Heroin's grip: Epidemic scars generation of kids
Parent's heroin abuse stealing childhoods, leaving scars that can last a lifetime
Kymbal Pruett sat with her son Miquel, age 4, as she graduated from the Volunteers of America's Freedom House recovery program. May 10, 2016. (Photo: By Pat McDonogh, The CJ)
By Laura Ungar
Editor's Note: Today, The Courier-Journal begins a three-part series on the growing scourge of heroin in our community, with a look at its devastating effects on children. Next Sunday, we will examine the threat of infectious disease from rampant intravenous drug use; and the following Sunday, we will share the stories of families seeking solace and support as they struggle with the aftermath of addiction.
Miguel Diego spent his first years in heroin's hell.
His mom shot up in front of him. He was in a car with her when her brother sped the wrong way down a one-way street after being punched in the face by a heroin dealer.
And he was there when an overdose left his mom, Kymbal Pruett, unconscious and nearly dead, with another addict pleading as she came to, "You got to get up. You got to take care of Miguel."
The vivacious, brown-haired 4-year-old is among the youngest victims of a drug epidemic gripping Kentucky, Indiana and the nation and striking at the very essence of childhood. Heroin tears parents from children, erases stability and steals innocence, joy and any sense of safety. Instead of getting the love and attention they need to grow, children of heroin become secondary to the addict's endless quest for the next high.
"The impact on the next generation is heartbreaking," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention. "We've seen so many lives destroyed."
Paula Sherlock, chief judge in Jefferson Family Court, witnesses the devastation close to home.
"When I came on the bench 12 years ago, we never heard the word heroin. … Now, almost every case I hear on the abuse and neglect docket involves heroin," she said. "The kids don't have food. They're unsupervised. I've had to have the police pick up kids wandering in their diapers on the streets."
The toll is enormous:
• Foster care and other out-of-home placements are at an all-time high in Kentucky - 8,084, compared with about 7,000 six years ago. State leaders say drugs, especially heroin, are the major driving force. And the picture is similar in Indiana, where records show 2,600 children were removed from homes because of parents' drug use during the six months leading up to March 2015, up 71 percent from the same period two years earlier.
• Other child welfare statistics are equally grim. Kentucky's substantiated social service reports involving drug abuse rose to 8,542 last year, up from 6,303 in 2011. Drug abuse also helped swell the ranks of children growing up without either parent, Kids Count data show, from 63,000 in 2010 to 80,000 two years ago in Kentucky, and from 81,000 to 89,000 in Indiana.
• Uncounted parents are among heroin's dead. Overdoses involving the drug claimed 228 Kentuckians in 2014 and 213 more in the first six months of last year. That's up from 42 in 2011. Indiana had 63 in 2011 and 170 three years later. And those figures don't include deaths ascribed to morphine that are likely from metabolized heroin.
But more telling than statistics are the daily tragedies local children live - detailed in cases Sherlock can't forget.
In one, a 10-year-old boy got his little brother up and dressed for school, and on the way out the door stepped over the body of a family acquaintance who died overnight of a heroin overdose. In another, three unsupervised children of heroin addicts, the oldest only 8, accidentally burned down their house.
And just a couple of months ago, Louisville police entered an addict's squalid, moldy home and found a small child whose eye was injured running into a lit cigarette.
No one had bothered to take the child to the doctor.
Kymbal Pruett's past is full of an example of heroin's toll on children. "The impact on the next generation is heartbreaking," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention.
Growing up in danger
Many stories of addiction - including Pruett's - are multi-generational.
Long before Miguel came along, Pruett grew up with a drug-addicted mother, watching brothers and cousins slip into addiction as she did too.
She began popping pills at 14 and used various drugs for years before turning to heroin in her 30s after a breakup with an abusive and alcoholic boyfriend. "For me, it was a coping thing," she said. "It was just making me not feel."
From Miguel's perspective, it took away his mother. Sometimes, heroin left Pruett so incapacitated she couldn't even pour orange juice or make lunch for him, so he learned to get his own drinks and make his own peanut butter-and-jelly sandwiches by age 3. She strolled him down drug-infested streets to buy heroin and left needles around the house. She wasn't there when a virtual stranger took Miguel overnight from his dad's house or when he wandered out the door alone.
Pruett's 2014 overdose haunts her most. "I could have died with him right there," she said. "That should've been the end of my using. But it wasn't."
What finally led her to tackle her addiction was discovering she was pregnant again and being referred to Norton Healthcare's New Vision for Expectant Mothers, which helps women detox, get into drug treatment and find doctors. From there, she went into a recovery program at Volunteers of America's Freedom House, where she stayed with Miguel and his new infant sister.
At 36 and more than six months clean, Pruett now pledges to make it up to Miguel, "to do the right thing and take care of him and be a mom.
"He's seen enough," she said.
So have scores of other area children, such as 6-year-old Kamryn Murphy and his 5-year-old brother, Kolton.
They are being raised by their paternal grandparents, Angela and Dave Murphy of Louisville, because both parents are addicts. The Murphys' son, Kevin, grew up in a middle-class family where neither parent used drugs but nonetheless became addicted to painkillers he bought on the street as a young man.
Eventually, he was shooting up heroin with his girlfriend, who became pregnant. Their first son was born into suffering; Angela recalled how his tiny body shook uncontrollably from drug withdrawal.
Kevin was in and out of jail and rehab but kept slipping back into addiction. On his worst days, he would take two or three trips a day to sketchy areas to buy heroin, often with a baby in the car, and shoot up in the bathroom at home.
Child Protective Services got involved. Kamryn went to live with his mother's mother at 3 months old, and Angela and Dave gained permanent custody shortly after he turned 1. Kolton was born around that time, but the Murphys didn't get custody of him until he was 2.
That meant Kolton spent some of his earliest days homeless, with Kevin dragging him from place to place in a carrier, staying with whoever let them spend the night. The baby earned a nickname Angela hates: "Tote-tote."
Kevin, 29, is now in recovery, living in transitional housing and suffering from hepatitis C from years of intravenous drug use. Angela doesn't share much about his past with the boys, who just know their dad is sick and can't live with them.
"Kolton has a bond with his dad. …To Kamryn, Kevin is a play friend," said Angela, 51. "Dave and myself, we're their mom. We're their dad."
Kevin is determined to stay sober and play a bigger role in his children's lives someday.
"I'm tired of living that life," he said, "tired of being nothing."
For now, he sees the boys at his place every other Saturday. Kolton eagerly looks forward to these visits - eating pizza and candy with his dad and pretending to make him food in a play kitchen. He likes when Kevin tosses him on the bed or picks him up and runs around until he gets dizzy.
"I miss him," Kolton said in a small, quiet voice. "I love him."
Insidious, lifelong harm
The youngest children of heroin suffer most.
"What happens between zero and 3 can affect kids throughout their lives, affecting their relationships for decades," said Jennifer Hancock, president and CEO of Volunteers of America Mid-States. "Also, they're the most vulnerable population because they're so physically small."
The list of dangers is practically endless. Stray needles. Substandard housing. Unreliable or even abusive babysitters. But even worse for many babies and toddlers is an often-absent parent.
"Kids that age don't have a good sense of time," Hancock said. "So they sometimes feel like Mom is never coming back." This, coupled with the mom's emotional absence when she's using, keeps a child from forming a healthy attachment to her, a building block for all relationships going forward.
Some children of drug-addled parents suffer severe, even deadly, neglect and abuse. Of the 26 child fatalities or near-fatalities in Kentucky last year, six involved substance abuse. Two years earlier, state figures show, 12 of 49 child deaths or near-fatalities involved drugs.
But the harm is usually more subtle and insidious. Terry Brooks, executive director of Kentucky Youth Advocates, pointed out that Kentucky ties with Wyoming and Montana for the highest rate in the nation of children with three or more "adverse childhood experiences," including parental drug abuse, which can harm a child's health and economic well-being for a lifetime. Substance abuse adds a particular layer of uncertainty.
"It's like their life is a lottery. They'll feel like, 'Today, I won because Mom or Dad is not high,' " Brooks said. "The next day, if the parent is high, they'll feel like they've lost. Think about the impact of how that wears on a kid."
It also sets a bad example, which is often compounded by a genetic predisposition for addiction.
"All kids who are in homes with heroin use … have a substantial substance abuse risk," said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. "Most of us seem to emulate the behaviors we've seen. When kids grow up and all the people around them are using drugs to cope, that becomes normal."
Parents are often stymied in their efforts to get clean and do better for their children. Addicts face a severe shortage of drug treatment throughout the region and nation. Volunteers of America, for example, recently had 18 pregnant women on its waiting list for its Freedom House recovery program.
With treatment out of parents' reach, children sometimes must be removed from unsafe homes. The first choice in such cases is to place them with relatives, said Tim Feeley, deputy secretary of the Kentucky Cabinet for Health and Family Services. But if there's no safe place to go, he said, "foster care is always a second choice."
Meanwhile, the crisis just keeps growing, hurting not just addicts and their children but society.
"It's easy for all of us to think about substance abuse on an individual basis," Brooks said. "But there's an accumulated effect when you have so much of it. It becomes almost a tidal wave."
That tidal wave swept up a 2-year-old named William as an infant, but his parents hope they rescued him early enough.
His mom, Laura, found her husband Jeremy's needle and spoon in their house when she was three weeks pregnant. She knew he had used heroin in the past but had figured he was getting treatment at a local methadone clinic and tried to convince herself he was recovering.
They struggled and argued as Jeremy, who didn't want his last name used for fear of repercussions, spiraled further into addiction. Though sober at William's premature birth in February 2014, he snorted heroin as soon as he got home from the hospital.
Laura knew he was high during those early months, but couldn't concentrate on her husband's problem while caring for a newborn. Jeremy sometimes brought William with him to the park to meet his drug dealer or shot up in the bathroom with William strapped in his car seat just outside the door.
He also took William along when he met a friend at Hogan's Fountain at Cherokee Park to snort heroin.
That day, his friend overdosed on the drug. Jeremy panicked, typing 9-1-1 into his phone. Then he froze. If the police showed up, he figured, he risked losing custody of the baby. So instead of calling, he poured water on his friend's face, tried to slap him awake and kept checking to see if he was breathing as he slipped in and out of consciousness. If necessary, he reasoned, he could call 9-1-1 from a hidden spot nearby. Meanwhile, he kept moving, pulling his friend a few feet at a time and then moving William in his stroller – and praying. His friend survived.
Eventually, when William was just a few months old, church friends convinced Laura to kick Jeremy out of the house. Despondent, he spent a week at a hotel drinking and shooting up before finally deciding to seek help. After telling Laura, he curled up with William on his hotel bed and cried.
The couple's divorce became final last year. William lives with Laura, and Jeremy stays in transitional living, getting help in a 12-step recovery program and working as general manager of a restaurant. Today, Jeremy said, "the thought of losing William – of him knowing me as a drunk, junkie dad – keeps me from using."
Jeremy and Laura have stayed friends, and he visits regularly. On a recent day, William walked from parent to parent, giving each a tiny fist bump.
Although William won't remember his first months of life, Laura fears he may suffer long-term effects of the stress pervading the family's life since he was in her womb. Scars can be deep and lasting.
Pruett has the same worries about Miguel.
But for now, like others in recovery, she and her children take life day to day. And Miguel's days - for the first time - finally resemble those of a typical preschooler. He loves to run, kick a soccer ball, cradle his sister Elisabeth and talk to his mom in Spanish and English.
A recent afternoon featured assembling a train puzzle, watching "Teenage Mutant Ninja Turtles," eating an ice pop and climbing into his sister's baby bed.
Pruett tickled him, cooing: "Are you the baby? Are you the baby? No, you're a big boy!"
Pruett is convinced she can stay clean after her seven months at Freedom House. During a graduation ceremony, Pruett told fellow clients through tears: "You all know you can do it. Just keep your mind focused and stay strong."
Pruett has dreams now. She lives in her own apartment, works for a janitorial service and hopes to someday earn a business degree and open an aromatherapy shop.
She's made promises to her children - that Miguel's suffering is over, and his baby sister will never know the horror that is heroin.
Reporter Laura Ungar, who also covers health for USA TODAY, can be reached at (502)582-7190 or at firstname.lastname@example.org.