According to the National Institute on Drug Abuse, an estimated 2.1 million people in the United States suffer from substance use disorders related to prescription opioid pain relievers in 2012; another 467,000 are addicted to heroin. Now, more than 90 Americans die every day after overdosing on opioids. Last year alone, 33,000 people died of opioid-induced overdoses, making it the leading cause of death for Americans under 50. But there’s a whole section of the population that suffers and often remains an afterthought: the children of opioid addicts. An opioid dependent baby is born every 20 minutes and the foster care system — especially in such states as Arizona, Ohio, Georgia, and Indiana — is burgeoning with kids who have been removed from their biological parents due to abuse and neglect from drug use.
Sarah V.* knows this devastation first hand. She and her husband live in a section of Northeastern Ohio where opioid abuse is rampant. Over the course of 12 years, they’ve adopted two children and served as foster parents more than 20. Of their 20 foster children, half were infants born addicted to drugs. Here, Sarah talks about the challenges of the system, what makes adoption during the opioid crisis more difficult than previous crises, and adopting her first daughter, who was born at 28 weeks and going through opioid withdrawal.
In general, there’s no foster or adoptive placement that doesn’t begin in tragedy. No matter what mommy has done, whether it’s abuse or neglect, or abandonment, kids want their mommies. On a daily basis, you’re dealing with grief, and trauma, and heartbreak that most children don’t even have the tools to express. It can make for some rough days.
Most placements, statistically, will be six months or less. Of the 20 foster children that we’ve cared for, 10 of them were newborns. All 10 of them were exposed to drugs and in withdrawal, some mildly, some severely. But here’s the deal: if your child has tested positive at birth for one illegal substance, it’s also likely that a whole rainbow of illegal drugs has been ingested during the pregnancy. The more different substances the child is exposed to, the harder their start is going to be in life.
When my husband and I started fostering children, the number one reason that children and babies came into foster care was “neglect due to substance abuse.” Drugs are always involved, almost in every case, whether the child was exposed in utero or not. We’ve had placements of children who were left alone for days, with a box of Cheerios in a basement, while their mom was binging on drugs.
When we first began, the big drug in our area was meth; now it’s heroin. Heroin is way more lethal. The kids who are exposed in utero are experiencing more lethal exposure and more intense withdrawals.
There’s been an explosion of children who are coming into foster care because their parents are dead. When we began in 2005, we never, ever, took placement of a baby whose parents died from an overdose. Now, it happens just about weekly in our county.
With the heroin epidemic, there’s still a lot unknown. What we find is that a lot of drug-exposed kids have learning challenges. You have a child who is traumatized by the loss, but the effect of trauma on the developing brain literally changes the surface of the brain. That change causes a certain set of behaviors. Some of those behaviors are negative or aggressive. Kids don’t sleep well or get PTSD diagnoses. It impairs their ability to sleep, which impairs their ability to learn.
When we began in 2005, we never, ever, took placement of a baby whose parents died from an overdose. Now, it happens just about weekly in our county.
A lot of our kids have Attention Deficit Disorder and their reading comprehension tends to lag. And so you ask, “Is that because of how the opioids have damaged their brain? Or are they distracted by trauma? Are they just paralyzed by grief? Is it because they can’t sleep?” The answer is yes, maybe. Possibly. Probably all of it.
Here’s a story: An 8-year-old child in my home wanted to know if she was in her birth mom’s tummy, why she wasn’t with her birth mom. This child’s birth mom is alive, but still an addict. She has occasional contact with her birth mom and the question came about a week after a visit. Her birth mom invited us to come to wherever it was she was staying, it could have been with friends or in what are called crack houses. I said, “Thanks for inviting us, but that won’t happen.”
My little girl was very angry. She said: We could have gone, she invited us to go, why do you have to be so mean? So I just sat her down and I explained: “She loves you, and you love her. And we love her. And we’ll always consider her part of this extended family. But you need to know that this is a person, who for as much as she loves you, has made a choice in her life, that put her in situations that are dangerous. Your safety would not be a priority, not because she doesn’t love you. This has nothing to do with her love for you or your love for her. If she was a person who could keep herself and her child safe, you would be with her. But it’s not possible.”
I think it was hard for her to process the fact that her birth mom, that she truly loved, might put her in harm’s way. But I think she understood that I was being truthful. I said, “Look. You were inside her. She was the first face you saw, the first voice you heard, she was the first person who fed you, who held you, who kissed you, who hugged you. It’s a special bond. You’re allowed to cherish the bond and you’re allowed to love her. The loss of that is horrible. And I am so sorry that you lost that. But you’re allowed to love her and cherish that. You’re allowed to have that special bond with her.” She cried and cried. It’s hard.
There were the sleepless nights. We had to feed meher with the medicine dropper because she couldn’t suck on a bottle. She tremored. She shrieked and screamed a lot.
Before we adopted our first daughter, we were packing our bags and leaving the next day to take a week in Florida at the beach. We had just said goodbye to a foster baby who had been with us for nearly a year. For the first six or eight months of the case, it was moving to adoption. In about the ninth month, the case changed direction when relatives stepped forward, and of course, we were just decimated. So we decided to take a break and go to Florida for a week.
As I was packing, the phone rang. We have caller ID. So when Child Services came up on the Caller ID, like an idiot, I answered it. It was the call for a baby girl who had been born exposed and premature. Often children who are exposed in utero are born too early, compounding all of the problems. There was no prenatal care so they estimated she was born at 28 to 30 weeks. She weighed two and a half pounds and was in withdrawal. By the time we were identified as foster placements and they were ready to release her, she was five weeks old.
It dawned on me that this baby had been alone for five weeks in the NICU. Her mom presented at the hospital as intoxicated, and within hours of giving birth, I think she feared that she would be arrested, so she ran. Thoughts of vacation in Florida went out the window. I called my husband and he agreed. We brought her home. Our first goal was to get her to five pounds.
We look at our children, where they’ve come from, and how far we’ve come, and we think, this is the maximized outcome. We couldn’t be more thrilled
One of the things that isn’t widely known is that withdrawal can be more than a newborn survives. To ease the withdrawal, they are given methadone, and then they have to withdraw from methadone. It’s basically just a lesser of the evils. We braced ourselves for withdrawal from that. There were the sleepless nights. We had to feed her with the medicine dropper because she couldn’t suck on a bottle. She tremored. She shrieked and screamed a lot. For the first two or three months, there were endless rounds of doctor appointments and specialists just to get this child healthy.
When we went to pick her up to bring her home, her attending doctor in the NICU said to us, “We’ve done everything we can. She was exposed to all sorts of substances. She was born too early. She has a heart condition.” He just went down the line. He said our best hope was to be out of a sterile environment and in a normal, loving, stable family situation so that she would have a chance of hopefully developing normally.
We adopted her at 20 months. She struggles with the things that children who were exposed struggled with in school, but she has all the help available. She’s a cheerful, happy, well-adjusted child.
Sometimes, I think if people on the outside could look at our life from the inside, they would think that we’re not normal. But we look at our children, where they’ve come from, and how far we’ve come, and we think, this is the maximized outcome. We couldn’t be more thrilled.
— As Told To Lizzy Francis
Sarah V.’s name has been changed to protect the anonymity of her children.
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