OFFICIALS BALANCE BABIES' NEEDS, MOTHERS' ADDICTIONS

Envision a newborn child -- small and delicate, innocent and tender,
helpless and shaking violently as it screams and struggles to kick a
drug habit inherited from its mother.

That's a scene that can turn heads, evoke a sense of shame or
disgust. It's also one too often seen by doctors, social workers and
law enforcers in Muskogee County and elsewhere.

Appalled by this reality, local officials are grappling over ways to
deal with mothers who give birth to drug-addicted babies.

The lines become blurred when it comes to taking action. Officials
have to balance the realities of public health policies promoting
treatment for an addicted, pregnant woman dealing with her
insecurities and uncertainties with the public's pleas to punish
those who would wrong a child.

That balancing act came into focus recently with the arrest of a
Muskogee mother who was charged with one count of felony abuse after
allegedly giving birth in February to a baby born addicted to
methamphetamine. A similar charge awaits a second mother who gave
birth to another baby in the same condition. That woman has yet to be arrested.

The charge, according to Jan Ray, an investigator with the Muskogee
County Sheriff's Office, was the first of its kind filed in Muskogee
County District Court. Working in tandem with the district attorney's
office, Ray -- who said these arrests and subsequent prosecutions
will act as deterrents to other mothers -- said there will be more to come.

While many people may applaud such an aggressive policy, there are a
number of others who say that tact may not be the best.

Public health officials express concern that pregnant women who
struggle with addiction will shun physicians and avoid seeking health
care out of fear of being arrested. That possibility has health care
workers worried about a higher rate of infant deaths and dwindling
numbers of women who get proper prenatal care.

Dr. Edd Rhoades, deputy commissioner for Family Health Services with
the Oklahoma Department of Health, said Oklahoma already ranks among
the bottom 10 percent when it comes to the number of women who seek
prenatal care during the first trimester of pregnancy. Statewide,
only 77.8 percent of pregnant women seek prenatal care during the
first trimester. Nationally that number is 84.1 percent.

"We are concerned about the health and welfare of babies being born
addicted to use of illicit drugs," Rhoades said. "But at the same
time we would approach the situation differently -- by trying to work
with the women earlier (in their pregnancy) so they can benefit from
earlier treatment."

Rhoades said the ideal situation would be to identify pregnant women
who have a problem with any drug -- illegal or otherwise -- and help
them get the treatment necessary to kick their dependency. But he
admits that might be hard to attain for two reasons:

The already low number of drug-addicted women who seek prenatal care;

And the lack of resources available when it comes to drug rehabilitation.

According to a report released February 2005 by the Oklahoma
Governor's and Attorney General's Blue Ribbon Task Force on Mental
Health, Substance Abuse and Domestic Violence, alcohol and drug
treatment capacity must be expanded. The report emphasized the need
for services meeting the specialized treatment needs for pregnant and
parenting mothers.

"At least 100 to 200 additional adolescent residential substance
abuse treatment beds are needed to address current demand, along with
the provision of more outpatient mental health and substance abuse
programs for adolescents and their families," the report stated.

Dr. Michael Stratton, a Muskogee pediatrician, said he agrees there
needs to be earlier intervention and more opportunities for
treatment. He said treatment alone, however, isn't enough to wean
methamphetamine users from the drug and its potent effects.

"The rehabilitation rate for meth addicts (who seek outpatient
treatment alone) is almost nil," Stratton said. "But if locked up and
kept away from the drug for 90 days or more, there's a lot better
chance they (methamphetamine addicts) are going to be able to quit."

Muskogee County Sheriff's Investigator Tim Brown said he has no
problems with those who argue treatment should take priority over
punishment when it comes to shaping public policy. But he said when
pregnant women and mothers fail to seek -- or refuse -- treatment for
their addictions, then law enforcement has to step in.

"We don't want to come off like we're monsters," Brown said. "But if
your first priority as a mother is not your child, then we'll make it ours."

Gerald Davis, assistant county director of Muskogee County Department
of Human Services, works with Ray, Stratton, Brown and several others
who are part of a local multidisciplinary team that deals with issues
such as drug-addicted babies. Davis said as the team goes forward
trying to come up with a plan to address this issue, he hopes reason prevails.

"This is a subject that requires careful consideration of a lot of
things," Davis said. "You have constitutional and legal issues that
have to be considered in addition to the public health aspects involved."

"I hope we can proceed on a case-by-case basis and look at each case
individually," Davis said.