he Office of Assistant Secretary for Planning and Evaluation (ASPE) has released research on the relationship between increased substance abuse (especially opioids) and the increasing foster care numbers. The ASPE study, Substance Use, the Opioid Epidemic, and the Child Welfare System: Key Findings from a Mixed Methods Study takes a much deeper look at the data at the county level and supplemented that research with the perspectives of child welfare administrators and other key parties including law enforcement, judges, and practitioners.
The three broad conclusions: Overdose and drug-related hospitalizations does increase the rates of child abuse reports, increases the number of substantiated child abuse and neglect cases, and increases foster care numbers. The availability of treatment is limited, especially family friendly options and the caseworkers, courts and other providers misunderstand treatment and how to incorporate it into child welfare practice. The system response has been challenging with barriers to collaboration between parties, a shortage of foster homes and trained child welfare staff limits an effective response to the crisis.
The ASPE reports (see below the other related report) were presented at a CWLA webinar in January and the discussion and research will be one of the topics at the CWLA National Conference. Other highlights of the research:
• Foster care entries and overdose deaths are related nationally but show variation across the country. Appalachia, parts of the Pacific Northwest, parts of the Southwest, Oklahoma and New England had strong relationships between overdose deaths and foster care entries.
• A 10 percent increase in overdose death rates correspond to a 4.4 percent increase in the foster care entry rate and a ten percent increase in the hospitalization rate due to drug use corresponds to a 3.3 percent increase in the foster care entry rate.
• While in past drug epidemics family and communities could fill some of the gaps, today agencies report that family members across generations may be experiencing substance use problems forcing greater reliance on state custody and non-relative care.
• Parents using substances have multiple problems including domestic violence, mental illness, trauma history, and addressing substance abuse alone is unlikely to be effective.
• There is a shortage of treatment and the treatment course may be shorter or different then what is needed.
• Substance use assessment is haphazard and there is a lack of “family-friendly” treatment that includes family therapy, child care, parenting classes and developmental services.
• While not a new problem but one that has intensified, caseworkers and agencies are overwhelmed, community leaders see it as worse now than past years and there is greater danger for caseworkers involving safety which includes dangerous confrontations and the interaction with hazardous drugs workers might come into contact with.
• There is a shortage of foster homes and this is exacerbated by the need to keep children longer in care which keeps existing homes full and unable to accept new placements.
• Differential response is viewed as inadequate in these sites.
• Differences in treatment views, approaches to families and the sharing of data is making collaboration between child welfare, courts and treatment agencies difficult. (see below for additional information).