The opioid crisis gripping states and communities across the country has spawned a new focus on the way child and family welfare agencies think about addiction, and whether mothers and fathers should be allowed to keep custody of their children as they undergo treatment.
Many states have seen a surge in the number of children entering foster care systems, an increase likely tied to the prevalence of opioids. In the past, those states considered substance abuse a form of neglect, sufficient to remove children from dangerous homes.
Now, some states are creating programs aimed at keeping children with their parents during treatment. They hope that approach will encourage parents to seek the help they need, without adding the trauma caused by removing children from their homes.
“Children do better when they’re with family,” said Wendi Turner, executive director of the Ohio Family Care Association.
In Nebraska, where officials cite methamphetamines as the primary drug menace, the state Division of Children and Family Services has launched a “mom and me” program that allows children to join their mothers in treatment facilities.
“Mom can get the necessary substance abuse treatment she needs without being subject to the trauma of a removal as well,” said Matt Wallen, who runs the department.
New Jersey is one state that does not equate substance exposure — mothers who take drugs while pregnant — with child abuse. That gives the state flexibility to determine whether a parent is a risk to their child. Conflating substance abuse with child abuse is “impounding trauma upon trauma,” said Jason Butkowski, a spokesman for the state Department of Children and Families.
“[We] don’t want to stigmatize someone who is currently facing addiction and looking for recovery options and recovery services,” Butkowski said in an interview, adding that they've "found that some folks aren’t reaching out for services because addiction is such a charged term.”
Ending stigma as a way to incentivize treatment is an increasingly common approach in many states. In Colorado, the state has launched a “Lift the Label” campaign aimed at removing the stigma of addiction in order to encourage victims to seek care.
“People believe that when you become sober, there’s this idea that you can’t have any relapses,” said Robert Werthwein, who runs Colorado's Office of Behavioral Health. “If you relapse, you’ve failed. That’s not the way to look at recovery.”
Some child welfare advocates say keeping children with their parents can serve as an inspiration for a parent to get clean. B.J. Walker, director of the Illinois Department of Child and Family Services, said mothers can become more susceptible to drug culture if they do not have the responsibility of caring for a child.
Washington, D.C., has seen its population of children in foster care decline through a combination of kinship care programs — in which a relative takes a child who may be at risk — and robust mental health services funded by Medicaid for parents seeking help.
“Pretty much all the families vulnerable in one way or another have access to mental health care systems to support families that may be struggling with the underlying issues that are related to poverty and mental health and substance abuse,” said Brenda Donald, director of the District’s Child and Family Services Agency.
States pushing for more sympathetic views of parents dealing with addiction point to specific circumstances caused by the opioid epidemic in which victims can become addicted after undergoing a medical procedure.
“Put the person first,” Butkowski said. “[We’re] asking the question, ‘What happened; why are you in this place in your life?’ rather than ‘What did you do; how can you make it better?’”
— Emily Birnbaum contributed to this report.