Massachusetts has reported some new and detailed information on the impact of substance abuse on child abuse reports.  The data, reported recently by the Boston Herald indicates that within a six month period substance abuse was a factor in 14,000 cases, or 30 percent, of the 47,700 total reports of abuse and neglect the state investigated.   The reports are significant because much of the national and state data across the country has not been as detailed over the years.  For Massachusetts, the 30 percent of cases with substance abuse outstrips the next two main causes of child maltreatment, domestic violence (21 %) and mental health (18 %).

In the same article Linda Spears, Commissioner of Children and Families, is quoted as saying that “We’ve always said that certain factors are prevalent in our caseload, including substance abuse, domestic violence and mental health. At least at the front door, substance abuse is a bigger proportion of what we’re seeing.  Higher than any of the (other) co-occurring categories.”

The increases do not necessarily make Massachusetts unique since there have been significant increases in foster care numbers with all but eight states seeing increases between 2013 through 2015.  National foster care numbers have risen from 400,000 in 2013 to 427,000 in 2015.  Much of it is likely due to the opioid and other substance use issues with an increase especially at the infant and toddler categories of children.  Massachusetts like most states have had increases in foster care placements.

The pattern of abuse starts with adults becoming addicted to prescription pain killers with a later switch over to the cheaper heroin.  As part of the recent strategy some states are attempting to better control and monitor the use of prescription drug pain relief. Parts of the 2016 Comprehensive Addiction and Recovery Act (CARA) encouraged or directed greater monitoring of prescription medication by states and by the federal Medicare program.

A recent study in the Journal of Health Affairs showed that state-run prescription drug monitoring program data and pain clinic laws reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent.  The Health Affairs paper indicated that a broader strategy would be required because the prevention and monitoring did not necessary reduce heroin deaths significantly.

As far as Massachusetts, the Boston Herald reported that as of August 2016, there were approximately 9,500 kids in foster homes and other settings, a 10 percent jump since Gov. Charlie Baker took office at the start of 2015. Massachusetts has been investing heavily over the past year and a half to implement a new set of reforms after a child fatality that caught the public’s attention.