Great Falls Tribune - Montana
Meth babies start their lives in a hole.
"These babies are crying all the time. They don't know how to feed. They may have difficulties bonding with their mothers," said Dr. Dan Nauts, director of the Benefis Addiction Treatment Center.
"And of course, you have mothers who don't know how to respond, either."
Every week in Great Falls, a baby is born who tests positive for methamphetamine.
Sometimes the babies are abandoned. Sometimes the state already is caring for the baby's siblings and knows the newborn won't be safe returning home with his mom.
Most of the time, it isn't clear what should happen to these new arrivals.
Having a baby to care for may be the best incentive meth moms ever have to get clean. But babies are helpless, and meth babies need extra attention and care that a recovering addict may not provide.
Benefis nurses are required to call the Department of Child and Family Services if a mom or baby tests positive.
From that point, officials must balance the interests of the mother and the child, with the ultimate goal of keeping them together.
"When we intervene it doesn't mean removal," family services intake supervisor Teri Bellusci said. "Terminating parental rights is the last option."
Last year, Cascade County judges handled more than 150 youth-in-need-of-care cases.
Starting this year, the state is tracking how many infants and children are coming to family services because of meth. Cascade County kept its own count last year, estimating nearly half of its referrals are the result of meth.
The court has the option of requiring parenting classes, regular home visits by family services and drug tests to keep parents clean. Relatives are called upon to help care for the babies and supervise the parents.
But just like their babies, addicted parents have plenty of problems to overcome even after kicking the habit.
Meth dulls feelings of happiness, makes addicts numb to their responsibilities and reduces their attention spans.
"Those really warm feelings that women feel following delivery that causes them to bond with their infant are going to be impaired," Nauts said.
Meth babies spend their first weeks asleep, some barely waking to feed. Within four to six weeks, they begin crying uncontrollably, irritated by normal sounds and lights.
This can be overwhelming for any adult, let alone someone who is battling meth addiction.
Nauts makes room in booked long-term treatment programs for meth moms who want help. He knows it's the best time to reach them.
"If we take the child away, the drug use starts all over again," he said.
Love for their newborn babies is the best reason an addict will have to stop using.
Still they slip.
"A pregnant person is usually the most motivated to break the habit," Great Falls obstetrician Dr. Thomas Key said. "They will absolutely sacrifice all those things because of drugs."
Meth's pull is like no other drug. Because it permanently alters the brain's chemistry, treatment takes two years, not 12 weeks.
"This drug highjacks the brain," said Kathy Masis, an addiction treatment expert with Billings-area Indian Health Services. "Parents lose interest in their children, and pregnant women lose interest in their pregnancy. They are thinking about meth and when they're going to use it next."
Addicts don't feed themselves, let alone their kids. They go days without sleeping and then crash.
Breastfeeding babies share meth with their moms.
If someone is cooking meth in the house, babies are exposed to hazardous and explosive chemicals.
Bellusci has seen meth needles in diaper bags and broken light bulbs with drug residue within children's reach. Filthy homes offer little food.
"It's heartbreaking," she said. "If a mother is dependent enough to use through her pregnancy, she's not going to stop once the baby is born."
With the baby's safety the top concern, family services turn to grandparents or other relatives when parents can't kick their addiction.
If that's not an option, babies are placed temporarily in foster care — though foster families are in short supply.
Cascade County has roughly 350 kids in 100 foster homes. Statewide Montana has 2,160 displaced children in foster care, the highest number since May 2001.
With homes in short supply, Cascade County sends children to Helena, Havre and Conrad for short times.
Few foster parents have the experience and training needed to give meth babies the extra care they require.
Federal guidelines give family services 15 to 22 months to decide if the baby or child should be removed permanently.
Bellusci says that's often too soon to know if an addict has really kicked the drug.
"We want to avoid the revolving door where they maintain sobriety for a period of time, get their children back and then start using again," she said. "It takes longer with meth to make sure they can maintain sobriety."
It's eventually up to a judge to sever the parent's rights to the infant, allowing the child to have a permanent adopted home.
"I'd like to say we can help everybody," Nauts said. "But some people are so immersed in their addiction, the best we can do is help the child and hopefully find a good environment."
An international study done in the late 1980s followed meth babies to age 10. Those who were placed in multiple foster homes fared worst, even compared with those who remained with meth-addicted parents.
Children who had stable foster or adoptive homes still have hyperactivity disorders, said Dr. Rizwan Shah, medical director of Blank Hospital's regional child protection center in Des Moines, Iowa. She's been studying meth's effects on babies since 1993.
"Child behavior depends a lot more on what happened in the environment after they're born than what happens in the nine months while in the mother's womb," she said. "The first three to five years of life are very important for development. People need to understand the risk of abuse and neglect."
Local doctors and nurses first started seeing meth babies five years ago. Soon those children will be entering the school system.
The long-term damage of meth in the womb and the chaos of their first years might become more evident as teachers work with these children and see how well they learn.
"So much of the potential effects can take years to show themselves," Great Falls neonatal Dr. Evelyn Rider said. "We really won't know until they go to school what effects the drug has had on the babies' brains."
Rider and other doctors from across the state are meeting at the end of April to discuss methamphetamine's impact on infants.
If nurses or family services spot them, they place these babies in programs that work the weak parts of their brains. Their parents are taught techniques to help their young ones catch up to other kids.
"They are going to take a lot of teacher time," warned pediatric physical therapist Karen Thornton. "This is going to be a wave effect through our community."