THE LOVE CURE

The baby sleeps like an angel, its soft flesh snuggled in a sea of
blankets in a dark, quiet nursery. When a slight noise interrupts its
sleep, the infant's blue eyes open wide, its upper lip trembles
uncontrollably and a high-pitched cry shatters the peace. Another
drug-addicted newborn faces the painful reality of withdrawal in its
first days of life.

Barbara Stewart, a volunteer at Sunny Hill's infant development
centre, tries to ease the pain by holding and cuddling babies like
this one. A volunteer in a "cuddling" program that began almost two
years ago, Stewart will never learn these innocent addicts'
identities but hopes she's making a difference in their lives.

"Sometimes they will be very stiff and hard to hold or irritable and
crying, but they are deeply lovable babies," says Stewart, who always
hands over a baby she is cuddling if its birth mother enters the
development centre.

This baby's crib is one of four permanently set aside at the Sunny
Hill facility, part of the Children's and Women's Health Centre, to
treat babies from around the province that show acute signs of drug
withdrawal-health workers call it Neonatal Abstinence Syndrome.

It costs about $1,500 a day for each of Sunny Hill's withdrawal cribs,
with stays lasting between one and four months. Last year, the
facility treated 31 babies with an average stay of 41 days. Most
ended up in the care of their mothers or other family members. As
they grow up, these children will be at risk of addiction, learning
difficulties and ongoing health and social problems.

The number of babies born addicted to drugs in B.C. has soared over
the past decade, leading to calls for tougher treatment of pregnant
women abusing drugs. Some, like Betty Green of the Vancouver Right to
Life Society, argue addicts should be forced into treatment programs
for the duration of their pregnancies. "Most people when they see an
addicted baby in a crib are appalled that it's allowed to happen,"
said Green.

But others say the real answer is better care, not
coercion.

Pediatrician Dr. Christine Loock, who has worked at the Sunny Hill
facility for 15 years, gets hot under the collar when she hears
people argue for forced treatment. "In all the high-risk women I've
worked with I've never met a mother who was out to damage her baby,"
said Loock. "We shouldn't be looking at punishment to get women into
treatment; we should look at where the gaps are in supporting women."

The idea of forced treatment of pregnant drug addicts was effectively
quashed by a 1997 Supreme Court of Canada decision in Manitoba. The
previous year, Manitoba's Department of Family and Children's
Services obtained a provincial court order to detain a young native
woman, a glue sniffer, who was five months pregnant and had already
given birth to two permanently disabled children later placed in
government care.

The Manitoba Women's Health Rights Coalition successfully appealed the
decision, but the Manitoba government took the case to the Supreme
Court the following year. The court ultimately ruled forcing a
pregnant drug abuser into treatment was contrary to the Canadian
Charter of Rights and Freedoms, because existing laws do not protect
the unborn fetus.

The pregnant mother voluntarily stopped sniffing glue and gave birth
to an apparently healthy child in December 1996. The Right to Life
society was appalled by the court decision, however, and is now
lobbying provincial and federal politicians to change laws so
government agencies can step in and forcibly protect an unborn baby at
risk. "The feds do everything they can to stop people smoking because
it hurts the unborn baby," Green said. "But they'll deny [the unborn
baby] exists in the eyes of the law."

But Loock, who helped develop the harm reduction model of care the
province has used to deal with pregnant addicts since the mid 1990s,
says the Manitoba decision had nothing to do with the debate between
pro-life and pro-choice movements. "This was a decision about offering
a woman compassionate care in a proactive way instead of waiting until
she was 20 weeks pregnant then trying to force her into care," she
said. "The young woman wanted to stop but when a detox bed did become
available she was high and didn't want to go. Why weren't they there
when she was 16 having her first baby?"

In fact, Loock said changes in the provincial government's handling of
pregnant addicts since the Supreme Court ruling have helped keep some
NAS babies and their moms together, which used to be rare.

"Separation of the mother baby pair is a terrible outcome and while we
may or may not be able to keep the mother with her baby in the long
term, Sunny Hill welcomes birth moms to stay at the facility and be
active in the withdrawal process. Some even choose to go through the
withdrawal at the same time, which helps them stay with the infant."

To ensure pregnant addicts have adequate support, Loock helped found
Sheway, a Downtown Eastside pregnancy outreach centre, in 1994.

The Hastings Street program, which offers addiction services, medical
services, food support, regular group counseling and help with
accommodation and travel, is jointly funded by the Ministry of
Children and Families, the Vancouver/Richmond Health Board, Vancouver
Native Health, YWCA and Health Canada. Health workers in the Downtown
Eastside refer all pregnant drug addicts to the shop-front program.

"It's a place where pregnant, drug-abusing women don't feel criticized
and the staff assist the woman to make the best decisions she can
make at the time," said the director. "When staff experience
frustration with the situation they problem-solve and try and find
creative ways to deal with the woman."

On a park bench opposite Oppenheimer Park, 23-year-old Rachel smokes a
$10 rock of crack as she watches seagulls dip and rise on a sunny
Vancouver afternoon.

Rachel was born to a heroin-addicted mom in East Vancouver at a time
when babies were usually stripped from birth mothers known to be
chronic drug and alcohol users.

When Rachel had her first baby, at 18, the province had changed its
approach. Sheway had just opened and addicted moms were being
encouraged to improve, as best they could, the chances for their
unborn babies. At Sunny Hill, some babies are born addicted to
methadone as a result of their mothers switching from heroin during
pregnancy, but that's considered a harm-reduction success because the
mother has reduced the risk of contracting HIV through shared needles
and is less likely to prostitute herself for drug money.

When Rachel found out she was pregnant, she cut her drug habit by a
quarter and went on a pregnancy program where every Friday she got
free bread, milk and eggs.

"I smoked cigarettes, pot and rocks, but I quit doing heroin and I
stopped drinking," she said "I got sick when I was born not because my
mom was a heroin user but because of how she used. She drank alcohol
and coffee and smoked cigarettes." Research shows that birth defects
associated with prenatal cocaine use are not as devastating on the
fetus as heroin or alcohol use.

Rachel's first baby was born healthy, while her second, born 18 months
later, had infant asthma. "My daughter was born healthy, happy and
smart and the doctor told me I was lucky. But I exercised, I ate, I
slept and I got proper nutrition."

Rachel kept both her kids but lost custody after going on a binge in
1999 that ended with her being jailed on a drug-dealing charge.

Dyan Siegl, a Downtown Eastside street nurse, meets many pregnant drug
addicts like Rachel who aren't interested in giving up drugs. "I've
learned not to focus on treatment," Siegl said. "I try more to
promote health in a way that's acceptable to them at that time, the
basics like vitamins and [whether] she has a place to live. A little
is better than nothing, so I try and find what's acceptable to them
and what they are interested in doing. Once we are involved there is
usually a better outcome."

Of the last three pregnant addicts Siegl worked with, two had
abortions and the other, just 16, decided to have her baby and was
referred to Sheway. "The majority of pregnant addicts I know do
heroin but there is a lot of crack-smoking right now. I'm in awe of
the power of addiction and what it forces people to do. It's
mind-boggling that their greatest fear is withdrawal and that fear is
more powerful than protecting the unborn."

A 1998 report from the B.C. Ministry of Health's Information and
Analysis Branch identified drug-affected babies as a significant
public health issue.

Based on hospital records, the ministry found about 150 NAS babies
were born in B.C. from 1995 to 1996-a six-fold increase over the
previous decade. The report found rates of NAS are about four times
higher in Status Native mothers than in the rest of the population
and most mothers of drug-affected babies are under 30, primarily using
crack, cocaine and heroin.

NAS babies are quickly identified through tell-tale symptoms of
irritability, sneezing, a rigid body, explosive stools, tremors, poor
appetite, high-pitched crying, chills and hiccups. Those that can't be
dealt with by local community health facilities are sent straight to
Sunny Hill, depending on bed availability. The infants are placed in a
dark, quiet nursery where they're treated with tapered doses of morphine.

Geographically, Vancouver has the highest rate of drug-affected
babies, with about one-third of the cases in the province. Other
health regions with high rates are Burnaby and the Thompson and
Northern Interior districts.

Dr. Loock attributes the increase in NAS numbers partly to greater
awareness of the problem. "These figures are not a bad outcome because
the epidemic has been recognized. Before, we had babies apprehended
from their mothers because of neglect, the adoptive parents knew
nothing about the baby's problem and the birth mother was thrust back
out with no support."

Ross Dawson, head of the B.C. Ministry of Children and Families' child
protection branch, says his ministry is willing to take more risks to
keep NAS babies and mothers together because harm reduction is
considered the best approach to deal with addiction. But he admits
feeling frustrated when he sees drug-addicted babies.

"You see children born whose life expectancy is shortened dramatically
and with disabilities for life as a result of this, when it's a
preventable problem and a huge and growing health-care cost," said
Dawson.

He said the ministry's decision not to detain pregnant addicts stems
from the Manitoba legal case, not from its own policy. The government
can detain a pregnant addict under the Mental Health Act if she is
certified mentally ill, but that isn't the case for most addicts.

The Ministry of Children and Families has worked with the ministries
of health and social development and economic security to develop a
protocol for dealing with pregnant addicts, including how to arrange
services and when to call in child protection officials. But Dawson
points out that addicts are in no way obligated to participate.
"There's more outreach going on to influence pregnant mothers if
there's a suspicion or knowledge of drug abuse. But those must be
voluntary interventions."

Back at street level, Rachel, now over her five-minute crack high, has
her own views about mothers and pregnant users unwilling to do
anything about their addictions.

"Some lady walked up at Carnegie Hall with a stroller with an infant
and a child behind the stroller and bought dope. I slapped out the
guy that sold her the dope and told her if she comes back with her
kids I'll beat her," says Rachel, whose knocked-out and decayed
teeth mar a once-pretty face.

Soon after, Rachel calls over a friend, then lies on the park bench
and drops her head back like a lover looking for a kiss.

Her street buddy, Merlin, kneels over her with a syringe loaded with
cocaine in a saline mix and slides it into her jugular vein. Rachel
pipes up again.

"I'm a good mom, I love my kids and they love me," she says, hopeful
that she may one day win them back. "If you take care of yourself, you
can use at the same time as being pregnant. You've just got to love
your kids."