Addicted at Birth

My interest in neonatal abstinence syndrome was piqued several years ago by comments made by Sullivan County District Attorney General Barry Staubus in an article I edited for the Bristol Herald Courier.

Staubus is the prosecutor who led the effort to rid the area of deadly bath salts five years ago and who spoke out against the proliferation of “pill mills” in the county.

This time, he sounded the alarm about infants whose first moments are filled with immediate and intense pain and discomfort as a result of drug use by the mother during pregnancy.

And he didn’t just say there is a problem locally; he said Sullivan County and Northeast Tennessee have some of the highest NAS rates in the nation. I was startled.

These babies are the most vulnerable victims of the opioid crisis, of which Sullivan County has been called the “epicenter.” NAS babies are considered by many to be a secondary epidemic.

Over the last four years, we’ve published dozens of additional stories on the subject, and many of them involved Staubus, who toured a local neonatal intensive care unit to see for himself what the newborns endure. He also traveled to Nashville to share that experience with state lawmakers, testifying before a subcommittee that was hearing evidence related to a proposed law that would allow the mothers of NAS babies to be charged with a misdemeanor. The controversial law, which Staubus favored, was approved but allowed to sunset after two years.

In February, we invited him to come to the newspaper and speak to the staff as we embarked on this project, largely as a result of the attention he called to NAS. His thoughtful comments, passion and answers to our many questions left us fired up for the work that was to come.

Over the last seven months, the news team delved into every angle of the heartbreaking plight of these babies. Dozens of people were interviewed and much time was spent compiling and analyzing the numbers. The writers, photographers and editors spent hundreds of hours on the nearly 30 stories, compelling photographs, graphics, video and searchable databases. Every employee in the newsroom had a hand in this package.

Over the next week, you will read stories of children born withdrawing from drugs, the guilt of their mothers, who often lose custody, and the grandparents who end up raising them. Every day will feature a personal story.

You will meet several families who have adopted NAS babies and are working to help them overcome the lingering effects of their exposure.

We will introduce you to doctors and nurses on the front lines of neonatal intensive care units, where these babies often spend weeks being slowly weaned through decreasing doses of morphine. In many cases, these caregivers are developing the formulas and methods for dealing with NAS babies from scratch because they don’t currently exist.

Doctors at East Tennessee State University’s Center for Prescription Drug Abuse Prevention and Treatment are studying the problem and working to develop solutions. Because not much is known about the long-term effects of NAS, researchers at the center are also creating a registry from the records of hundreds of babies born in this area exposed to drugs.

And you will read about the “distinctive cry,” a haunting, high-pitched shriek made by NAS babies who shiver, suffer tremors, sweat, sneeze and vomit, and who have increased body temperature, rigid muscles, difficulty eating and diarrhea. The cry was described separately by a number of those interviewed for these stories, many of whom describe the toll that working with these babies takes on them emotionally.

Our work also revealed that Northeast Tennessee has more NAS cases than Southwest Virginia, although many Southwest Virginia babies are treated in Tennessee. But the Volunteer State is far ahead of Virginia in its recognition of the problem and efforts to combat it.

In June, Staubus and two other attorneys general from Northeast Tennessee filed a civil lawsuit that seeks to hold opioid manufacturers responsible for the opioid crisis.

The face of the suit — actually listed as a plaintiff — is an unidentified NAS baby from Sullivan County called “Baby Doe.”

Take a moment and think about that.

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