It’s a constant reminder for Jessica Coleman. She took the video of her baby boy Jax, screaming in agony, in order to show her doctor how severe his symptoms were. Jax was born physically dependent on the heroin replacement drug Suboxone. Every time she watches it, the guilt is overwhelming.
“He detoxed. I mean, he screamed, he cried. He had all the symptoms,” Coleman told “America Tonight.” “There’s no settling them. You know, it’s that uncomfortable.”
Her son’s withdrawal from Suboxone was so bad that she thought he might die.
The rise of replacements
Coleman has lived her entire life in Rutland, Vt. It’s a picturesque town with a dark secret: the most opiate-addicted pregnant women per capita in the country. A Vermont clinic dedicated to caring for addicted mothers and their babies said the number of drug-affected newborns it’s seen has doubled in the past two years.
The drug is rarely heroin, but rather the replacement medication Suboxone, which acts on the same opioid receptors as heroin without the intense high, easing addicts through their recovery. Suboxone sales have skyrocketed in the past few years, at the same time as the resurgence of heroin. And pregnant women on the drug transmit it to the unborn baby in utero.
After birth, a percentage of infants suffer from “neonatal abstinence syndrome,” or withdrawal.
By her 20th birthday, Coleman was hooked on heroin, and she lived with the addiction for 10 years. She went into rehab five years ago and has been clean, but on Suboxone, ever since. Her firstborn, Cade, was born addicted to Suboxone and struggled with withdrawal. But nothing prepared her for Jax.
After the birth, Coleman and Jax were kept at Rutland’s hospital for four days, then sent home. But Jax continued to show severe withdrawal symptoms, and Coleman said she was uneasy. A few days after leaving the hospital, she was trying to settle her son, rocking him back and forth. She said she was exhausted taking care of her sick baby and didn’t know what to do. Then Jax went quiet. His lips turned blue.
Panicking, Coleman picked him up, shook him lightly and then blew in his face. Finally, he took a breath.
“It felt like forever,” she said. “It was probably a good 20, 25 seconds, you know, where he just was limp.”
Born drug sick
“Drug sickness amplifies itself with physical symptoms — vomiting, diarrhea, stomach pain,” explained Amy Pfenning, a clinical nurse. “These babies get very stiff. Their muscle tone gets stiff, very rigid, and in itself it is very uncomfortable.”
Pfenning works at the Rutland Regional Medical Center’s BAMBI clinic, one of the state’s new clinics that treat drug-affected babies. Vermont is at the forefront of an innovative approach that keeps Suboxone-dependent mothers and their newborns together, as the baby is treated. BAMBI stands for Babies and Mothers Beginning In-Sync, and 54 mothers have gone through the program since it opened two years ago.
“America Tonight” was allowed a rare visit, and Pfenning pointed to one baby in withdrawal from opiates. “We like to keep the environment really calm, dim the lights, keep down the stimulation for the babies, and that helps them settle … most of the time,” she said.
Most babies at the BAMBI clinic are held there from six days to two weeks, but some require up to 40 days of hospitalization. They are often treated with methadone, another opioid drug, and morphine. And they require near constant care. It can be tough for even the professionals to watch.
“If you have a baby that’s frantic and fussy and irritable, that’s a lot on the practitioner to have more than one withdrawing baby on their assignment, because they want to be held,” said Pfenning. “So it can be a very tedious 12 hours.”
Don’t go cold turkey?
Heroin replacement drugs have plenty of critics, who see them as substituting one addiction for another. But Gordon Frankle, who oversees the BAMBI program, said that keeping mothers on a heroin replacement drug during pregnancy and after birth is better than going cold turkey.
“All the research shows that women who are pregnant, who have opiate dependence, do much better if they’re engaged in treatment with medication-assisted therapy,” Frankle said. “These treatments allow for a continual level of the opiate in the system, so that the babies and the mom don’t go into withdrawal.”
Frankle claims most babies make it through the program without serious problems.
Now 15 months old, Jax has been fully weaned off Suboxone, and appears to be a normal, engaging toddler. But the future of Suboxone babies remains in question. Frankle said there hasn’t been enough research to determine the long-term effects of Suboxone on newborns. It’s difficult to study, he added, because so many factors have a role in a child’s development.
“A lot of it has to do not just with what you’re exposed to in utero, but also what the environment you’re born into [is like], and what’s the home life like?” he said. “What type of nutrition do you get? What type of education do you get? What kind of support do you get as you grow up? So all those factors are really important in a child’s development.”
‘They’re both going to have that gene’
Coleman remains worried that her children could eventually develop a learning disability. But what worries her even more is raising her kids in Rutland, where the heroin epidemic shows no signs of letting up.
“It’s a challenge,” she said. “I mean, I’m an addict. Their father was an addict. So chances are they’re both going to be, they’re both going to have that gene.”
Coleman said she doesn’t want to be dependent on Suboxone all her life, but without it she’s afraid she could relapse.
Her children, however, are a daily reminder of why she got clean.
“I’m grateful for the life that we have,” Coleman said. “On days where I’m struggling, or I feel like giving up … I look at their little faces and there’s no way. There’s no way. They’re my heart.”
With editing by Timothy Bella