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Playing Hot Potato With Pregnant Drug Addicts

  Xavier FrancescoMedlinis only 11-days-old anddetoxingfrom prescription drugs. His mother HillaryMedlingazes down on him as she gives him a bottle, and baby Xavier starts to scream.

鈥淚 know your tummy hurts,鈥 Medlin says to her baby. A trio of wires poke out from under his onesie and connect to a screen monitoring Xavier鈥檚 heart rhythm and heartbeat. A cuff on his tiny foot measures Xavier鈥檚 oxygen level.

Xavier鈥檚 screams are heartbreaking.

鈥淭his is new,鈥 Medlin says. 鈥淭his is part of the withdrawal.鈥

Medlin, 25, was an opiate addict when she got pregnant. Withdrawal during pregnancy is dangerous, in part because the baby goes through withdrawal, and in part because detoxing mothers will sometimes turn to dangerous street drugs.

So her doctor prescribed oxycodone, and now mom and baby are detoxing together after birth.

鈥淚t definitely sucks seeing them go through withdrawal because that鈥檚 the first thing they go through when they鈥檙e born,鈥 Medlin said. 鈥淎nd they don鈥檛 know what鈥檚 going on. Us when we go through withdrawal, we know why.鈥

Medlin鈥檚 story isn鈥檛 unique, in Florida or the nation. At Halifax Hospital in Volusia County, Xavier is one of six newborn babies detoxing on the same day. Things have gotten so bad, the hospital is expanding its neonatal intensive care unit, or NICU.

Nationwide, the rate of babies born addicted to opiates has tripled in the last two decades. But in Florida, the state formerly known as the Oxy Express, the rate of addicted babies grew ten fold.

And that has leaders trying to figure out what to do with pregnant addicts, even as county health departments get out of prenatal care statewide.

Health News Florida is highlighting details of its Pregnant and Poor investigation all week. See the series .

A complex problem

Medlin wears a black T-shirt with the picture of a wolf emblazoned above word 'Survivors'. She has freckles, a wide smile and big brown eyes that can鈥檛 hide her pain.

Her road to addiction started with two slipped disks and two bulging disks. She has piriformis syndrome, a condition where the muscles around her sciatic nerve weaken, causing low back pain. She was on a legal prescription to control the pain, but then she lost her insurance.

鈥淥nce my insurance got cut off, that鈥檚 when I went to the street with my dependency,鈥 Medlin said. 鈥淚 didn鈥檛 know what to do and I just took everything I found to feel better.鈥

She took any opiate she could get her hands on: morphine, oxycodone, roxycodone, loratab, percoset.

Medlin takes a deep breath.

鈥淚 do feel guilty putting him through this,鈥 Medlin said. 鈥淏ut I feel if I wasn鈥檛 on something we both probably wouldn鈥檛 be here.鈥

She鈥檚 referring to last November when she had an overdose, right before she got pregnant.

鈥淚t was whatever I could find in the cabinet,鈥 Medlin said.

Medlin鈥檚 problems are complex. She has a legitimate medical problem that causes her pain. But she鈥檚 an addict as well.

Medlin鈥檚 doctor Pamela Carbiener said it鈥檚 hard to sift through what is acute and chronic pain from withdrawal and dependency on opioids.

Carbiener is one of the few doctors who will treat pregnant drug addicts in Volusia County, and she risks her own medical license by doing it.

Her job has recently been complicated as the Volusia County Health Department stopped offering prenatal care. Statewide, more and more health departments are getting out of prenatal care.

If a doctor saw patients through the Volusia County Health Department, they couldn鈥檛 be sued. But the health department stopped offering prenatal care in the last two years, leaving doctors wary of seeing pregnant addicts for fear of being sued.

Carbiener told a panel working on solutions to the problem of pregnant addicts that doctors are overwhelmed, under-educated and don鈥檛 want to deal with this population when they have no resources to help.

鈥淚f there鈥檚 a bad outcome, (doctors) fear liability,鈥 Carbiener said. 鈥淎nd that鈥檚 one of their biggest fears because too often there will be a bad outcome. It鈥檚 hard to get good outcomes in these circumstances.鈥

What鈥檚 next

Xavier doesn鈥檛 know it yet, but he鈥檚 got a big task in life: Saving his mother. Medlin calls Xavier her second chance.

鈥淲ith my first son, he got taken away because I was in another rough patch with the dependency,鈥 Medlin said. 鈥淗is father found out. I would drink and drive with him. I would snort anything I could find while he was in the room. You know he could walk then. And I knew he knew something was going on if he had seen. 鈥 I finally went to detox.鈥

In the intensive care unit hospital room, Medlin and her doctor start talking treatment. Medlin can鈥檛 keep the prescription-strength ibuprofen down. She鈥檚 getting a steroid pack to help with the pain.

Carbiener promises to work with the pharmacist in the morning.

鈥淭here鈥檚 no way to do it today? Just asking, just asking,鈥 Medlin said.

Carbiener asks if her mom is coming to pick her up. No, Medlin says, she has the car.

鈥淚f I were to give you a script today, would you give it to your parents when you get home?鈥 her doctor asks.

鈥淵eah,鈥 Medlin says. 鈥淚鈥檓 going home after we鈥檙e done here for a couple hours to chill out.鈥

Carbiener nods.

鈥淚鈥檒l give your mom a call and make sure she knows you have a script that needs to be handed to her when you get home,鈥 Carbiener says.

Medlin also received a steroid shot for her back pain. If those don鈥檛 work, she may get the nerve endings in her back burned so she doesn鈥檛 feel pain.

Once Hillary Medlin is weaned off opioids, she can go into a residential treatment program called WARM: Women Assisting Recovering Mothers.

WARM was originally founded to help snow babies, babies born to mothers addicted to cocaine and crack. The program has evolved to treat women addicted to pills.

Participation in WARM ballooned alongside the state's prescription drug crisis. The program that started with 16 beds now has 80. Alicia Vincent is the program director for WARM. She says it鈥檚 scary how many women are afraid to seek help.

鈥淭he thought process is there if I or my baby test positive at birth the state is gonna step in and remove my baby,鈥 Vincent said. 鈥淣ot always the case, but still that fear factor is there, so a lot of women remain over in the shadow because they don鈥檛 want to run that risk.鈥

Rhonda Harvey and Alicia Vincent  work with WARM. They flip through a box of photos of women who have been though the program. One photo stops them.

Some come through the program successfully, Vincent said. And some don鈥檛 make it.

鈥淭his young lady here didn鈥檛 make it, is not currently parenting that baby,鈥 Harvey said. 鈥淵ou can tell him where she is now.鈥

鈥淭his current lady here, in heaven,鈥 Vincent said. 鈥淪he died.鈥

Harvey tears up at the photo. Harvey said the staff at WARM finds strength in those tragedies. Every day, the goal is to not let it happen again.

鈥淪orry,鈥 Harvey says, her voice wavering.

鈥淚t鈥檚 OK,鈥 Vincent says. 鈥淭his, oh. We gotta put the box away.鈥

Abe Aboraya is a reporter with in Orlando. WMFEis a partner with, which receives support from the Corporation for Public Broadcasting.

Copyright 2020 WUSF Public Media - WUSF 89.7. To see more, visit .

Hilary Medlin and her newborn son Xavier.
WMFE /
Hilary Medlin and her newborn son Xavier.

Rhonda Harvey, left, is chief operating officer of WARM, and Alicia Vincent, right, is the executive director.
WMFE /
Rhonda Harvey, left, is chief operating officer of WARM, and Alicia Vincent, right, is the executive director.

Health News Florida reporter Abe Aboraya works for WMFE in Orlando. He started writing for newspapers in high school. After graduating from the University of Central Florida in 2007, he spent a year traveling and working as a freelance reporter for the Seattle Times and the Seattle Weekly, and working for local news websites in the San Francisco Bay area. Most recently Abe worked as a reporter for the Orlando Business Journal. He comes from a family of health care workers.
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