Last week Wednesday, November 8, the House Committee on Education and the Workforce held a hearing on the impact of opioids on children, youth and families.  The hearings were under the banner of two of the Committee’s subcommittees with an emphasis on children.

According to the Committee information provided, 61.8 million patients received opioid prescriptions last year (19 percent of the population) and that that includes 3.7 million children and teenagers.  In addition, 276,000 children and youth aged 12 to 17 were using nonmedical users of pain relievers with 122,000 having an addiction.

The witnesses included Tim Robinson, Addiction Recovery Care, Louisa, KY, Toni Miner, Family Support Partner Child and Youth Leadership Commission, Jefferson County, CO, Dr. Leana Wen, Health Commissioner, City of Baltimore, Maryland, Dr. David Cox, Executive Officer of the County Board of Education, Allegany County, Maryland.

Mr. Robinson an addiction recovery expert and person who had to deal with his own addiction said the challenge people face and as a result the challenge of this latest drug abuse crisis is not simple.

“Everyone is looking for a silver bullet to our addiction crisis…Addiction recovery requires a whole person approach which starts with identifying those in addiction, intervening with treatment, investing in their economic future through education and workforce development, and inspiring them to join the effort to do for others what was done for me: help another person discover their destiny and walk out their own recovery.”

Toni Miner speaking to efforts in one Colorado county proposed that there were four strategies that must be combined: 1) collaboration across agencies, 2). focusing on the entire family, 3). educating communities and families regarding substance abuse, and 4). partnering with parents to work with other families before, during or after involvement with the child welfare and court systems.  Miner described her own addiction challenges recounting that as a young woman she had to deal with drug addiction as a young mother.  That in turn drew the involvement of the child welfare system.  She was helped by a dedicated caseworker through the child welfare agency who provided her with vital support at a key point.  While she was able to regain custody she also noted that her daughters would also become addicted and she is now providing the vital role of kinship care provider for her grandchildren.

Dr Wen described conditions he has addressed as the Health Commissioner in the city of Baltimore where heroine has been such a problem for so long. He said that in 2016 there were 694 drug overdose deaths which is twice Baltimore’s murder rate.   Dr Wen also described a three-part strategy.  1) prevent deaths from overdose and save the lives of people suffering from addiction, 2) increase access to quality and effective on-demand treatment and provide long-term recovery support, and 3) increase education and awareness to reduce stigma and encourage prevention and treatment.

Finally, Dr David Cox spoke to the impact this is having within school systems.  He oversees the school district in the Cumberland Maryland area.  In many ways a typical example of some of the nation’s highest areas of the opioid epidemic with a dwindling economy and an area of Maryland just off easy highway access.  Dr Cox described several incidents over the past year where school personnel came face to face with the impact the opioid epidemic was having on their students, especially the very young.

“On two different occasions, staff from our County’s Head Start Program made home visits only to encounter a young child who answered the door.  Each of those times when asked “Where is your mommy?” the child responded, “She is asleep”, and when further investigated, the mothers were deceased.  In both cases, the cause of their death was overdose.”

He also emphasized the need for health and mental health services saying,

“I have great difficulty in finding the words to describe the magnitude of the unmet mental health needs of my students and families.  The opioid crisis is connected to this issue on the front end, in that many are self-medicating their depression and anxiety, and many come from families with histories of addiction issues.  Children are left with mental health scars when they lose parents to overdose deaths, and quite simply, there aren’t enough resources to provide all the needs for counseling, therapy, and treatment.  Keeping options for Children’s Health Insurance Programs is a critical need.”

There was no clear path forward by Congress despite all the recent attention.  The President’s Commission on Combating Drug Addiction and the Opioids Crisis released its final report on Wednesday, November 1 but did not affix a dollar figure to addressing their 56 recommendations.  Commission Chair, Governor Chris Christy (R-NJ) said it was on the Congress to now act on the recommendations.

Commission recommendation number 47 deals specifically with children and families and child welfare but does not offer much support.  The recommendation encourages the promotion of “best practices” by HHS, SAMHSA, and the Administration on Children, Youth and Families regarding keeping families together (including kinship care), promising models for pregnant and post-partum parents, supportive housing and implementing a “plan of safe care.”

A potential area that could assist child welfare is the called for expansion of Drug Courts and Diversion programs to all 93 federal jurisdictions.  The Commission indicates that only 44 percent of counties have these courts that divert people from jail to treatment.  There is a similar effort such as family drug courts that focus on families in danger of losing their children due to an addition problem.