In her Arizona home, Tawni Carson oversees a play date with her three children and the daughter of the woman who, Carson says, helped save her life.
"Clarissa is a very important person to me," Carson said. "She saw me in my deepest, darkest, lowest point, and she said, 'I'm going to help you get better.'"
Clarissa Collins was the first voice Carson heard when she called Hushabye Nursery. Carson was abusing opioids. She was also five months pregnant.
"It just opened my mind to something that I didn't think was possible, which was getting better and actually trying to be a mom again," Carson added.
Hushabye exists specifically for moms misusing opioids and their children who are born showing symptoms of withdrawal — called neonatal abstinence syndrome, or NAS. It's a community that's multiplied over the course of this century. In three years, the organization has served almost 730 babies.
"It is hard to watch babies tremoring, and them just crying and not being able to settle them," said Tara Sundem, Hushabye's executive director. "It's heartbreaking."
Hushabye receives babies days after they're born and keeps them for, on average, nine days. The mom stays there too because the nursery practices a recovery model called "Eat, Sleep, Console." It works by keeping the family together.
"Babies withdraw better with their parents," said Sundem. "If we can get them to stay with us, that's absolutely what we want to do."
That's what Carson did when she gave birth to Dahlya. Today her 2-year-old daughter is free of symptoms, and Carson is free of addiction. She's a model testimony to "Eat, Sleep, Console."
That's the easy story. When you go deeper, it gets harder.
A review of research on NAS found that opioid-exposed newborns rooming-in with their mother have substantial reductions in length of stay compared with those cared for in neonatal ICUs at the hospital. Rooming-in, as Hushabye does, is the recommended model. Yet it's far from common practice.
"There's nothing really radically new in treatment aside from a couple of medications since then," said Dr. Mishka Terplan, who has spoken about this issue for years, including at the U.S. House of Representatives. "So it's not a scientific question. It's really an implementation of will, a priority question."
Terplan is among many who say the system as is doesn't follow the evidence. It too often separates the parent and child, and it lacks the stability to get the parent needed treatment.
In short, it's complicated — as is the full story of Tawni Carson.
Even after calling Hushabye, Carson relapsed several times before finally staying clean. She's lived in her home for all of two weeks, back from a transitional treatment program where she stayed with Dahlya.
Triumph through addiction is not linear and not easy. But because Carson knows that, she thrives in her new job — as an intake specialist at Hushabye. Now she's that first phone call — working just down the hall from her first phone call, Clarissa Collins.
"I get to help people today with this person that, in some ways, saved my life," Carson said.
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