack cocaine and methadone in his system. His foster parents took him in when hew was 1 week old. For several weeks, they handled diaper changing, bathing, feeding- tending to the everyday needs of an infant. His foster parents also handled this special duty. Administering a prescription drug six times a day so a feeble Baby Brian, who weighed 6 pounds at birth, would not suffer withdrawal symptoms from drugs his pregnant mother abused.
Now 5 months old, Baby Brian is an alert, giggly, good-natured baby who weighs a chunky 15 pounds, earning him the nickname �Bruiser� from his foster parents.
The infant is free of cocaine and methadone today and, at least at this point, he shows no ill effects from his drug-addled start.
Baby Brian appears to be one of the fortunate ones.
Others go through a worse hell, some for several months, some for the rest of their lives- all because their pregnant mothers could not stop using cocaine, heroin and other illegal drugs.
Baby Brian is just one example of a drug-affected newborn in Cecil County, where the number of babies born with drugs in their systems continues to grow.
Alarming Escalation
Five years ago, a �Baby Brian� case would have been noteworthy at the Cecil County Department of Social Services, according to Nick Ricciuti, agency director.
A decade ago, when Ricciuti came to the department, a case involving a drug-affected newborn would have turned heads.
�When I came here in 1997, it was a relatively unusual event to have a drug-affected newborn. You might see one or two cases a year � maybe,� Ricciuti said. �But some time around 2000 or so, the numbers slowly began to increase. That�s when we started witnessing the phenomenon of drug-affected newborns in Cecil County.
�This is a disturbing occurrence. I haven�t seen anything like it. The growing number of drug-affected newborns here is absolutely startling.�
In 2005, according to Social Services statistics, the county agency handled 16 cases involving drug-affected newborns.
Of those, eight babies remain in local foster care, a program that had been stretched to the limit even before this drug-affected newborn surge.
Another drug-affected child born here in 2005 is under the care of a relative.
The remaining seven babies have been returned to the biological mother, biological father or both � after the parent or parents � successfully completed drug counseling and other Social Services programs. The agency continues to monitor those households.
Meanwhile, if January is any indication, the number of cases here in 2006 will greatly exceed last year�s figure. �In January alone, we had six drug-affected newborns in Cecil County,� Ricciuti said.
The number dropped to two in February, lower than the previous month. But it is still high compared to officials� estimates of previous years � before lawmakers required them to keep statistics. Anecdotally, however, the two cases from February are equally heart wrenching.
�We have one baby born in February who is still going through a severe withdrawal in Christiana Hospital. The baby had cocaine and methadone in its system,� said Laura Mitchell, a Social Services caseworker with special insight into the phenomenon.
�The growing number of babies born with drugs in their bodies is sad and alarming,� she said.
Responding To A Need
Mitchell is Cecil County�s drug-affected newborn coordinator, one of 24 in the state.
Hers is a relatively new position. The need reflects the depraved state of the underground drug culture or, perhaps, just how good social workers and doctors are at detecting, reporting and handling these special cases.
Before officials in Cecil County noticed a rise in drug-affected newborn cases authorities across Maryland witnessed the increase.
The bottom line: A growing number of women were using street drugs and illegally obtained prescription narcotics during pregnancy, creating a population of addicted babies in need of care.
Maryland�s spike mirrors a nationwide trend.
Spurred by health care officials and social workers throughout the United States, federal lawmakers passed the Keeping Children and Families Safe Act of 2003.
The law amended a much broader Child Abuse Prevention and Treatment Act by requiring each state to establish a plan to handle the growing number of drug-affected newborn cases.
As a result, Maryland adopted policies and procedures in June. One month later, Cecil County appointed its drug affected newborn coordinator.
In August, social services agencies in all jurisdiction reviewed policies and procedures for handling drug-affected newborn cases with staff at hospitals and birthing centers.
In addition, the law required every social services department to keep monthly tallies of drug-affected newborn cases.
Caseworkers in Cecil County do not have the benefit of official statistics before 2003. But local office staff agree the increase in drug-affected newborn cases started about five years ago.
�It�s a big problem up here. We�re seeing the results (of habitual drug use during pregnancy) more and more often now,� Mitchell said. �It�s a very sad situation. Most of our clients are crack cocaine users. That seems to be the drug of choice in Cecil County. But we also see women who chronically use heroin, methadone and other opiates during pregnancies.�
The impact a pregnant woman�s drug use will have on her unborn child varies greatly. It depends on the type of drug or drugs she uses, how much she uses, how long she uses, and so forth.
As an example, Mitchell compared the progress of two 6-month-old drug-affected newborns in Cecil County.
�One still can�t lift its own head. The baby�s still very lethargic,� she said. �The other one can lift its own head. That baby is very alert and very strong. �Every case is different.�
Taking Action
A pregnant woman who appears to be high in a hospital delivery room.
A known drug addict who comes to the hospital to give birth. A pregnant woman whose body is riddled with needle marks, indicating intravenous drug use.
A pregnant woman who lacked prenatal care.
And the clincher- the presence of heroin, cocaine or some other drug in a newborn�s body.
These are red flags that prompt doctors and health care providers to notify Social Services, which follows a rigid protocol in investigating, according to David Trolio supervisor of intake at the county Department of Social Services.
The agency receives about 1600 complaints a year.
Callers typically complain about suspected or known domestic violence in a household and parents who appear to be abusing or neglecting their children.
Within five days, depending on the allegations and their severity, caseworkers conduct interviews, review pertinent records and take other stops to assess the validity of the tip.
From there, caseworkers conduct full-blown investigations in about 800 cases per year, and Social Services typically takes custody of the children at the outset. Preliminary inquiries in the remaining 800 complaints determine that abuse or neglect is not occurring.
With 16 cases recorded in 2005 and the eight documented cases so far this year, caseworkers are not as surprised when they receive yet another drug-affected newborn case.
But each time, they are just as appalled.
�When we see any case of an emergent nature, we�re trained to respond and to formulate a plan,� Trolio said.
�Do we still get emotional? Is it tough to hear that circumstances of some of the allegations? Yes and that�s good. If you get too desensitized, you probably shouldn�t be doing this anymore.�
Article 3
Drugs Stronger Than the Desire To Raise The Child
By Carl Hamilton
Cocaine and heroin can be more attractive to drug addicts than their own children.
Drugs warp parental judgment more often than people realize, according to Elkton based lawyer Michael J. Scibinico II, who routinely witnesses drug-influenced lifestyles.
Scibinico has been the attorney for the Cecil County Department of Social Services for nine years. He represents the agency in court after it has taken custody of children from parents deemed unfit.
�Even the birth of their child won�t shake some of these drug addicts out of it,� Scibinico said. �The drugs are stronger than the desire to raise their own child.�
Consequently, he says, abandonment sometimes occurs early. �We�ve had cases where the parents left the hospital and never came back for their baby.�
Such abandonment is typical after a baby is born with drugs in its system, prompting doctors to report the case to Social Services.
A small percentage of drug-addicted parents, meanwhile, clean up their acts through government-sponsored parenting classes and substance abuse programs and then fight passionately to regain custody of their children.
Most, however, do legal battle half-heartedly. Others do not even show up for their court dates, Scibinico said.
In 2005, Scibinico handled about 75 new court cases for Social Services. Of those, he said, about 35 to 40 involved parents whose drug addictions caused them to lose their children.
�In at least 50 percent of the cases I handle, cocaine, heroin and alcohol, as well, are at the root of the problem. Mostly, it�s drugs,� Scibinico said.
Like other court officers and social workers, Scibinico has witnessed an increase in the number of cases involving drug-affected newborns in Cecil County.
In those cases- there were 16 in Cecil County last year- Social Services takes custody of infants born with drugs in their systems or ones who exhibited drug withdrawal symptoms. Legal battles waged by parents wanting to regain custody sometimes follow.
�I don�t have statistics and I don�t know the reasons why. But certainly, in the last year, there has been a definite increase here in the number of drug-affected newborns,� Scibinico said.
And Many of those cases represent missed wake-up calls, the continuation of a drug-addicted lifestyle even after parents lost or surrendered custody of an older child or children.
�A lot of the cases I see, it�s not just one child,� Scibinico said. �The mother already has lost custody of a child or children maybe through a court order. Or sometimes they informally gave custody to a grandmother or some other relative.�
Along those lines, he added, �We see cases where the mother is struggling between the baby and drugs and out of an overriding concern for her child, she gives the baby up. Most of the time the mother admits she�s a drug addict in the hospital (delivery room).�
Aside from suspicions raised at birth, complaints from neighbors and teachers or school officials can result in Social Services investigations, which often uncover drug-addicted parents or other domestic problems.
�If the child is under school age, a neighbor calls because the child is dirty and hungry. And when they�re students, the school jumps in to say the child is being poorly taken care of,� Scibinico said.
The sights and stories generated by these investigations can be repulsive, he said.
�When we go into these homes, the conditions are so appalling. It�s amazing children have survived in such an environment. You have babies left in cribs for hours at a time. There�s filth everywhere. Just a whole litany of things.�
�You hear stories of mothers bringing their babies with them to buy drugs. You hear 4-year-old children describing their parents� drug use, talking about white powder and needles.�
To put things in perspective, Scibinico recalled the reaction of a 5-year-old boy when Social Services arrived at his home.
�Ill never forget this, the little boy said. �I knew you�d be coming,� Scibinico said.
�Even at that age, he knew his family couldn�t live the way they�d been without someone finding it. It was like he was hoping to be rescued.�
