- Associated Press - Friday, November 27, 2015

WILMINGTON, Del. (AP) - Katie Morgan is a heroin addict in recovery, a 29-year-old expecting a child in January.

She is part of a novel Delaware corrections program: Rather than serving time in prison for drug crimes and probation violations, Morgan is being held at a Newark group home - where she receives treatment for addiction, and can retain custody of her baby.

Methadone, the synthetic opioid Morgan takes to treat her heroin addiction, courses through her blood and the blood of the baby boy she’s carrying.

That means her newborn will likely spend his first weeks in the throes of opiate withdrawal - fighting neonatal abstinence syndrome, or NAS, a condition that makes babies sleep-deprived, irritable, prone to tremors and vomiting, and difficult to feed.

The first sensations felt by her child will be similar to what heroin addicts feel when they quit cold turkey - wracked with pain, clawed by cravings.

“I can imagine what he’s going to go through when he comes out. I’ve been through withdrawal before,” Morgan said, sniffling. “I’m really upset with myself. I cry about it a lot because I did it to him. But he’s healthy, and the doctors say he’s going to be OK. So, it’s just a mistake I have to learn from.”

Morgan’s predicament is becoming far more common in America. Heroin use more than doubled in the last decade, and more and more babies are starting their lives in withdrawal. In 2004, 39 babies were discharged from a Delaware hospital after being treated for NAS. Last year, 300 babies received that diagnosis - nearly 3 out of every 100 born here.

While heroin and methadone are much less likely to affect a child later in life than other drugs expectant mothers are urged to avoid during pregnancy - such as alcohol, tobacco and cocaine - the quick rise in NAS cases in Delaware is an unsettling trend.

Christiana Hospital, which has seen more than twice as many NAS babies since 2010, announced plans Thursday for a $260 million overhaul of its women and children’s services at its Stanton campus. That expansion will create eight new floors and provide more room for its neonatal intensive care unit and a new nursery just for high-risk infants, such as those exposed to opioid drugs during pregnancy.

To medical staff accustomed to giving care in stressful conditions, infants with NAS can seem to be in agony. And caring for them is agonizing.

“What’s different about babies who are born to moms on opiates is it does cause fairly immediate withdrawal symptoms,” said Dr. David Paul, chief of pediatrics at Christiana Care. “Immediate means babies can show symptoms of withdrawal in the first hours after birth.”

Adds Nancy Forsyth, a neonatal nurse at Beebe Hospital in Lewes: “They may cry inconsolably. If you listen to their cry, it’s the cry of a baby that is in pain. It’s really distressing to see a baby going through this.”

Like other states around America, Delaware is struggling through the heroin pandemic. Overdose deaths have nearly tripled in the past decade - from 63 in 2004 to 185 in 2014.

High school nurses are being trained to give emergency doses of opiate-blocking drugs to prevent fatal overdoses, and police officers and emergency medical technicians carry the drug Narcan to save the lives of those who have overdosed.

In New Castle County, heroin seizures climbed 400 percent between 2012 and 2013, and emergency rooms are being inundated with overdose victims.

The signs of stress are visible statewide.

“The addiction epidemic is straining our public system beyond its capacity, with many people turned away for services when they are ready for treatment,” Gov. Jack Markell said in August.

Jim Martin, the leader of a Georgetown home for homeless men and a director of a Seaford addiction resource center, knows of parents in Seaford who routinely sweep heroin baggies off their sidewalks so their children don’t find them.

Heroin “has just exploded in our communities. It’s like a nuclear bomb went off and little heroin packets are going everywhere,” Martin said. “The experience I’m having dealing with heroin is folks seem to have so much more relapse. The drug just pulls you back, even if you’ve had some clean time. It’s just a terribly addictive drug.”

Three years into treatment for heroin addiction, Courtney Murphy, 31, brought her baby girl, Sophia, into the world on Oct. 27. Murphy had taken methadone and the baby showed signs of NAS in the hours after her birth, but made it through the rough patch and was discharged without much fuss six days later.

“Her tremors did scare me a little bit. I’d never experienced that,” Murphy said as she rocked Sophia, in her Nike booties and a pink-and-white outfit, to sleep in her New Castle apartment.

Murphy’s sons, ages 2 and 6, watched cartoons in a bedroom while, nearby, her 11-year-old daughter fussed with her hair. The church where Murphy attends addiction group therapy each week is just a few minutes’ walk down the street.

“It’s an everyday struggle,” she said of her recovery from addiction. She said it began at age 18 after a car crash when she was prescribed opiate painkillers. She’s been clean three years now.

“It’s made me become a better mom,” Murphy said. “My daughter’s 11 - she’ll be 12 soon - and I was actively using when she was younger” - taking street drugs in the child’s presence. “Now, I’ve been able to be there a lot. Not just physically. Mentally. Knowing what’s going on with my kids. I mean, it’s a big difference.

For Murphy, her new normal is this: Her oldest daughter catches a bus to a charter school at 5:45 a.m. A 2-year-old son who was also born when she was taking methadone, Duke, walks to her father’s house, where he’ll be cared for. Murphy’s husband, a painter, goes to his 12-hour shift at a Dover work site. Then, Murphy and Sophia make their way to the clinic where Murphy’s methadone treatments are administered.

“I take the baby with me to the clinic. It’s a job just to get there, back and forth every day,” she said. When she can, Murphy makes time for Narcotics Anonymous meetings and church meetings on addiction. She’s learned, in recovery, to plan a day ahead wherever she can - making lunches, laying out school clothes. It’s a choreography she never could have sustained when she was abusing heroin.

In high school, “I was a cheerleader. I hated, despised anyone who did drugs. I never thought this would be my outcome,” Murphy said as she got her children ready for a lunchtime walk to the corner deli. “But I’m making the best of the situation. So, that’s all that matters.”

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Information from: The News Journal of Wilmington, Del., https://www.delawareonline.com

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