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Drug program in jeopardy for pregnant women

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Awaking in a haze, the first thing she noticed was the camera, pointing at her. She wore different clothes and nail polish, and her long black hair was painted with silver streaks. Bags of shoes and jewelry sat next to her, along with a jar stuffed with $300.

This was in 1998. Katrina Robinson was a model from Carrboro, 14 years old, who'd recently moved to Durham. The daughter of a dancer and singer, she had long eyelashes and often wore sparkly eye shadow. That day she had agreed to model for a hairstylist neighbor at a show. She traveled to her neighbor's boyfriend's house, where he served her Chinese food and a Dr. Pepper. Eight hours later, she woke up on his couch with different clothes and a camera, mounted on a tripod, aimed at her. She didn't recall what happened.

A few days later, Katrina learned that he had drugged her, stripped her naked and shot photos for a child pornography website. Katrina's life changed after the experience. She cut ties with her modeling agency. She chopped off her long black locks. My hair is the reason this happened, she told herself. She started taking ecstasy, then snorting cocaine. She dropped out of high school. She smoked blunts laced with crack, lost 45 pounds and mourned her modeling days, crying every time she saw America's Top Model.

Her mother worried. "Why don't you just have a baby?" she suggested. "You need to preserve your legacy."

My legacy? Katrina thought with disdain. I'll find a way to preserve my legacy. She started acting bizarre, spitting on sidewalks and placing used bubble gum in random places, just to leave her mark. "I was insane," she says now. "Just insane." By the time she was 28, she was strung out and at her wit's end. She was also pregnant.

UNC Horizons offers medical and other treatment to pregnant women and mothers with addictions. Last week the program hosted its annual conference in Chapel Hill. Among the discussion topics was Neonatal Abstinence Syndrome, or NAS, a condition associated with the withdrawal symptoms of newborns exposed to illicit drugs in the womb.

As the number of opiate pain-reliever prescriptions have surged across America, more pregnant women struggle with dependency. From 2004 to 2011, the rate of hospitalizations in North Carolina associated with NAS rose 355 percent, according to the N.C. State Center for Health Statistics. Babies with opiate-withdrawal symptoms are often born premature, with low birth-weights and disrupted heart rates and motor skills. NAS can also impact the baby's sensory stimulation, sleep and feeding patterns.

Funded primarily with government grants, Horizons is one of a few treatment centers offering residencies to pregnant women in North Carolina, and the only one of its kind in Orange County. Its successes are documented: 1.5 percent of Horizons patients gave birth to premature babies last year, compared with 7.5 percent of other North Carolina mothers and 23.5 percent of mothers with untreated drug problems, according to administrators. Last year 100 percent of Horizons residential patients were reunited with children removed from the home by Child Protection Services.

But some Horizons services are in jeopardy. Senate Bill 594, which will likely be up for a vote in the upcoming legislative session, would require drug screening for all mothers on "Work First" public assistance. Should the bill pass, women who fail drug tests would be forced to leave Horizons, which relies on Work First. "This bill would decimate our program," says Director Hendrée Jones. "It's a catch-22. To get into the program, they have to test drug positive. But if they test positive afterward, they would lose the benefits."

Two months ago the center was abruptly kicked out of its long-term home in Carrboro. It operates out of a temporary space but seeks a one-time $1 million appropriation from the General Assembly to secure permanent housing.

About 5 percent of pregnant women use an illicit drug in any given month. Fourteen percent of pregnant women (and 26 percent of pregnant women in the South) are prescribed opioid pain relievers. Over the last decade the average hospital charges in America related to NAS increased to $53,400 from $39,400.

But despite the complications brought on by NAS, a sound treatment program can eliminate these symptoms. "Opiates don't make babies with funny-looking eyes and limbs," says Jones, debunking any myth. For several years, doctors have treated NAS with decreasing doses of methadone. More recently, they've used morphine.

But pregnant women with addictions have few places to turn. Doctors often fear liability. Methadone clinics won't always take women ousted from pain management programs. Women with opiate withdrawal are often drawn to the heroin market.

Judges worry about resources. Recent budget cuts have eliminated drug courts across the state. Judge Beverly Scarlett, the primary judge for Orange County's Adult Drug Treatment Court and Family Drug Treatment Court, put it bluntly: "I never have enough residential facilities for a mother and child."

When Katrina got pregnant, she stopped using crack but continued drinking and smoking weed. Her daughter was born with marijuana in her system. Katrina immediately fell in love with the baby who shared her wide mouth and dimples. She named her Journey, to mark her voyage into motherhood. But she started using cocaine again, making sure to save enough money from her diner job to buy both the drug and diapers. She would escape some nights while her siblings watched Journey, shuffling home as the sun rose. "Good morning!" she would say, rubbing Journey's back.

Nonetheless, Journey did well. She began singing songs nearly as soon as she could talk. Then Katrina became pregnant again and had another daughter, who was born with cocaine in her system. Word of the positive test reached a Horizons caseworker, who offered Katrina services.

Katrina started rehab. She relapsed twice and landed in jail. Now reunited with her daughters, Katrina will graduate from Horizons in two months. "Ten months ago I didn't believe in myself or my potential," she told conference attendees. "I didn't love myself, and I didn't think anyone else did. But now I'm very excited about my life today."

She works as a housekeeper and is enrolled in online business administration classes. She dreams of opening a family diner. "No alcohol," she says, "but you can bring your love and good conversation."

Journey is now 3, and her sister is 19 months. When she was born, she was like a remedy—"a remedy for my journey," Katrina thought. So Remedy is her name.

This article appeared in print with the headline "House of pain"

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