UNION, Ky. – By all accounts, Keegan is a happy, smiling 5-year-old boy loving life, especially when he gets to play with his train set. But behind his smile are the lasting effects that his mother passed onto him, hindering him for a lifetime.
Keegan’s birth mother was a heroin addict.
Her addiction is costing not only her youngest son the chance at a normal life, but also millions of dollars in infant treatment and foster care.
Currently, one out of every 10 babies at the Neonatal Intensive Care Unit (NICU) at St. Elizabeth Healthcare is born addicted to heroin. And from 2012 to 2013, the number of babies doctors treat for neonatal abstinence syndrome has doubled.
“It is a shocking statistic,” said NICU Medical Director Ward Rice. “As a person who takes care of babies, obviously you feel bad for those babies, but part of my job is to lessen their burden and make those babies feel better.”
For Keegan, another mother was waiting in the wings of foster care to give him the chance at life that his birth mother could not.
Born Innocent And Addicted
It’s no mystery where Keegan gets his beaming smile or contagious laugh; however, it's not the only thing that his birth mother, Cynthia Inabnitt, passed down to her son.
Inabnitt, now 37, was 23 years old when her addiction began: First with marijuana, then prescription pain pills for a lifelong ailment in her lower back. And then came heroin once her prescription ran out.
“The only thing I could afford was the heroin,” Inabnitt said.
So began her love affair with the drug for more than five years.
“It took me away from how I was feeling. It gave me this energy. I was superman, or superwoman—no hurting, no problems. It numbed all the feeling, and all the aches and pains that I was having,” she said.
“I wish I had never discovered it."
She didn't learn it soon enough for Keegan.
“Keegan will never live a normal life,” said Jenny Knecht, of Union, Ky., who adopted Keegan after fostering him from virtually the moment he was born.
He never chose to stick his tiny arm with a needle for the first time.
He never chose to be conceived to an addicted woman.
He never chose to be born hooked on the same methadone that was treating his mother.
But because of his mother’s addiction, Keegan will live with the effects of his mother's addiction. He will never:
- Communicate with ease and will always use an electronic device to express himself.
- Eat without a feeding tube; never able to enjoy the vegetables his family grows in their garden.
- Walk to the school bus or his sandbox in the backyard without braces on his legs.
Inabnitt discovered she was pregnant with her fourth child four months into her pregnancy. She said she sought treatment at the methadone clinic when she found out about the pregnancy.
“I thought that would be good, but honestly, all that’s just another drug,” she said.
'Lifelong Sentence For These Kids'
As a result, Keegan was born eight weeks early, addicted to methadone and benzodiazepines. He weighed two pounds and it took doctors three weeks to detoxify his fragile, newborn system.
From seizures, to irritability and sensitivity to light and sound, it was a slow process. And it was a heart-wrenching time for Knecht.
“The long-term effects of methadone are severe as well. It’s almost like the lesser of two evils. It’s lifelong, lasting effects,” Knecht said. "If you think of an adult going to through withdrawal and how painful that is, think about an under 4-pound baby experiencing that.
"It’s unfathomable,” she said.
Knecht was able to bring him home when he was 3 weeks old, still weighing less than 4 pounds. He was so tiny that they couldn’t find clothes to fit him.
“Another misconception is you take these babies going through withdrawal, and you think that after, say, a month or how ever long it takes them to overcome it, we’re in the clear. That couldn’t be farther from the truth. Because this is a life-long sentence for these kids.”
Early on, she said, she noticed Keegan wasn’t meeting his milestones as an infant: He couldn’t roll over, he wasn’t crawling, he couldn’t sit up, he couldn't support his own head.
At 3 months old, they sought out specialists and therapists who worked with Keegan and who continue to work with him on speech, and physical and occupational therapy.
At 5 months old, Keegan was put on a feeding tube.
“To get him to eat two ounces took, sometimes, up to an hour and was extremely difficult,” Knecht said.
He couldn’t walk until he was 2 years old and was eventually diagnosed with ataxic cerebral palsy, the most rare form of cerebral palsy.
“He is the poster child for addiction,” Knecht said.
Inabnitt cried uncontrollably as she admitted responsibility for Keegan’s difficult life during a recent interview where she spent time with her son.
“If it wouldn’t have been for my addiction problem, none of this probably would have happened. But because me being an addict has definitely caused a lot of the problems that he has,” she said.
“It tears me up inside to know that because of me, that’s how he has to live in this world now. It hurts. It hurts a lot,” she said.
It’s just after noon and Keegan’s bus comes to screeching halt.
The door opens.
After he lowers himself from the last step, he begins his long journey uphill on the paved driveway. Hand in hand with one of his two caretakers, he hobbles along with a brace securely fastened on each leg and a backpack on his back.
Squinting at the sweltering sun, he eagerly reaches his Knecht, gives her a hug and in a soft voice says, “Hey there!”
Keegan, who used to avoid eye contact, graduated from kindergarten this year, and now his adoptive mom can’t wipe the smile from his face.
“He’s the happiest child you could ever hope to meet and we would never change anything about him, but he faces struggles every day that were completely avoidable and it’s just so frustrating,” Knecht said.
In addition to two biological daughters ages, 11 and 7, she and her husband Mike Knecht, have fostered more than 30 children.
The Knechts have two foster children —ages 20 months old and 2 years old —one of which was born addicted to heroin.
Addicted Babies On The Rise
Addicted newborns were less common in 2009 when Keegan was born.
Doctors began noticing an increase in early 2013. Now, pregnant mothers admitted to St. Elizabeth Healthcare under suspicion of addiction are given a urine test and the fetus is tested via its umbilical cord tissue.
The number of infants treated for addiction at St. Elizabeth has increased from 63 in 2012 to 80 in 2013.
Just four months into 2014, the number of babies born addicted to heroin is 39.
It costs on average of about $13,887 to treat an addicted newborn at St. Elizabeth.
On any given day, there are about 20 to 30 newborns in the hospital's neonatal intensive care unit. In 2013, about 12 percent were being treated for opiate withdrawal symptoms. That was doubled from 6 percent in 2012.
The number this year is on the rise already, said Rice, a neonatologist for more than 30 years at St. Elizabeth.
“It’s of concern and it’s a larger problem than just our neonatal intensive care unit, it’s a societal problem that needs to be addressed adequately so that those babies don’t have this start in life.
And what is the long-term impact?
“This is a relatively recent development in our culture and as a result, we do not have a lot of long-term experience with these babies in terms of the magnitude of the problem that we now face,” he said.
'Addiction Same For Babies'
Heroin-addicted newborns have different needs than babies who are born addicted to other drugs, experts said.
But they suffer the same symptoms as adults going through withdrawal: diarrhea, vomiting, sweating, irritability, tremors, seizures and low weight, Rice said.
Some need to be treated with drugs to lessen the pain of withdrawal, he said.
Treating infants going through withdrawal takes about 12 days, depending on the severity of the addiction. Some do not require medicine if they are not diagnosed with neonatal abstinence syndrome, he said.
“If we leave them in a dark space, leave them swaddled, they’ll be fine in that fashion and do not need pharmacologic treatment,” Rice said.
Nurses spend much of their day holding, swaddling and rocking them to soothe their withdrawal symptoms, said Tracy Burch, a registered nurse in the NICU.
“As humans we all respond positively to a hug. It’s important for babies to feel that,” she said.
Burch makes her way down the sterile, baby blue hallway of the neonatal intensive care unit. The smell of soap and babies lingers in the air.
A doorbell breaks the silence in the unit, alerting her that one of the babies is distressed.
A tightly swaddled 12-day-old girl cries from a dark room. The pink plush giraffe resting on her incubator is no comfort as her legs thrash about from inside her cocoon-like blanket.
The nearby monitor displays her heartbeat in green. It’s on the rise as she shrieks. Her teeny fists balled up, flailing in the air above her increasingly red face. A tiny hospital bracelet is wrapped around her wrist, identifying who she is. She continues to punch around her.
She’s hungry, Burch acknowledges, as she gently picks up the bundle from her bed.
Rocking her back and forth...
Back and forth...
Back and forth...
Slowly the comforted baby turns her face inward to the nurse, who holds her close to her chest. The hungry baby’s cries are eventually muffled as she is fed.
Cords from the baby, keeping track of her vital statistics, dangle to the floor.
Pacified, Burch lays the tiny newborn down, her eyes closed and belly full.
Cost In Millions
On Knechts' hallway wall, a sign reads: ‘A house is a home when it shelters the body and soul.'
Keegan and one of his foster siblings are a just a few of the hundreds of Tri-State children born addicted and in need of foster homes.
“We have seen a significant increase, especially in the last six months,” said Teresa James, Department for Community Based Services commissioner.
In Kentucky, there are 7,700 children in foster care, and 1,172 of those are in the Northern Bluegrass region—a 12-county region, including Boone, Campbell and Kenton counties.
“[It’s] the highest number I have seen since I arrived in 2008,” James said.
Statewide, approximately 23 percent of youth entering care either had parental drug abuse or drug abuse by the youth as a “condition present” at the time of removal, said Anya Weber, with the Kentucky Cabinet for Health and Family Services. That number increased by 10 percent from 2010 to 2013.
In the Northern Bluegrass region, nearly 41 percent of youth entering foster care in 2013 had parental drug abuse or drug abuse by the youth as a “condition present” at the time of removal. That number increased by 67 percent from 2010 and was the largest increase across all regions in Kentucky.
The need is quickly outpacing available foster homes.
“We need foster parents who are going to be there when the child puts his fist through the wall for the first time,” James said.
“When you think about heroin and the addicted qualities, it makes it very difficult to even consider leaving a young infant in those homes. Heroin’s too unpredictable, too lethal,” she said. “We struggle with heroin—it’s not cocaine, marijuana, it’s a very difficult variable for us to manage because of the difficulty to treat the addiction.”
And with increased need, comes increased taxpayer cost. Placing a drug-addicted child in foster care costs about $28,000 a year and the average length of stay for a foster child is about two years. So the cost of foster care placements of 348 children placed due to a drug-addicted parent was roughly $19 million in the Northern Kentucky counties of Boone, Kenton and Campbell in 2012 and 2013, based on a WCPO analysis.
“The long-term [effects] for our society in terms of cost, and the emotional cost to families is the most concerning to me,” James said.
Opening Her Home
Framed family photos line the living room, and sketched on the Knechts' living room wall are the simple words: ‘Having somewhere to go is a home. Having someone to love is a family. Having both is a blessing.’
“It’s not saints that do this, we’re everyday normal people,” Knecht said about fostering children throughout the years. She stopped counting after 30.
“They choose us,” she simply stated.
Flipping through an album showcasing photos of her foster children through the years, Knecht reminisces about the memories made with each child.
“All you can do is love them while they’re here. Even if they don’t get it when they go home at least they had it here,” she said.
She does it, she said, to give the kids the good times, the love and the firsts that many may never experience again after leaving her home.
The payoff, she said, is seeing a child lick an ice cream cone for the first time, feel a hug for the first time, lay down in a bed that is their own bed.
“You don’t always see the payoff of what you’re doing in the moments,” she said. “The nights of no sleep, behavioral issues you’re dealing with become insignificant. They’re just moments, looking at the big picture, those moments are all worth it.”
The best payoff with Keegan was the day that she and her husband Mike will never forget. The day they adopted a then-2-year-old Keegan in November 2010.
“Adopting Keegan was just a formality for us,” she said. “We felt like he was our own long before the adoption date.”
“I no longer had to say I was his 'foster mom' but just 'mom' now,” Knecht said.
“Being a mother is what I’m meant to do. Foster care was where my heart was. This was my calling."
A Lifelong Battle
Inabnitt said she's been clean for eight months and just recently saw Keegan for the first time in 18 months.
“I’m kind of like a person in a shell. My eyes are just now opening,” Inabnitt said.
“I’ve been battling with this whole drug ordeal for 10-plus years and, at first it was a game. I was young and I was playing. I got too far into it and when it was time for me to get out of it, I couldn’t get out of it.”
She said she's overdosed three times and lost Keegan.
“Where I was at and where I needed to be… I just needed to stop, it was either that or I was going to die."
Things are looking up for her, she said.
“I’m very blessed because these are the things I never thought I could get back,” she said of being around her children.
She acknowledged that without the Knechts, she doesn’t know where Keegan would be.
“Jenny and her family, they’ve been a godsend. They were there from the beginning… I couldn’t take care of my son.”
She said she knows her son is better cared for now:
“God’s put [Jenny] on this Earth for a reason. With my son being with her I have no worries..."
"He has so much with her. I couldn’t have done it. I know I couldn’t have done it.”
Photos provided by the Knecht family and by Jessica Noll | WCPO
Take Action: If you’re interested in becoming a foster parent, call the Northern Kentucky Department for Community Based Services at (859) 292-6632.
Heroin: The Societal Cost is a series, pinpointing and documenting what the heroin epidemic is costing the Northern Kentucky region. Read more at www.wcpo.com/heroin.
Northern Kentucky Voice: Your Voice, Your Story is a periodic and ongoing series on WCPO.com about the people of Northern Kentucky making a difference in their community. If you would like to tell your story, or know someone who should, email Jessica Noll at Jessica.Noll@wcpo.com.
WCPO-TV 9 On Your Side story by Lanny Brannock, special projects producer