Children Exposed to Parental Substance Abuse: the Impact

• Publication year: 2005
• Pages: 29
• Citation: Vol. 34 No. 2 Pg. 29

34 Colo.Law. 29 Colorado Bar Journal 2005.

2005, February, Pg. 29. Children Exposed to Parental Substance Abuse: The Impact

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29

Vol. 34, No. 2, Pg. 29

The Colorado Lawyer
February 2005
Vol. 34, No. 2 [Page 29]

Departments
CBA Family Violence Program
Children Exposed to Parental Substance Abuse: The Impact
by Sharon G. Elstein

This department is published quarterly to provide information about domestic violence and CBA Family Violence Program activities

Sharon G. Elstein, MS, is a senior research associate for the ABA Center on Children and the Law, Washington, D.C. This article is a reprint of Elstein, "Children Exposed to Parental Substance Abuse," 20 ABA Child Law Practice (Oct. 2001). C2001 American Bar Association. All rights reserved. Reprinted with permission from the ABA Center on Children and the Law, Washington, D.C. For information about this publication or to receive a free sample issue, contact Lisa M. Waxler, Publications Coordinator: (202) 662-1743 or e-mail: waxler@staff.abanet.org

Children in the child welfare system due to parental substance abuse face many challenges. As lawyers, judges, and agency professionals working with families under child welfare agency supervision, you may handle cases involving a parent who is substance dependent and has used drugs around the children. Maybe the mother used substances while pregnant or she is currently pregnant and using

It is essential to help the addicted parent; doing so will in turn benefit the child.1 But efforts must also focus on assessing the needs of and tailoring interventions for the child. Where do you begin?

The first step is to understand how exposure to parental substance abuse affects the child. Literature abounds on the impact of drugs and alcohol on children, particularly prenatal exposure to alcohol, cocaine, and cigarettes. You have probably read some of it. This article will acquaint you with the most salient and newest research findings.

What Substances Are Being Abused?

When you hear substance abuse, do you usually think of crack or cocaine addiction - heroin or methamphetamines? Don't forget that alcohol remains one of the most-abused substances. Most substance-addicted parents abuse more than one drug. Polysubstance abuse usually includes a combination of illicit drugs, alcohol, and, often, cigarettes.2

In a study of the Intact Family Project, Cook County (an integrated child welfare and substance abuse service program of the Illinois Department of Children and Family Services), 86 percent of the women served reported polydrug use.3 The primary drug of choice was cocaine (50 percent), heroin (22 percent), or alcohol (19 percent). The secondary drug (used along with the primary drug) was alcohol (36 percent), cocaine (35 percent), and marijuana (22 percent).4 Methamphetamines are gaining favor among addicts, especially in the western, northwestern, and midwestern United States.5 Two-thirds of women in one study cited "meth" as their primary drug.6

Alcohol use deserves special attention due to its proven harmful impact upon the developing fetus (more, below). Experts in maternal substance abuse note that alcohol abuse usually accompanies drug abuse and, in fact, should be recognized as a "co-primary" drug.7 Alcohol may be used to extend the effects of the drug, soften the "landing" when coming down off drugs, or replace illicit substances when they are unavailable.

Prenatal Exposure

How Big is the Problem?

The National Pregnancy and Health Survey (National Institute on Drug Abuse) reports:8

5.5 percent of American women used an illicit drug while pregnant, resulting in some 221,000 drug-affected newborns

18.8 percent of women drank alcohol
2.9 percent of women used marijuana
1.1 percent of women used cocaine.

Some 5,000 babies with Fetal Alcohol Syndrome ("FAS"), a set of disabilities resulting from alcohol use during pregnancy, are born each year, with 50,000 infants born with alcohol-related afflictions to their central nervous systems.9

Impact of Prenatal Exposure
To Substances

Substance abuse during pregnancy may result in an array of medical, mental health, developmental, and behavioral problems for the child. These effects may be profound and life-long or moderate and ameliorated through intensive services. The degree of impact depends on the substance used, timing of exposure (when in the fetus's development), and environmental factors, which may enhance or mitigate the effects (maternal health, nutrition, prenatal care).10

Premature birth is a likely consequence of prenatal substance exposure, and leaves the baby open to such risks as cerebral palsy, respiratory problems, and visual dysfunction.11 Newborns exposed in utero to substance abuse may exhibit the following symptoms at, or in the hours and days following, birth: irritability and jitteriness alternating with lethargy, prolonged crying, affected muscle tone, frantic sucking of hands, seizures, fevers, sweating, diarrhea, sleep disturbances, and unresponsiveness or overreaction to stimulation.12

Babies born to addicted mothers are at higher risk for infectious and sexually transmitted diseases ("STDs") that may cross the placenta or be transmitted during delivery, such as gonorrhea, syphilis herpes, chlamydia, hepatitis B, HIV, AIDS,...