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Home > Advocacy > CWLA 2007 Children's Legislative Agenda > Substance Abuse

 
 

CWLA 2007 Children's Legislative Agenda

Substance Abuse

© Child Welfare League of America. The content of these publications may not be reproduced in any way, including posting on the Internet, without the permission of CWLA. For permission to use material from CWLA's website or publications, contact us using our website assistance form.

Action

  • Support expanded federal resources to increase substance abuse treatment capacity within the child welfare system and stimulate effective partnerships between child welfare and substance abuse agencies, including the reintroduction of the Child Protection/Alcohol Drug Partnership Act.

  • Support increased funding for the Substance Abuse Prevention and Treatment (SAPT) Block Grant.

  • Support funding for Section 756 of the USA Patriot Act to expand methamphetamine treatment services to pregnant and parenting women.

History

Alcohol and other drug problems devastate the lives of hundreds of thousands of American children and their families each year. A major factor in child abuse and neglect, substance abuse is associated with the placement of at least half of the children in child welfare custody. 1 Substance abuse is a factor in one to two-thirds of cases of children with substantiated reports of abuse and neglect and in two-thirds of cases of children in foster care. 2 Furthermore, children whose parents use drugs or alcohol are three times more likely to be abused, and four times more likely to suffer from neglect. 3 In addition, children from families with substance abuse problems tend to come to the attention of child welfare agencies younger than other children, are more likely than other children to be placed in out-of-home care, and once in out-of-home care, are likely to remain there longer. 4 The recent increased use of methamphetamine especially threatens the lives and security of our nation's children.

Growing up in a home plagued by alcohol and drug abuse poses a powerful threat to our nation's vulnerable youth because substance abuse, on top of being a root cause of child abuse and neglect, is often cyclical and intergenerational in nature. Children with a substance-abusing parent show greater adjustment problems, as well as behavioral, conduct, and attention-deficit disorders than children without substance abusing parents. 5 The severe emotional and behavioral problems exhibited by many youth from substance-abusing families often include a tendency to choose risky behavior, including alcohol and drug use. Studies show that children of parents with substance use disorders are at higher risk than other children for developing alcohol and drug problems of their own. 6 Multiple recent studies have indicated high rates of lifetime substance use and substance use disorders for youth in the foster care system. 7

Parental addiction is one of the most common reasons for entrance into the child welfare system; indeed, substance-abusing parents dominate the child welfare caseload. 8 Although alcohol and other drug problems affect a majority of the children and families involved with the child welfare system, when appropriate treatment is provided, many more children can remain safe, and permanently breaking familial ties can be avoided. Many recent studies demonstrate that substance abuse is a treatable public health issue with cost-effective solutions, and that treatment is effective for families involved with the child welfare system. 9 Treatment has been shown to reduce alcohol and drug use and lower health care costs, as well as to increase family functioning. 10

Yet all too often, a lack of substance abuse treatment capacity poses a significant barrier to success. According to the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Survey on Drug Use and Health (NSDUH), approximately 23.2 million Americans needed services for an alcohol or drug problem in 2005, but only 3.9 million actually received treatment. This is consistent with a 1997 CWLA study that found child welfare agencies could provide drug abuse treatment to less than one-third of parents who needed it. 11 The supply of treatment services for women and children is especially inadequate. 12

The significant rise in the number of children entering out-of-home care due to parental drug use over the last two decades represents one of the most serious policy and practice challenges to the field. The overall shortening of timelines and movement to make quicker permanency decisions in out-of-home care cases required by the Adoption and Safe Families Act (ASFA) of 1997 has increased the sense of urgency and further emphasized the pressing need within the child welfare system to develop adequate capacities to address parental substance abuse issues. 13 Clearly already strained child welfare agencies cannot stand alone in serving the complex needs of children and families struggling with substance abuse. Good assessment, early intervention, and comprehensive treatment are key to determining when and if a child can safely stay at home or be reunited with his or her family. 14 New relationships must be formed between state and local government child welfare and drug and alcohol agencies and parallel non-government programs to provide high quality, effective services. 15

It is vital that agencies work together to prevent and effectively treat substance abuse in families involved in the child welfare system. Additional federal resources are necessary to facilitate this. In 2006, Congress reauthorized The Promoting Safe and Stable Families program (PSSF, S.3525) and included $145 million in mandatory funding dedicated over a period of five years to support competitive grants for projects addressing methamphetamine and other substance abuse as it affects the child welfare system. The legislation also specifically instructs grantees to consult with state substance abuse agencies as appropriate. The funds provided by these grants are to be used to support family-based, comprehensive, long-term substance abuse treatment services, including a range of components such as early intervention and preventative services for children, counseling for children and families, mental health services, parenting skills training, and/or replication of successful models of comprehensive family treatment. The comprehensive family treatment model includes the entire family unit in treatment efforts and focuses on integrating mental health, domestic violence, sexual abuse, and family therapy counseling services.

Developing this important grant program represents society's recognition of the dire need for new federal resources to fund comprehensive, proven prevention and treatment strategies for substance-abusing parents who maltreat their children. Given the gravity of the problem as it impacts child welfare, Congress must go even further to ensure such comprehensive family treatment services, including home-based, outpatient, and residential treatment programs that accept women and children, are more widely available and accessible to the child welfare population.

Child Abuse/Alcohol and Drug Partnership Act

The Child Abuse/Alcohol and Drug Partnership Act encompasses the comprehensive family treatment model and addresses the need for additional substance abuse treatment for caregivers involved in the child welfare system. Originally introduced on April 13, 2000 in the Senate with the support of Senators Olympia Snowe (R-ME), John Rockefeller IV (D-WV), Christopher H. Dodd (D-CT), Mike DeWine (R-OH), and Christopher S. Bond (R-MO), this legislation needs to be reintroduced in the 110th Congress.

The bill would provide five-year grants to state child welfare and substance abuse agencies that agree to take steps together to develop and increase treatment services, establish appropriate screening and assessment tools, or improve strategies to engage and retain parents in treatment and provide aftercare support. The activities must be directed to families with substance abuse problems who come to the attention of the child welfare system. State child welfare and substance abuse agencies, working together, would have the flexibility to decide how best to use these new funds to enhance treatment and services. This would allow states to develop or expand comprehensive family-serving substance abuse intervention and treatment services that include early intervention services for children that address their mental, emotional, and developmental needs, as well as comprehensive home-based, outpatient, and residential treatment for parents with alcohol and drug abuse dependency. Evaluation components of the legislation would also lead to much needed improvement in data systems and strategies that identify the effectiveness of treatment-particularly those parts of substance abuse treatment collaborations with child welfare which have the greatest positive impact on families.

This legislation recognizes that the majority of parents involved in the child welfare system need substance abuse treatment, and that even with recent federal efforts, only a small fragment are actually getting the treatment. All states report long waiting lists for substance abuse treatment, especially for this population. In turn, this lack of resources for parental substance abuse treatment causes delays in making final decisions about the well-being and safety of children in foster care whose parents are awaiting treatment.

Substance Abuse Prevention and Treatment Block Grant

Congress must provide substantially increased funding for the Substance Abuse Prevention and Treatment (SAPT) Block Grant, which serves as the backbone of the nation's publicly funded substance abuse prevention and treatment system. This flexible funding stream, designed to help states address their own unique needs related to addiction, is vital to ensuring increased treatment system capacity to facilitate collaboration between child welfare and substance abuse agencies.

Impact of Methamphetamine on Children

The use and spread of methamphetamine (meth) poses one of the more significant threats to children in recent years. In certain parts of the country, this is a critical concern to the child welfare community. A 2005 survey by the National Association of Counties revealed that meth has an immensely negative impact on communities and children. Forty percent of all child welfare officials in the survey reported increased out-of-home placements because of meth since July 2004, and 59% indicated meth is making family reunification increasingly difficult. 16

National treatment rates for meth have been increasing, with treatment admission rates rising by more than 42,000 between 2000 and 2003. 17 Rates of methamphetamine abuse have continued to grow rapidly, as the number of past month methamphetamine users who met criteria for illicit drug dependence or abuse in the past 12 months increased from 164,000 in 2002 to 346,000 in 2004. 18 Alarmingly, the percentage of female admissions for methamphetamine abuse is higher than the percentage of female admissions associated with any other drugs except tranquilizers, sedatives, and opiates. 19 Women represented 45% of the total number of individuals admitted to treatment in 2003 for methamphetamine addiction. 20
Methamphetamine abuse has received increased attention from Congress during the past few years, and in 2005, CWLA provided testimony at a Congressional hearing outlining the strain meth has placed on the child welfare system. Meth is an almost instantly addictive stimulant that produces intense highs and elevated levels of euphoria that often last hours, and can extend into days and weeks. Typical treatment and recovery is often more intense and longer than other chemical dependency programs. Children living in environments with meth labs may face hazards such as dangerous chemicals and the risk of explosions. These children often become victims of maltreatment as drug addiction takes precedence over food, supervision, shelter, and medical care.

Child welfare workers report the needs of children removed from meth labs who have suffered prolonged periods of neglect are great. Outside of immediate physical health concerns, these children may exhibit greater social, educational, emotional, and behavioral challenges than other children entering foster care. The lack of parental attention has not allowed the children to achieve appropriate levels of development and they may face confusion and doubt about who to trust. They also have difficulty associating with peers and lack guidance in their everyday actions.

Clinically appropriate treatment for methamphetamine addiction is effective. CWLA urges Congress to provide $20 million for Section 756 of the USA Patriot Act to help expand methamphetamine treatment for pregnant and parenting women offenders who come in contact with the criminal justice system, including family-based treatment programs where women and their children can receive the services they need at the same time, in the same location. This targeted funding for methamphetamine treatment for pregnant and parenting women would expand critical collaboration among the state substance abuse programs and the criminal justice and child welfare systems to ensure these women and their children receive the effective services they need.

Key Facts

  • Substance abuse is a factor in one to two-thirds of cases of children with substantiated reports of abuse and neglect and in two-thirds of cases of children in foster care. 21

  • In a 1999 national survey, 85% of states reported substance abuse was one of the two major problems exhibited by families suspected for child maltreatment. 22

  • States spent an estimated $24 billion and more on addressing substance abuse. Slightly more than 20%, or $5.3 billion, goes to child welfare costs related to substance abuse. 23

  • An evaluation of the Center for Substance Abuse Treatment's (CSAT) Pregnant and Postpartum Women (PPW) program, which funded the expansion of comprehensive residential treatment programs, found that the number of women reporting drug and alcohol use was dramatically reduced from 90% during the six months before admission, to 32% at six months following discharge. 24

  • Substance abusing parents tend to engage in fewer family activities with their children, and sometimes force children to take on roles and responsibilities inappropriate for their age. 25

  • Prenatal exposure to alcohol increases physical and mental health risks for children, including hyperactivity and attention deficit, childhood depression, memory and information processing delays, poor problem-solving skills, lower IQ scores, and difficulty with linguistic, perception, and motor development. 26

  • Children of alcoholics tend to exhibit greater stress and anxiety than other children, increasing the likelihood they will drink alcohol or use other substances to reduce anxiety. 27

  • Children of substance abusers are more likely to have extensive exposure to criminal activity and the criminal justice system. 28

  • A 2005 National Survey on Drug Use and Health found that youth who have been in foster care had higher rates of illicit drug use than youth who have never been in foster care-33.6% versus 21.7%. 29

Sources

  1. Alcohol and other drug survey of state child welfare agencies. (1997, February). Available online. Washington, DC: Child Welfare League of America. back
  2. U.S. House of Representatives, Committee on Ways and Means. (2004). Substance abuse, section 11. (In 2004 Green Book). Washington, DC: U.S. Government Printing Office.Wells, K., & Wright, W. (2004, Sept. 14). Medical summit. Presented at Idaho's Second Annual Drug Endangered Children Conference, Post Falls, Idaho. Available online. back
  3. Wells, K., & Wright, W. (2004, Sept. 14). Medical summit. Presented at Idaho's Second Annual Drug Endangered Children Conference, Post Falls, Idaho. Available online. back
  4. Semidei, J., Radel, L.F., & Nolan, C. (2001). Substance abuse and child welfare: Clear linkages and promising responses. Child Welfare, 80(2), 109-128. back
  5. Johnson, J. L., & Leff, M. (1999). Children of substance abusers: Overview of research findings. Pediatrics, 103(5), 1085-1099. back
  6. U.S. Department of Health and Human Services. (1999). Blending perspectives and building common ground. Washington, DC: Author. back
  7. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, National Survey on Drug Use and Health. (2005). The NSDUH report: Substance use and need for treatment among youths who have been in foster care. Washington, DC: Author. back
  8. No safe haven: Children of substance-abusing parents. (1999, January). New York: The National Center on Addiction and Substance Abuse at Columbia University. back
  9. Safe and sound: Models for collaboration between the child welfare & addiction treatment systems. (2003, April). New York: Arthur Liman Policy Institute, Legal Action Center.  back
  10. Ibid.
    Substance Abuse and Mental Health Services Administration, The National Treatment Improvement Evaluation Study. (1996). Preliminary report: The persistent effects of substance abuse treatment one year later. Rockville, MD: Author.
    Center for Substance Abuse Treatment. (2000). Substance abuse treatment: Reduces family dysfunction, improves productivity. Rockville, MD: Author. back
  11. Alcohol and other drug survey of state child welfare agencies, CWLA. back
  12. Price, R. (1997). What we know and what we actually do: Best practices and their prevalence in substance abuse treatment. In J.A. Egertson, D.M. Fox & A.J. Leshner, (Eds). Treating drug abusers effectively. Malden, MA: Blackwell. back
  13. Semidei, Radel, & Nolan. back
  14. Physician Leadership on National Drug Policy. (1998). Major new study finds drug treatment as good as treatments for diabetes, asthma, etc., and better and cheaper than prison. (Press release of a study sponsored by Physician Leadership on National Drug Policy). Available online. Providence, RI: Author. back
  15. Maluccio, A., & Ainsworth, F. (2003) Drug use by parents: A challenge for family reunification practice. Children and Youth Services Review, 25, 511-533. back
  16. National Association of Counties. (2005). The meth epidemic in America. Two surveys of U.S. counties. Available online. Washington, DC: Author back
  17. Substance Abuse and Mental Health Services Administration. (2005). Treatment Episode Data Set (TEDA). Highlights - 2003. National admissions to substance abuse treatment services. (DASIS Series: S-27, DHHS Publication No. (SMA) 05-4043). Available online. Rockville, MD: Author. back
  18. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, National Survey on Drug Use and Health Report. (2005, September). Methamphetamine use, abuse, and dependence: 2002, 2003, and 2004. Washington, DC: Author. back
  19. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2006, April). Treatment Episode Data Set (data file). Available online. Rockville, MD: Author. back
  20. Boles, S., Dennis, K., Otero, C., & Young, N. (April 2006). Methamphetamine addiction, treatment, and outcomes: Implications for child welfare workers. (Draft prepared for the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration. Washington, DC: National Center on Substance Abuse and Child Welfare. back
  21. U.S. House of Representatives, Committee on Ways and Means, Substance abuse, section 11back
  22. National Center on Child Abuse Prevention Research (2001). Current trends in child abuse prevention, reporting, and fatalities: The 1999 Fifty State Survey. Chicago: Prevent Child Abuse America. back
  23. National Center on Addiction and Substance Abuse at Columbia University. (2001). Shoveling up: The impact of substance abuse on state budgets. New York: Author. back
  24. Clark, H. W. (2001). Residential substance abuse treatment for pregnant and postpartum women and their children: Treatment and policy implications. Child Welfare, 80, (2) 179-198. back
  25. National Center on Addiction on Substance Abuse at Columbia University. (2005). Family matters: Substance and the American family. Available online. New York: Author. back
  26. Richter, L., & Richter, D. M. (2001). Exposure to parental tobacco and alcohol use: Effects on children's health and development. American Journal of Orthopsychiatry, 71(2), 182-203. back
  27. Schuckit, M. A. (1994). Low level of response to alcohol as a predictor of future alcoholism. American Journal of Psychiatry, 151(2), 184-189. back
  28. Austing, G., & Pendergast, M. (1991). Young children of substance abusers: Prevention research update no. 8. Portland, OR: Northwest Regional Educational Laboratory. back
  29. SAMHSA, The NSDUH Reportback

CWLA Contact

Tim Briceland-Betts
703/412-2407



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