‘What happens in the NICU didn’t start in the NICU’


By Sarah Colson

The proportion of babies born in Tennessee with NAS more than tripled in the five years from 2009 to 2014. Rates are highest in this area.

The proportion of babies born in Tennessee with NAS more than tripled in the five years from 2009 to 2014. Rates are highest in this area.

Second in a series. Editor’s Note: Delving further into Neonatal Abstinence Syndrome here at News & Neighbor, we are quickly learning how difficult it is to adequately understand – and thus convey – each element of the many-faceted problem. We continue to consider the effort of a series worthwhile, and will publish articles as we grasp specific facets in ways that, while not expert, make us capable of shedding some light. This week’s story highlights a grant-funded program called “Woven” that helps women who have realized that in order to help their children, they must first help themselves. At the center of the grant and the program is Families Free, a nine-year-old, faith-based organization “dedicated to making positive impacts on families who are vulnerable, especially those who are affected by incarceration.” Participants’ names are changed to protect privacy. 

“I’d love to have my own trailer with some flowers in the window, a rocking chair and a little schnauzer.”

“I want (my family’s) trust back more than anything.”

“I want the world to remember that I was a good person and that I was kind.”

“I’ve always wanted to travel. I just want to go overseas. I want to see Ireland. I just want to see what it’s like.”

“I want to be a good mother.”

Lisa Tipton, director, Families Free. Photo by Sarah Colson

Lisa Tipton, director, Families Free. Photo by Sarah Colson

These are the words of women overcoming addiction through Families Free’s Woven program. Sitting around a small room on couches and comfortable chairs, 11 local women discussed recently what it would be like once they are finally freed from addiction. They are all mothers who are in the program by choice.

Woven is a pilot program funded by the Tennessee Department of Health that serves mothers who deliver a drug-exposed, or Neonatal Abstinence Syndrome (NAS), infant. In January of 2016 alone, Families Free served 177 women from the Department of Children’s Services (DCS), from jails in Carter, Sullivan and Washington counties, through the drug courts, and in their Woven program.

Most of the Woven moms that shared during News & Neighbor’s visit had lost custody of their children.

“The biggest obstacle in my life is overcoming addiction and changing the way I think,” shared one participant, Mary. Mary has two little girls, but no longer has custody of them. Though her children suffered from NAS, it wasn’t until a few years later, when she lost custody, that she realized she needed to change her life.

Families Free was established in 2007 to deal with the “why” behind drug-addicted women in the area. One thing that became abundantly clear when peeling back the layers of people with substance abuse issues is that many of them have suffered trauma that has been classified in the current parlance as “adverse childhood experiences.”

Lisa Tipton, co-founder of Families Free and Woven, said that those adverse childhood experiences often get repeated if a mother does not seek treatment. All too often, fallout from that includes babies born with NAS, the incidence of which has been skyrocketing in Northeast Tennessee through the past half-decade.

Tipton has her own thoughts on what the community needs to decrease the chances of babies born addicted.

“In this region, we need more good clinical services,” she said. “We need more availability of real treatment, of real hope…Someone who has a substance abuse addiction, they have a lot of other challenges too. So are we going to say, just take this baby home?

“We had a situation where a parent had a baby in the NICU that (she) hadn’t visited the entire stay. But because she had a legal script, she went and picked him up and the hospital had to let (the mom) take him. So now we have him through DCS.

“There are some really, really rough situations that the average community member doesn’t know anything about. They have no idea what’s going on right around us in the community and they don’t really understand that what happens in the NICU didn’t start in the NICU. And it will not end when these moms and babies leave the NICU without some intervention, without some investment, without some good treatment and without some help.”

Buprenorphine (Suboxone or Subutex), a drug used to help addicts get off of other opiates, is a factor in many NAS cases, and is most prevalent in Northeast Tennessee as the dark shaded areas of this map show.  Source – Tennessee Department of Health

Buprenorphine (Suboxone or Subutex), a drug used to help addicts get off of other opiates, is a factor in many NAS cases, and is most prevalent in Northeast Tennessee as the dark shaded areas of this map show.
Source – Tennessee Department of Health

When Tipton worked with a foster program prior to founding Families Free, she realized that children need their mothers, whom mentors – no matter good – can’t replace.

Some addicted moms showed no interest in their children, but most she talked to in local jails wanted more than anything to recover for their children.

In 2013, Tipton got a chance to help make that happen. Families Free is credentialed to provide services for DCS, and in 2013, the Department of Health reached out and asked them to start a pilot program for moms who give birth to NAS babies.

“We don’t think that we just need to manage some of these issues and hope that people make it,” Tipton said. “We believe that people can heal from that inside out and that the lives can be changed and that they can provide a future for their children that’s different than what they’ve experienced. It’s about weaving together DCS, our agency, the mom, the baby, and weaving these things together for the good of the family.”

Tipton said moms leaving the hospital face many obstacles and often return to old habits of substance abuse. Mary did, before eventually entering the Woven program.

As part of her treatment, Mary shared with the group a picture of a caterpillar changing into a butterfly, which she drew to represent herself.

“I’m changing and healing like the caterpillar changes into a butterfly,” she said. “I’m learning things from everybody here. I’m changing into something colorful and free.”

Woven lasts four to six months and is designed to help women understand, “some of the attitudes, beliefs and experiences they’ve had in the course of their life that have led to the behavior of becoming dependent on substances to cope with life,” Tipton said. “And that’s a pretty deep and intensive process.”

Participants develop treatment goals and graduate once those goals are met.

Families Free is a licensed mental health facility, and so can offer services for mental health issues as well.

“There’s a lot of people with substance abuse issues that have some really deep, underlying history with adverse childhood experiences, with trauma,” Tipton said, “and when they can go back and understand how all of that plays into addiction and begin to really take care of themselves and their (unhealthy) relationships stop working and their physical and emotional health improves, they do OK.”

Tipton said that though Woven works with the women directly, the entire community is affected through their work with DCS and others.

For Mary, that help has inspired her to speak out about what substance abuse looks like: “It can happen to anybody,” she said. “You become that drug; you become that alcohol. But we’re not bad people. I just want people to see that we’re trying.”

Woven Volunteer Rachel Adams said the imagery of a caterpillar’s journey toward becoming a butterfly is the perfect metaphor for what the women are trying to accomplish in Woven. Every fall, Adams said, her family gets a Monarch caterpillar in a jar and watches it transform.

“The process is really long and yucky,” Adams told the small group gathered at Families Free. “It is nasty and filthy and the jar is gross. And then it forms the chrysalis. And it stays in that chrysalis forever. You think, ‘this is never going to happen. I bet my caterpillar died.’ And then, when it’s coming out, it has to struggle to get out of the chrysalis and if you help them get out, it would destroy it. It would never be able to fly because it has to struggle getting out so that it’s able to get the fluid into its wings. So the process is a miracle, but it’s ugly and it’s hard and it’s painful and it’s messy.

“Watching you all just a couple hours a week, you all are doing the hard, messy, painful work and you’re some of the bravest people I’ve ever seen in my life. So I love that picture you shared because it does turn out beautiful, but it isn’t pretty in the process. So just be encouraged. Just because you don’t see the miracle right now, it’s still happening. What you do matters for yourself, for others, and for the bigger community because we’re all a part of each other.”



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