Fighting Meth, Healing Families

Nationwide, methamphetamine, or “meth,” is devastating children, families, and the child welfare agencies that serve them. Adding to the crisis is the widespread misconception that meth addiction is untreatable. This myth not only hurts children and families, but makes it even more difficult for child welfare agencies to secure the government resources and community supports necessary to address it.

In collaboration with law enforcement, business, and the media, however, child welfare agencies are learning more than ever about new partnerships, tools, and programs that are working to protect families against meth.

1. Media Campaigns

In recent years, several states have developed effective public education campaigns to warn against the risks of meth use. These campaigns are built on the premise that, in a media-saturated world, one message is not enough when it comes to preventing substance abuse.

When software billionaire Timothy Siebel learned about the devastating effects of meth on Montana’s communities, he put his money to work to create a comprehensive advertising and community action project to reduce meth use in the state. In 2005, the Montana Meth Project began targeting 12- to 17-year-olds, with graphic, disturbing TV commercials, radio ads, billboards, and posters to warn against meth use.

The campaign worked. A March 2006 survey of more than 1,460 respondents found shifts in attitudes about the perceived “benefits” and risks of meth by as much as 30% over a period of only eight months, including a significant increase in communication between parents and teens.

2. Expanding Permanency Options

With adequate supports, good substance abuse treatment services, and strong collaboration between multiple systems, parents can successfully kick meth habits and keep their families together.

But even the best possible interventions do not work for everyone. To help those children who cannot return home to live safely with their parents, child welfare agencies and the courts are redoubling efforts to ensure permanency through adoption and guardianship. In particular, subsidized guardianship is an increasingly valuable permanency tool when adoption or reunification with parents is not viable. This option is especially popular for children who are being cared for by grandparents and other relatives.

Subsidized guardianship programs, now available in at least 37 states and the District of Columbia, provide ongoing financial support to allow children to leave the foster care system to live with a permanent family that has agreed to provide them a safe, loving home. Subsidized guardianship is a particularly important permanency option for many older youth who do not want to be adopted. Subsidized guardianship is also a useful option for grandfamilies -- grandparents and other relative caregivers -- who do not want to disrupt family relationships by terminating parental rights, and for Native American and other populations for whom termination of parental rights is contrary to cultural norms.

An estimated 20,000 children in the foster care could leave the system if a permanency option like federally supported guardianship were available. If subsidized guardianship were widely available in all states, many of these children would be able to exit foster care to the permanent care of loving relatives and other foster families.

3. Interagency Collaborations

Because meth affects children in many different ways, partnerships are critical to ensure that all involved agencies -- from child welfare to law enforcement -- are addressing individual needs effectively.

One particularly effective model gaining influence nationwide is Drug Endangered Children (DEC) partnerships. DEC partnerships are designed to coordinate the activities and responsibilities of all agencies that may be involved as first responders at a drug scene or in a meth-related crisis intervention, including law enforcement personnel, child protection workers, emergency room personnel, prosecutors, and fire and hazmat crews.

To support the more than 25 states and regions that have established DEC teams, a National DEC Training Program has educated more than 5,500 professionals from multiple disciplines in 20 different states. Building on the success of these collaborations, the National Alliance for Drug Endangered Children has also been established to provide technical assistance and support for the state networks of professionals involved in substance abuse issues.

As part of the reauthorization of the Patriot Act, Congress recently authorized $20 million dollars in grants to the states to expand and establish new programs to provide comprehensive, coordinated services to drug-endangered children living in homes where meth and other controlled substances are made and used.

In addition to law enforcement partnerships, more child welfare agencies are also turning to broader collaboration with the substance abuse treatment community and drug courts. The National Center for Substance Abuse and Child Welfare (NCSACW), funded by the U.S. Substance Abuse and Mental Health Services Administration, was created specifically to help foster greater collaboration among these agencies.

NCSACW’s technical assistance resources and online trainings provide agencies the basic structure for successful collaborations, including a framework for shared values and principles, interagency protocols for working together, substance abuse expertise for child welfare agencies and family courts, information on developing strong and early assessment processes, and other resources.

4. New Supports for Grandfamilies

Grandfamilies have become lifelines for millions of children who cannot live with their parents due to meth and other substance abuse. As the child welfare system’s reliance on grandfamilies continues to grow, a number of new programs and resources have become available to address the unique issues they face.

To help grandfamilies break the cycle of substance abuse in their lives, the Children of Alcoholics Foundation has created a comprehensive guide and series of fact sheets, Ties That Bind, to help support relative caregivers dealing with parental substance abuse issues. The curriculum helps grandfamilies learn strategies for accessing child welfare services, ways to deal with changing family relationships, and managing children who have been affected by meth and other drugs.

Other programs are exploring new ways to help grandfamilies and other foster parents better address the developmental needs of children who have been affected by meth -- especially young children who can benefit most from special early intervention programs.

The Therapeutic Preschool Model, developed by a coalition of national child development professionals for the Green County Behavioral Health Services in Muskogee, Oklahoma, provides one-on-one support for young children who have been exposed to parental meth use. In addition to a range of developmental services, teachers also work directly with grandparent caregivers and foster parents who are caring for children who have been removed from their homes.

The needs of grandfamilies are also being incorporated into foster and adoptive trainings. As a former police officer and the current coordinator of the Cerro Gordo County Community Drug Court, Mike McGuire of Mason City, Iowa, has been watching the devastating effects of meth on communities across his state. Based on his extensive experience with children and families affected by meth, Mike now offers a series of peer trainings for foster and adoptive parents and grandfamilies who are raising children in the child welfare system. The trainings include general drug awareness, as well as classes on promoting positive relationships with birthfamilies and system professionals to increase positive outcomes for children.

“Relative caregivers caring for children in foster care have many of the same issues as other foster and adoptive parents,” McGuire say, “but one subject that tends to be ignored is the impact of meth on the entire family system. Wherever meth is present, we’ve just seen an explosion of relatives raising children.”

5. Enhancing Treatment Options

Comprehensive, readily accessible treatment programs are communities’ best hope have for breaking the cycle of alcohol and drug dependence and helping families stay together. One of the most promising treatment models is comprehensive family treatment, which provides services for both parents and their children.

A 2003 evaluation of 24 residential family-based treatment programs showed successful outcomes for mothers and their children, including 60% of mothers who remained clean and sober six months after discharge. The study also showed that 44% of children returned to their mothers from foster care.

In addition to the benefits to women and children, comprehensive family treatment programs also are a cost-saving alternative to foster care. In New York State, for example, effective family treatment costs $25,000 per family, compared with the $30,000 average cost to support one child in the foster care system and the $30,000 cost of incarcerating a mother in a state or federal prison.

Most important, comprehensive substance abuse treatment increases parents’ willingness to begin treatment in the first place. “In the family treatment program, I knew my wife and children were safe and healing,” says Darren Noble, an Ohio father in recovery from a meth addiction. “That really eased my mind so I could focus on my treatment.”

6. Family Drug Courts

The nation’s dependency courts are also responsible for ensuring children are safe and families can access the child welfare services they need. As many of these courts are finding, treatment works, but only if those who need it have the right support and motivation to try it in the first place.

Family drug courts have been widely lauded as a key ingredient to motivating families to enter and stay in treatment. These special courts handle substance-abusing offenders through comprehensive supervision, frequent drug testing, and immediate sanction and incentives to participate in substance abuse treatment. Drug courts bring all the players -- judges, lawyers, substance abuse treatment professionals, and child protection agencies -- into the process, forcing parents to confront meth use and other substance abuse-related issues.

One of the oldest and most effective drug treatment programs is the Sacramento County Family Drug Court in California. Over the past decade, the program has instituted a number of innovations that have substantially improved outcomes for thousands of children and families involved in the child welfare system.

At the very first detention hearing to determine a child’s placement in the child welfare system, parents are referred to the STARS program (Specialized Treatment and Recovery Services), directly across the street from the courthouse, where they receive a comprehensive evaluation for appropriate services and a treatment plan. In addition to intensive counseling and other comprehensive treatment components, parents in the program are assigned role models, individual certified addiction specialists who are also in recovery.

The American University’s Drug Court Clearinghouse reports that more than 400,000 offenders have participated in drug court programs like the one in Sacramento since they were created in 1989. A 1997 Government Accountability Office report estimated 71% of offenders participating in drug treatment courts had either successfully completed or remained actively involved in their programs. A 2001 Columbia University study found that drug courts continue to provide “the most comprehensive and effective control of the drug-using offender’s criminality and drug usage while under the court’s supervision.”

7. Targeted Community Supports in Indian Country

Children, families, and tribes in the Native American community have been hit particularly hard by the meth crisis. Nationally, American Indians and Alaska Natives use meth at two to three times the rate of whites, with the highest rate of use among people ages 15-44.

The devastating effects of meth on the American Indian community is compounded by the fact that native children are already disproportionately represented in the child welfare system. In fact, Indian children are placed in foster care at two to three times of other children nationally. In some states, Native American children represent as much as 50%-60% of the children in state care.

To ensure infants and young children and their relative caregivers receive the full range of early intervention services, the Tribal Social Services Division of the Confederated Salish and Kootenai Tribes of the Flathead Nation in Montana has developed a comprehensive Developmental Assessment Clinic for children who have tested positive for meth and other drugs at birth. Of these children, 70%-80% are placed in foster care with relatives and then referred to the clinic, where they receive physical therapy, speech and language, medical, and dental screenings.

Although many of these families would also benefit from in-home support services, funding isn’t available. “We need to learn how to remove, not just individual children, but whole families from the drug environment,” explains Arlene Templer, the tribes’ Social Services Division Manager. “We have the expertise to give children, parents, and relative caregivers the services they need, but we don’t have the money.”

New Hope, New Directions

Meth is not the first nor the last child welfare crisis. Policy changes at the federal, state, and local levels must be flexible and broad enough to address a range of current and unforeseen issues. At the same time, meth’s particular brand of devastation, especially on certain states and communities, is a potent reminder of the urgent need to continue testing, modifying, and replicating effective practices and new solutions to this entrenched problem.

In addition to promising strategies, the best weapon may be our nation’s inherent capacity to support change when it’s most needed. “We need to believe that change is possible,” explains an adoptive father of 8-year-old twins whose birthmother recently entered substance abuse treatment. “If we lose hope, we might all as well pack it in.”