A hospital isn't the best place for a baby to come off opioids, say John and Cindy Ness.
They would know: For the last 17 years, the couple has been foster parents to dozens of children — mostly newborns and toddlers, some of whom were born addicted to opioids.
• In depth: Minnesota's opioid epidemic
"You walk into a hospital nursery and you see a baby," John Ness said. "It's all bright and there's people around, poking and prodding. When babies are born with addiction, they need less stimulation."
In the last five years, the number of infants born with opioids in their systems has doubled in Minnesota, and the problem is worse in the northern part of the state where the Nesses live.
Roughly 7 percent of babies born in Bemidji have drugs in their system at birth — a number that's soared along with the national opioid epidemic which has claimed thousands of lives.
Now, a new training program in Bemidji is teaching foster parents how to wean infants off opioid addictions in their homes.
Many of the babies have to be weaned off opioid addictions using morphine. It eases withdrawal symptoms, but requires a 14-day hospital stay.
"Babies are just going to get more specialized care at home," said Alyssa Bruning, a registered nurse at the Sanford Medical Center in Bemidji. "They're going to be bonding with parents instead of nursing staff. It's just a better environment."
Bruning helped develop a small pilot training program to teach foster parents how to treat addicted infants at home.
Instead of morphine, eight veteran foster families, including the Nesses, were taught how to administer methadone. It takes longer — about a month on average — instead of two weeks, but it's easier to get the dosing right.
Sanford Medical Center hasn't yet put any infants through the new program. When it does, State Human Services Commissioner Emily Piper said it will be the first program of its kind operating in Minnesota.
Nursing infants through opioid withdrawal isn't something foster parents would have had to think about years ago, Piper said.
"Specific to babies born addicted," she said, "we know that neonatal abstinence syndrome in Minnesota has doubled in the past five years."
That syndrome refers to the babies born addicted, and northern Minnesota has seen more of it than other parts of the state. Piper said Sanford Medical Center in Bemidji sees more addicted babies since it serves three nearby reservations.
"Babies born to American Indian women in the state of Minnesota are born addicted to opiates at eight times the rates of white babies born on Medicaid," she said.
More white people in Minnesota die of opioid overdoses than anyone else, but the state's smaller Native American and African-American communities are disproportionately affected.
Last year alone, Bruning said, 75 infants were placed on child protective holds in Bemidji. Six years ago it was less than 30. Nearly all of them were placed on hold because either the mother or the child tested positive for an illicit substance.
The steep rise is starting to add up financially. A few weeks of morphine in a hospital nursery costs $30,000, Bruning said. A month with John and Cindy Ness costs less than $1,000.
The Nesses hope the new at-home methadone treatment will make life easier for drug exposed babies.
Addicted infants get a rough enough start as it is, they said.
"We had one little boy, every time you picked him up he'd throw up," John said. "Any time you picked him up he'd puke. Like projectile puke."
When they first started with foster care, no one would tell them if a child had been exposed to drugs. All John and Cindy knew was some children required very unpredictable care. Some couldn't get to sleep without a weighted blanket.
One baby slept for 23 hours a day. Cindy had to wait by the crib with a bottle, and rush to feed her the instant she woke.
"We did our best," Cindy said.
Eventually, they figured out what was happening. And as time went on, more and more babies showed signs of drug exposure. Now, just about every baby the Nesses care for requires some kind of specialized attention.
The Nesses could have been empty-nesters by now. Their first two kids are out of the house.
If Cindy hadn't talked John into being a foster parent 17 years ago, they would never have met their adopted children. They wouldn't have to sleep on the nursery floor, waiting for a newborn to wake.
Sometimes, John said, he thinks the empty nest might be nice. But he said the need is too great.
And if administering methadone can help, they said it's not much harder than what they're already doing.
"There's not that many people stepping up to help these little guys," John said. "We're capable of doing it. We can help give them a better start."