Miss Terrie Understands
Hard lessons ring familiar for a counselor at Bayview’s Center for Addiction and Pregnancy

Counselor Terrie Alexander, left, with a mother and her infant son. Born at Bayview, this baby required morphine drops at birth for withdrawal. His mother, once addicted to heroin, is clean now, thanks to Alexander and CAP interventions.

Alexander was about to face her probation officer in Baltimore, when she saw it—a poster for CAP that read: “Are you pregnant and addicted?” Below the words was an illustration of a pregnant woman shooting up (below). An elongated needle pierced her arm, extending into the fetus. “It got to me,” recalls Alexander.

Today, at 42, Alexander is the quintessential poster child for CAP. After years of training and education, she is now one of the program’s eight mental health associates. Once addicted, pregnant and nearly homeless, Alexander now helps other women do what CAP did for her: obliterate the recurring nightmare of addiction.

CAP opened at the Johns Hopkins Bayview Medical Center in 1991. It’s one of only a few programs in the nation that combines drug treatment with comprehensive prenatal and child care services while teaching women broader skills toward a healthy lifestyle. The program has weighty goals: to reduce drug and alcohol abuse and obstetric complications, improve birth outcomes, provide family planning services and assess children’s health.

At any given time 80 women are enrolled in the program. All arrive pregnant and addicted. They begin treatment with at least seven inpatient days. Each day, they go through about six hours worth of sessions on drug education, relapse prevention, addiction and domestic violence, parenting and group therapy. Outpatient visits continue for as long as insurance allows.

Twenty-five percent of their babies are born addicted and in need of treatment and monitoring for developmental delays. Some need “drops” of morphine for withdrawal. Many enter CAP’s day-care program. Most are followed for years at CAP’s pediatric clinic run by pediatrician Lauren Jansson and staffed by two nurse practitioners and an RN.

When Alexander became a CAP patient nine years ago, she didn’t have high hopes. In fact, she dropped out twice. But by the third admission she was eight and a half months pregnant, tired and scared. On March 5, 1996, Alexander delivered a healthy baby boy, Brian, born drug free. That was when reality set in. “I realized that I not only had to be responsible for my recovery, but also for my baby, who had spent most of his unborn life exposed to drugs but survived.”

Alexander completed the CAP program on Oct. 3, 1996. Two months later, she began working part time at Bayview as a unit secretary. During lunch she’d go to CAP support groups. Over the next several years, as a single parent, she raised Brian and earned degrees in addiction counseling and mental health technology at Baltimore City Community College, maintaining a 4.0 GPA and amassing 400 hours of internships at CAP. In 2001, she was offered a part-time job as a CAP group facilitator and has since worked her way up to outreach coordinator and case manager.

Clinical Director Vickie Walters, right, with Terrie Alexander in CAP’s cheerful nursery. Walters has known Alexander since the day she entered the program, addicted, pregnant and nearly homeless.

“Miss Terrie understands,” her clients will say. They know that for 17 years Alexander used cocaine and heroin. She, like them, once felt a sense of belonging when shooting up with friends. Years ago, she, too, had every imaginable excuse to use. “Terrie has empathy for her clients,” Walters says, “but she’s no-nonsense and sets firm boundaries. It’s been amazing to watch her conquer her former life.”

CAP’s achievements have not gone unnoticed. Besides boasting improved outcomes for mothers’ medical and mental health, the program has reduced NICU admissions, resulting in savings of nearly $5,000 per mother-infant pair. Last spring, Peter Bielenson, until recently Baltimore City health commissioner, presented CAP and its pediatric clinic a child health promotion award from the Maryland Childhood Immunization Partnership, which recognized CAP for having one of the highest immunization rates in the city.

As for Alexander, she hopes to complete her master’s degree in social work at Coppin State in 2007 and become a motivational speaker. Brian, now 9, has taken his mom’s lead as a stellar student.

There’s no going back to the old life, Alexander insists, her big brown eyes, once bloodshot and heavy lidded, blazing with resolve. Her transformation would have been impossible, she says, without dedicated CAP counselors. “They confronted me when I was wrong, they loved me, and they helped me to discover the person underneath all those years of addiction.”

—Judy Minkove

CAP Facts • Structured group treatment emphasizing women’s issues like sexual abuse, domestic violence and parenting. • Pediatric care, including one-on-one parenting education, newborn testing, well- and sick-child care, immunizations and 24-hour coverage. • Individualized case management, including help with housing, infant supplies and Medicaid paperwork. Collaboration with drug court, parole and probation. • Obstetrical care by certified nurse midwives (with physician backup) specializing in addiction and pregnancy. • Access to intensive outpatient treatment within 24 hours. Detoxification, stabilization and methadone maintenance unit. • Community outreach and in-home interventions by a certified therapist. • Family education, couples counseling, intensive relapse prevention, and psychiatric and medical consultation. • Day care with developmental play. Info: 410-550-3066.