Nestled in the quiet woods of La Center, past Annie's Berry Farm, you'll find the Johnson family home. It's a handsome house trimmed in white with A-frame windows that let in sunlight. Open the front door, and the noise and excitement tumble out — in the form of four blond children.
Friday morning, they squirm and squeal as mom, Julianne Johnson, ties their shoes and buckles them in their car seats in the family's minivan. It appears to be typical childhood chaos.
What you can't tell by watching these kids is that each of them was born addicted to drugs. Tito, 3, Bree, 4, Baily, 5, and Brooklyn, 7, are not the Johnsons' biological children. In the womb, they were exposed to a cocktail of alcohol, cocaine, methamphetamine and heroin. They were taken from their birth mother and put into Oregon's foster care system.
Tito, Bree and Brooklyn all have the same dad — the grandson of Julianne's sister — making the children the Johnsons' great nieces and nephews. Baily has the same mother, but a different father.
When Julianne got a letter from the state of Oregon in 2010, asking the Johnsons to adopt them, she was all for it. Her husband, Karl, a middle school teacher in the Battle Ground school district, was against it.
If Julianne wanted to adopt the kids, Karl insisted, she was on her own. They were getting older — she is now 45 and he is 49 — and already had six kids of their own. Julianne had just finished cancer treatments.
And then, a budding love formed, changing everything.
After two visits at the kids' shared foster home in Salem, Ore., the Johnsons took them home. Julianne started taking classes required to adopt them, setting in place a lengthy court process. Karl used up all of his vacation time going to Oregon.
There were fleeting moments of doubt. Looking back, Julianne says, "I didn't think I could love kids that weren't my own."
But they asked themselves: Who else would save them?
The Johnsons finalized the adoption in Marion County Superior Court in October 2011.
That year, there were 8,823 Oregon children in foster care and 731 children who had adoptions finalized, according to Gene Evans, spokesman for Oregon Department of Human Services. At any given time, he said, there are 100 to 120 waiting to be adopted.
In Washington, the numbers were even higher: 9,769 in foster care and 2,741 who were waiting to be adopted in 2011.
"It's bigger than people realize," Karl says.
"You're not going to find people who are going to adopt four kids together. It's unheard of," Julianne says.
Many of their friends praised their decision; they thought it was admirable, the right thing to do and offered support. Others looked down on the adoption. They stopped inviting the Johnsons to their homes for dinner and play dates.
"And that broke our hearts," Julianne says of losing her friends. "It's kind of lonely."
In the beginning, the kids hadn't met their major milestones. All of them were in diapers, including Brooklyn, who was 4 years old at the time. In four days, Julianne potty-trained him.
Bree, then 2, couldn't walk except on her knees, and she didn't know how to play. Julianne quickly taught Bree to walk by repeatedly putting her up on her feet.
The kids have made significant strides, but their past is still with them. When they moved from Battle Ground to their current home in La Center last month, the kids worried they were being uprooted again and would be passed off to another family.
Although it's gotten easier over the last two years, Julianne acknowledges her work is hard and time-consuming, and she has to swallow the occasional judgment.
"It's my choice," she says. "I wanted to do this. Sure, it's not easy sometimes, but I'm giving them a chance in the world."
She quit her job as a certified nursing assistant to focus on the kids full time. Julianne says with a laugh that she hasn't slept for three years. She keeps a large calendar in the home office of ongoing speech therapy, occupational therapy, IEP meetings and dental appointments. It's controlled chaos, she says. When they're out and about, she puts her youngest son, Elijah, 23 months, in a stroller while Bree and Tito hold on to each side of the stroller with Baily nearby.
As part of the adoption, the state of Oregon agreed to provide the children's health care. Tito and Brooklyn entered therapy for speech problems. Bree has poor eyesight and will be undergoing surgery soon to repair her eyes.
Developmentally, all of them, except for Baily, are about one year behind their peers, Karl said. Little is known about the long-term effects in utero drug exposure has on development. Studies suggest that the drug-using lifestyle, rather than the drug exposure itself, is the biggest concern. Neglect, domestic violence and poverty in a child's first few years of life shape their early development.
"It's not going to define them," Karl said. "It's tragic, it's sad, but they're not going to end up like their biological parents."
Dad is in jail. Mom lives in Montana with her fifth child from another father.
Karl, who was raised by his aunt and uncle, recognizes that "family" doesn't always mean you're related by blood. It's a bond forged over time with patience and love. But, Karl also recognizes the reality and gravity of what he signed on to. When the kids reach adulthood, he'll be in his 60s.
"These kids are great. They won the lottery," he acknowledges. But what about the rest?
Since the adoption, he's been approached twice about other children with similar histories in need of a home. He's tired of the calls. Drug addicts can't keep having babies, he says. It's not a sustainable system.
"There's something there," he said. "There's something bigger than I understand."
The Johnsons are playing a game of catch-up, but the bounds they've made so far are obvious and remarkable. Brooklyn is an articulate second-grader at La Center Elementary School who enjoys reading and superheroes.
"You're the coolest dude on the planet," Karl says to him in their family room.
"Yeah, I know that," Brooklyn calmly answers.
Baily is the "mother" of the group. She jumps up when Elijah fusses in his stroller, brings him toys to play with and shows him the book she's reading. She started kindergarten this year at La Center Elementary and performs in Christian Youth Theater.
Even though Bree now knows how to walk, it's rare to see her do it. She runs, she does handstands against the family room couch and plays with every toy she can get her hands on.
When Tito was an infant, he would have tremors in Julianne's arms, a side effect of being born addicted to substances. These days, he doesn't tremble. He doesn't even flinch at climbing the counter, the stroller, the wall.
The experience, Julianne and Karl say, has changed their lives and how they view what matters.
As the children bound into the front yard, they run fast and carefree through the grass and dandelions, calling to their mom as she calls back. They sprint through the lawn, and when they tumble, they get right back up. That's when it really hits you: The Johnsons are going to be all right.
With a smile Karl says, "Everybody's pulling for them."
Long, painful road awaits babies in drug withdrawal
What is it like to be 2 days old and withdrawing from drugs?
You cry constantly, have difficulty breathing, suffer from tense muscles and are otherwise inconsolable.
The cause of these ailments: maternal drug use. Unlike a grown-up addict, whose discomfort is localized, when a newborn withdraws from drugs, it feels pain over its entire, tiny body.
"I don't think people really understand the amount of suffering the babies go through when they become exposed to drugs," said Melanie
Fain, clinical manager of the neonatal intensive care unit at PeaceHealth Southwest Medical Center.
The symptoms of neonatal abstinence syndrome -- the medical term for when an infant goes through withdrawal from drugs -- vary depending on the drug mom used during pregnancy, how heavy her usage is and how the drug reacts to her body.
Women who are addicted to drugs typically have poor health habits, said Dr. Suzanne Swietnicki, a laborist at PeaceHealth. They may not be exercising or getting proper nutrition while pregnant, and they may smoke cigarettes, which are associated with premature births and lower birth weights. What happens in the womb can shape the baby's genetics, Swietnicki said. Exercise during pregnancy leads to better blood flow for the placenta and an easier delivery. A diverse diet can lead to a child who develops a liking for many different types of food.
"You wonder what genes are being turned on and off with chronic narcotic addiction," Swietnicki said. "Sometimes they have no prenatal care, and they show up at the hospital sick or in labor."
Pregnant woman in general are more susceptible to infection, but shooting up drugs can up the ante by leading to sepsis, a life-threatening infection in the bloodstream. Every time the heart beats when someone has sepsis, it circulates bacteria through the body, Swietnicki said. Left untreated, the infection leads to septic shock, in which the woman loses consciousness and her heart becomes unstable. Her baby can die from the infection. Patients with sepsis have to be fed IV antibiotics for six weeks.
"A lot of them are younger, so they're very fertile. They're doing drugs at the height of their fertility and they're not using contraception," Swietnicki said. "It's actually the worst time to get infected."
Some women may smoke marijuana during pregnancy, believing it's safe. Then, at the hospital, their drug screens come out positive for other drugs, such as methamphetamine or heroin. The dealers cut pot with other drugs to make it more addictive.
Women who use drugs are more likely to need a C-section during delivery, she said. The baby may take up to 48 hours to feel drug withdrawal symptoms.
In Washington, mothers aren't required to submit to a drug test if they don't want to, and they tend to underreport their usage, Fain said. Health care providers can, however, test the baby's urine, stool or a section of their umbilical cord without the mother's permission to reveal what drugs the baby may have been exposed to intrauterine.
During her 35 years as a nurse, Fain has seen drug trends shift and shuffle. When she first started out in the late 1970s, drugs like marijuana, heroin and cocaine were big. Nowadays, the drugs of choice run the gamut from methamphetamine to methadone.
If the mother tries to quit drugs cold turkey mid-term, the baby can have a seizure in the womb. The earlier the mothers can kick drugs, the more successful they can be.
Babies have to be weaned off narcotics, notably opiates such as heroin and prescription pain relievers Oxycodone and Oxycontin. The process can take months of inpatient care that includes very small doses of morphine administered every four hours, Fain said. They also have to be regularly rocked and consoled to get them through the rough times.
It's emotional for everyone involved -- the mother, the nurses and the physicians.
"It's really difficult to see them experience this," Fain said.