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Even the saliva that drips down her miniature chin is a source of pain. Her skin is extra-sensitive, and as bodily fluids make contact, her skin becomes extremely chafed. Like most detoxing addicts, she has diarrhea. The skin on her bottom is excruciatingly sore. She scratches her face incessantly and “roots around on her blanket” looking for relief from the withdrawal.

Then, there’s the crying. Local labor and delivery nurse Shauna Boggs and others use words like “heartbreaking” and “inconsolable” to describe the pain-filled wail that’s higher-pitched and more insistent than the typical newborn cry. A pediatrician notes that it’s “constant.”

Over the next few days, she’ll depend on nurses to put drops of the narcotic methadone — most likely paid for by the West Virginia Department of Health and Human Resources — into her bottle to help her wean from the prescription painkiller that claimed her before she had taken her first breath.

Barring complications, the tiny Mountaineer — the latest resident of a state where the motto is “Mountaineers Are Always Free” — will leave the hospital within five days. Her first several weeks at home will be spent in detox — slowly weaning her body from the drugs. Her parents or another caretaker will be responsible for making sure that she gets her doses of methadone at home.

She has a higher risk of cardiac defects than her peers. Her head may be smaller. When she starts school, she may find it harder to concentrate during lessons. She’ll possibly have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in elementary school. She may develop socially and intellectually at a slower pace than her friends and may have more trouble learning appropriate social behavior. She has an increased chance of being diagnosed with a learning disability.

Dr. Judd Lindley, an obstetrician/gynecologist at AccessHealth and past RGH chief of staff, reported that cord blood samples taken from infants born at RGH several years ago revealed that the hospital had the highest rate of newborns who were exposed to drugs in utero.

The results, published in the West Virginia Medical Journal, showed that 20 percent of local newborns have traces of drugs, including cocaine, alcohol, opiates like OxyContin, hydrocodone, methadone and Subutex, the latter two narcotics prescribed by local doctors for the treatment of drug abuse.

In West Virginia, Wyoming County has the highest overall numbers of drug-related deaths, followed by Raleigh County, according to statistics provided by Dr. John Fernald, a Beckley pediatrician who has closely followed the impact of the increasing drug problem on the health care field.

In 1999, around four Mountaineers per 100,000 fatally overdosed, according to the report. By 2001, the painkiller OxyContin was ravaging rural communities in Appalachia. First called “hillbilly heroin” or “poor man’s heroin” by local police and users, the powerful narcotic seemed to rage like a wildfire through southern West Virginia.

By 2002, Wyoming County residents were reporting to The Register-Herald that oxycodone and other prescription painkillers were diminishing small towns in the county, gaining a viselike grip on users — killing them and impacting their families.

In 2013, the number of overdose deaths in the state, most from prescription drugs, had skyrocketed by 605 percent, according to the study. Nowadays, painkillers are no longer “the poor man’s heroin.” Law enforcement officers, doctors and drug addiction counselors in the area report that heroin is now cheaper than OxyContin on the street and overtaking painkillers as the West Virginia addicts’ drug of choice.

Local doctors, teachers, business owners, counselors and law enforcement officers all agree that opiate addiction is no longer a dark secret that happens “in another neighborhood” in southern West Virginia. Most families have a loved one who has been impacted by drug addiction. Addiction is a force that’s shaping West Virginia families, school systems and the economy.

In 2013, several business owners had unsuccessfully urged Raleigh County Schools Board of Education to pass a student drug testing policy. The reason, they said, is that finding West Virginia workers who could pass a drug test was becoming increasingly difficult.

Fernald, who informally estimates that up to one in three newborns born in recent months at RGH has been exposed prenatally to drugs, pointed out that the drug-addicted and drug-exposed newborns will eventually become students in the local school system.

Beckley Treatment Center clinical supervisor Angela Chambers said a solution to the drug problem, which she has seen grow over her past 16 years working with addicts, would be for insurers to cover comprehensive programs such as those offered at BTC, which offer one-on-one and group therapy, along with medication.