This story, originally published by the Bristol Herald Courier, appeared Sept. 4, 2017. Copyright 2017 Bristol Herald Courier.
JOHNSON CITY, Tenn. — Ashton Shephard’s monitor beeped quietly, alerting those in his room at Niswonger Children’s Hospital Special Care Unit that he was in respiratory distress.
Respiratory distress was just one of the withdrawal symptoms the newborn had experienced since his birth 10 days earlier.
Born exposed to the Subutex that his mother, Tri-Cities resident Shawna Ramos, took throughout her pregnancy, Ashton started receiving morphine every three to four hours to help ease the effects of withdrawal. But he was now down to twice a day. Subutex is a drug used to treat opioid dependence, but because it’s also an opioid, it can be abused. Ramos, a 26-year-old mother of three, cried when she described the first time her infant shrieked from the pain of withdrawal. She admitted that he was paying the price for her eight-year addiction to prescription and illegal drugs.
She spoke to the Bristol Herald Courier from the hospital in June.
Ramos’ other children, ages 4 and 3, were also born drug-exposed, but they did not suffer the same withdrawal symptoms.
“I feel so guilty,” she said, tears streaming down her face. “All babies cry, but he has a high-pitched cry — like he hurts.”
She went on to explain that he also has a high temperature, stiffness and mottled skin, and he sucks excessively.
The symptoms Ashton experienced are common in babies born with neonatal abstinence syndrome. Other symptoms include tremors, irritability, sleeping issues, seizures, excessive sneezing and yawning, sweating, diarrhea and dehydration.
Ramos said Ashton had some of the other symptoms when he was first born, but the morphine helped alleviate them.
“He’s taking less [morphine] than he was at first — which is good — but no baby should ever have to feel the pain of withdrawal, and it’s hard knowing I did this to him,” she said.
Ramos’ addiction started when her boyfriend died. She was 18.
“I couldn’t shake the numbness I felt after his death,” she said. “My doctor gave me a prescription for painkillers, and when I couldn’t get it refilled, I got drugs off the street.”
By the time she was 22 and pregnant with her first child, Ramos was hooked on the painkillers oxycodone and Roxicodone. She said she couldn’t stop taking drugs because of the severe pain of withdrawal. So she went to a clinic for help.
“I hurt really bad. Everything hurt — my back, legs, everything in my body hurt like it was coming up from my bones,” she said. “I didn’t want my baby to feel that, so I went to a clinic to get Subutex. I thought taking that would be better than what I was on. The doctors at the clinic never told me that my babies could be addicted when they were born. They told me it was better for me to be on prescription drugs instead of illegal drugs, so I thought I was doing the right thing.”
Ramos said her first child’s NAS scores were a little high, so he spent five days in the hospital nursery. She also said since he wasn’t transferred to the NICU, she believed he was OK.
The NAS score sheet — called the Finnegan scale — lists 21 symptoms most frequently observed in opiate-exposed infants. Each symptom and its degree of severity is assigned a score and totaled — higher scores indicate a higher level of drug exposure. A baby must have a score of five or lower for three or more consecutive days to be released from the hospital.
Shortly after her first son was born, Ramos said she “slipped up” and starting using again. Soon, she was pregnant with her second child. His scores were also low, and he was released after five days.
“Having two young kids was hard, and being a single mom with little or no income added to the stress,” she said. “There are options to help with the stress, but the one I go to is drugs — they’re everywhere. It’s always around. There’s always someone who has something, and I started using again.”
When Ramos got pregnant with Ashton, she headed back to the clinic for help because her other two children weren’t born addicted. But watching Ashton withdraw has changed her mind on the cycle of taking Subutex for treatment.
“It’s been a wakeup call. Seeing him like this and knowing what he is going through makes me realize that I need to stop using,” Ramos said, looking at her son sleeping in her lap. “I know now that I need to even stop taking the Subutex because even though it helps me, it’s not worth this — I think seeing the pain he is in will help me to get clean.”
After her first two children were born, the hospital called the Department of Children’s Services to make them aware that the babies were born drug-exposed, she said.
“But because I was on a prescription medication, they closed the case pretty fast,” Ramos said. “They made sure I had a prescription, checked my home to make sure it was safe, drug-tested me, and at that point, they closed the case.”
DCS was called again when Ashton was diagnosed with NAS, and Ramos said they are handling things differently this time.
“This time, the case worker that came to the hospital told me about a program in Johnson City called WOVEN,” she said. “They have support groups and other things that can help me come off drugs and stay clean. I’ve already talked to them twice, so I’m going to go there, and they can help me come off of everything.”
The program is offered through Families Free in Johnson City and is for women who have delivered, or are at risk of delivering, a drug-exposed infant. Families Free is a faith-oriented, community-based organization that provides free treatment, education and intervention services to women and families affected by substance abuse, incarceration and domestic instability.
Ashton’s case with DCS is still open, and because of his addiction Ramos is unsure how long DCS will be involved with her treatment and recovery.
“My parents have temporary custody of my other two kids,” she said. “And when Ashton is released from the hospital, we’re going to live with them while I go through recovery. They are the only support system I have left.
“Addiction takes everything and everyone from you,” she added through tears. “I don’t know what I’d do without my parents. They are the only ones left who are willing to help me.”
Tammy Childress, Bristol Herald Courier