Photos by Mary Cabell Kelly

A Fighting Chance

Coraline Archer didn’t fathom how emotionally disturbing it would be to see her three-day-old baby receive replacement drugs for withdrawal every three hours.

While trying to get off heroin, Archer took Suboxone (Buprenorphine), a replacement drug for opiate abuse. Although she hadn’t planned to get pregnant, she also didn’t plan to have a baby with Neonatal Abstinence Syndrome.

Now, the baby spends her days wrapped in a thermo blanket in a plastic bubble, only to be taken out for food and medicine.

Archer began experimenting with prescription drugs when she was a young teen, and with an extensive family history of drug abuse and alcoholism, and it set the stage for her future choices.

She asked that her real name not be used.

When Archer was in college, she had her first daughter. When her daughter was 15 months old she started acting strange, and doctors told Archer she was just paranoid. Little did the doctors know, her daughter had a brainstem tumor. Her daughter was only 16 months old when she had her first brain surgery.

“The addiction started after my daughter was diagnosed,” Archer said. “I had PTSD because she almost died on me a couple times. It was terrible. She only had a five percent chance of survival at one point, you just don’t know how else to cope.”

Her daughter has now been cancer-free for nearly 12 years.

“When things took a big spin is when my daughter and I were in a car wreck,” she said. “A cab pulled out in front of me and my seatbelt was on, but it broke and I went through the windshield.”

Archer had multiple surgeries and had to take nine months off from work.

“They kept giving me pain pills,” Archer said. “I would run out, call them and they would give me more. Then one day I go in and they told me that my physical therapy was almost over and that this is my last prescription, and I was like, ‘Oh my God, what am I going to do?’”

She went back to work but started feeling sick, almost like she had the flu.

“I talked to a friend and told him I felt like I had been hit by a car and he was the first one who looked at me and said, ‘You’re dope sick,’” Archer said.

At that point, she was afraid she wasn’t going to be able to work a full-time job and take care of her daughter without any medicine.

“So it started with me just trying to find pain medicine on the side, just to get through the day,” Archer said. “Then my boyfriend and I split up, and it got worse, but we would try to keep each other in line. Then I was a single mom, and that was a hard adjustment. That’s when I really stopped controlling it, for whatever reason, and then you become a functioning drug addict. You have to keep a job and be a mom, and you’re still trying to figure out how to keep everyone happy.”

It got especially bad for Archer when she and her first daughter’s father split up.

“I went crazy, I went with all the wrong people and I did all the wrong things,” Archer said. “Every choice I possibly could have made, except for taking care of my daughter. Plus I kept my job, I honestly don’t know how.”

Then, she was promoted to a management position, which meant more money for more drugs.

“That’s when it became a lot cheaper just to do heroin,” Archer said. “I’d get tired of the Percocets, Lortabs and Roxies (Roxicodone). It was way cheaper. First you snort it, then smoke it and then shoot it. The next thing you know a year has gone by and you’re lucky you’re not dead.”

Dr. Stephen Loyd, MD at Mountain Home VA Medical Center, found himself in this exact situation abusing opiates many years ago. Now clean and back to working at the hospital, he finds time to act as a support system for Archer and women in similar situations.

“If you look at opiates and prescription drugs right now on the streets in general, it’s about a dollar a milligram,” Loyd said. “If you’ve got someone with a 200–300 milligram-a-day habit, which is pretty common, that’s a lot of money. The street value for heroin in Johnson City is about 10 bucks a bag.”

Loyd said Tennessee is third in the nation for property crime that is driven by substance abuse.

Archer said that she still cared what people thought, but drugs can affect that.

“When you are that far out you don’t care enough about yourself at that point,” Archer said. “I cared about everything else and what everybody thought. Even my mom had the most insane time understanding what is going on right here right now. It’s not been easy. I actually had to have security remove her on Sunday night when my baby was being taken out of the room.”

Archer’s mother has her own addiction as well, but her poison of choice is alcohol.

Loyd continued Archer on her medicine, for the sake of the baby. Archer’s mother couldn’t understand why she had to remain on Suboxone and why she couldn’t stop.

According to, opiate withdrawal is very hard on a fetus, and can cause a miscarriage. The odds of completing the pregnancy to term increase dramatically if a woman participates in a methadone or Suboxone program.

Loyd said that people don’t just stop using.

“One percent do it on their own, if not less,” Loyd said.

Archer knew she had to make a big change in her life.

“You have to cut ties with people, and that is what I had to do with my mom the other night,” Archer said. The last thing my mother said to me was ‘at least I didn’t have a drug addicted baby’. And I said, ‘yeah you do, you just haven’t realized it yet’. She doesn’t realize she modeled the behavior that I took on. After I made her leave, I picked her stuff up and thought her cup smelled funny, and then I realized she was hammered drunk, and I know that’s how she copes, but I didn’t know she was back to drinking again.”

Archer said that while she was growing up, she had a picture perfect family and everyone thought her mom and dad were so happy.

“Behind closed doors that’s not how it was, they hated each other and were both alcoholics, and they modeled that behavior for me and my brother and we both have the same problem. She can accept she has a drug-addicted child or not,” Archer said.

Making things more stressful, at the beginning of her pregnancy, her gallbladder ruptured.

“I was on Suboxone then and shortly after that I found out I was pregnant, and about a month later is when I met Dr. Loyd, and he has kept me on the right path,” Archer said. “These suboxone doctors are telling me these crazy things. One of them said to go to an OB that delivers at a hospital that doesn’t have a Neonatal Intensive Care Unit, and with my history with my other daughter, what if there is a problem with my child, what if she comes out and needs a NICU? None of it made any sense to me.”

After she found out she was pregnant was when she really started questioning them.

“My doctor was telling me that he was actually going to increase my dosage of Suboxone and I was going to stay on it the whole time I was pregnant and just not to say anything to anyone,” Archer said. “If I had done what they told me and gone to some dinky hospital and hadn’t said anything and my baby was showing some of the signs of NAS, they would have drug tested her and me and taken her from me because she needs a NICU.”

It’s also hard for Archer because of the way people see her, which is an irresponsible monster, but she knows being at the NICU is what will help her baby most because she needs treatment for withdrawal.

“Regardless of how my family looks at it or anyone else looks at it, I did what I had to do,” she said. “The drug addiction started years before I got pregnant and I wasn’t planning on having a baby. It just happened, but I don’t regret her for anything in this world.”

Krista Hatly, head nurse of the NICU at Niswonger Children’s Hospital, said that it’s hard not to judge these mothers.

“That is something that we are working on as a unit, I will say,” said Hatly. “As much as we don’t want to have judgment against the parent, its often we do, it’s just human nature.”

Archer struggles every day thinking about why her baby is where she is and the blame she feels for putting her there.

“It was so hard to go home last night,” Archer said. “I have all her baby stuff in the car and her car seat and she didn’t get to go home with me. It was terrible going home and seeing her bed and trying to just suck it up, because I have to. I didn’t realize how hard it would be to look at her getting her medicine and know that I’m the reason she is getting that medicine. It’s terrible, but I could have just quit the drugs instead of calling Dr. Loyd. She would have died, there is no way she would be able to handle the withdrawal.”

“These drugs are exceedingly addictive,” said Dr. Robert Pack, associate dean for academic affairs and professor of community and behavioral health at ETSU.

“We live in the worst part of the second worst state in the worst country in the world as far as prescription opioids,” said Nicholas Hagemeier, Doctor of Pharmacy and Philosophy, as well as the assistant professor at the Gatton College of Pharmacy at ETSU.

“They can get ahold of you and keep you. There are people that really crave them and want them so they go to doctors to find them.”

Archer can certainly relate to that, which is why she is so happy she found Dr. Loyd.

“Dr. Loyd has been a true blessing; I just know I can be completely honest with him and he cares. You can tell he is interested in what is going on and if I’m doing OK. He knows what we are going through. I just hope that there are more doctors that will take lead and see what Dr. Loyd is trying to do and step behind him and support him and stop feeding these women all of these lies.”

And even though she feels great guilt, she knows her family can get through this.

“I don’t know what else to do,” Archer said, “but watch her and keep her calm.”

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