OPIOID CRISIS: Sanford Bemidji's First Steps program helps addicted mothers, babies

BEMIDJI--The day of her sister's funeral, Ashley Benson decided she needed to make a change. "The day I went into treatment here in Bemidji is the day I buried my sister," said Benson, a 30-year-old mother of four. "There was no other option, bas...

BEMIDJI-The day of her sister's funeral, Ashley Benson decided she needed to make a change.

"The day I went into treatment here in Bemidji is the day I buried my sister," said Benson, a 30-year-old mother of four. "There was no other option, basically. It was either make my funeral arrangements or get myself together."

Benson's sister died of a heroin overdose in July 2016. She had completed a chemical dependency assessment and was waiting to get into treatment, Benson said. The sisters had both actively used opioids for about 15 years, and that July Benson was six months pregnant with her son, Grayson.

Once she arrived at the Oshki Manidoo treatment center, Benson was introduced to Kami Kelm, a case manager with Beltrami County Health and Human Services for the First Steps to Healthy Babies program. For Benson, as well as other women who connected with Kelm, that introduction was a lifesaver.

"She really just held my hand through the fight," Benson said. "Me and my boys had nothing when we went into treatment but what was on our back, and she just kept building up my courage and telling me that things were going to get better."


A growing problem

As the nation grapples with an opioid addiction crisis that shows no signs of letting up, health professionals in Bemidji and across the state are working to address a lesser-known consequence of addiction: neonatal abstinence syndrome.

The syndrome, caused when a fetus is exposed to substances used by its mother during pregnancy, has become more common in the past decade, according to Lisa Johnson, director of Women's and Children's Health at Sanford.


From 2012 to 2015, the number of newborns in Minnesota needing special treatment because their moms were addicted to opioids more than tripled, from 239 to 765, according to the Minnesota Department of Health.

As with the opioid crisis in general, the impact on Minnesota infants hasn't hit all groups equally. According to the Minnesota Department of Human Services, the prevalence of babies born with neonatal abstinence syndrome - i.e., on withdrawal from the drugs their mothers used - is more than seven times more likely to affect Native American infants than non-Hispanic whites, said Dr. Rahul Koranne, chief medical officer for the Minnesota Hospital Association.

So Johnson and Sanford, along with Beltrami County and Red Lake Family and Children's Services applied for and were awarded a $1.67 million grant to create the First Steps program.


Pregnant women are referred to the program through a variety of channels

Once a woman is connected with Kelm, they sign on to what she calls "intensive" case management. Kelm helps the women figure out how to get clean and stay clean, but also assists with other needs. She helps them find resources, housing and child care; Kelm essentially works with addicted moms to build a new life.

"It was figuring out my game plan and what I needed to focus on," Benson said of her experience with the program. "It was appointments, or as little as getting different documents to prepare myself when I was to get my own home...If it was deposits, a plate to eat off of, they helped me with."

Since its inception in 2014, the First Steps program has worked with 160 women, and the number of child protective holds placed at Sanford Bemidji related to maternal drug use has dropped.

"In 2016 our number (of holds) rose quite significantly," said Ali Bruning, a registered nurse and case manager. "And then in 2017 our number started to drop, which was really good to see...The year isn't over yet, but we saw that the number of holds decreased quite a bit."

Ninety-five percent of the 160 women were able to go home with their babies.

Sanford and First Steps is just one of several programs put in place to deal with the growing problem of neonatal abstinence syndrome.

Among other efforts across Minnesota:


• The White Earth Reservation's MOMS program, a culturally specific holistic treatment program, provides daily doses of Suboxone for pregnant women who were addicted to opiates.

• The Superior Babies program, operated by the St. Louis County Department of Health and Human Services, promotes sobriety for women who are struggling with addiction to drugs and alcohol, said Wendi Tvedt, public health nurse senior.

• The Minnesota Hospital Association, with federal grant money via the state's Human Services Department, is developing a "roadmap" to focus on neonatal abstinence syndrome, Koranne said. A key element is drug screening for all pregnant women as early in the pregnancy as possible.

'It's only a step away'

Benson and her friend Amanda Alger, who was four months pregnant when she went into treatment, were both able to take their babies home with them. The pair grew up together, entered treatment at the same time, and gave birth within hours of each other.

Benson now has custody of her son Grayson, as well as her three other sons. Alger lives with her daughter Carmen, and is working to regain custody of two of her other children.

"When I first started working with Kami, and I first got into treatment, I had lost custody of my kids," Alger said. "Two of my kids, they're still in foster care, but they told me that once I get my case closed that I have a fighting chance to get them back."

Both Grayson are Carmen are healthy, their mothers say. Grayson had to spend time in the hospital after he was born and was put on morphine, but is now thriving.


"I still guilt myself a lot, but he's living proof," Benson said. "But I will say that moment of having him, coming to the fact that the choices I made put my son in a situation medically, crushed me into a million pieces."

Both women are now working, living on their own and are more than one year sober.

"So many things have changed," Alger said. "I always remind myself that it's only a step away. It depends on you and which choice you make...which way you want to go."


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