Family Drug Courts: Combatting the Opioid Epidemic

• Author: Stephanie Tabashneck (2018)
• Position: First place, 2018 Howard C. Schwab Memorial Essay Contest; Northeastern University Law School, J.D. 2018; Doctor of Psychology (Psy.D.); forensic psychologist specialized in child custody, substance use disorders, and juvenile justice, www.stephanietabashneck.com, Boston, Massachusetts.
• Pages: 183-202

183

Family Drug Courts: Combatting the

Opioid Epidemic

STEPHANIE TABASHNECK*

Introduction

Every day in communities across the country, courts are confronted

with the devastating impact of the opioid crisis. From 2016 to 2017, more

Americans died from drug overdoses than were killed in the decades-long

Vietnam War.1 Most of these overdose deaths were from opioids.2 While the

opioid crisis has inuenced many spheres of society, opioid use disorders

1. The Centers for Disease Control and Prevention [hereinafter CDC] estimates that in

2016 there were 52,898 deaths from drug overdose, and in 2017 this number rose to 64,070

deaths. See CDC, nat’l Ctr. For health statistiCs, provisional CoUnts oF drUG overdose

deaths, as oF 8/6/2017 (Aug. 2017), https://www.cdc.gov/nchs/data/health_policy/monthly-

drug-overdose-death-estimates.pdf [hereinafter CdC overdose statistiCs 2017]; see generally

German Lopez, In One Year, Drug Overdoses Killed More Americans Than the Entire Vietnam

War Did, vox (Jan. 8, 2017), http://www.vox.com/policy-and-politics/2017/6/6/15743986/

opioid-epidemic-overdose-deaths-2016.

2. Deaths from fentanyl have increased opioid deaths to previously unheard-of rates.

Fentanyl is fty to one hundred times more potent than morphine. CDC Health Advisory:

Increases in Fentanyl Drug Conscations and Fentanyl-Related Overdose Fatalities, CDC:

CDC health alert network (Oct. 26, 2015), http://emergency.cdc.gov/han/han00384.asp.

* First place, 2018 Howard C. Schwab Memorial Essay Contest; Northeastern University

Law School, J.D. 2018; Doctor of Psychology (Psy.D.); forensic psychologist specialized in

child custody, substance use disorders, and juvenile justice, www.stephanietabashneck.com,

Boston, Massachusetts.

Published in Family Law Quarterly, Volume 52, Number 1, Spring 2018. © 2019 American Bar Association. Reproduced with permission. All rights reserved. This information or any portion thereof

may not be copied or disseminated in any form or by any means or stored in an electronic database or retrieval system without the express written consent of the American Bar Association.

184 Family Law Quarterly, Volume 52, Number 1, Spring 2018

have a unique impact on families.3 A parent’s addiction not only affects

his or her own life but destabilizes an entire family system.4 Children with

an opioid-dependent parent are at risk of neglect, abuse, and instability.5

Inundated with opioid-related child welfare cases and custody disputes,

family courts are faced with the at times daunting challenge of how to

manage these complicated cases.6 Judges confront difcult questions. Is a

child better off with a parent who repeatedly tests positive for opioids or in

a foster care placement of unknown quality? To what extent, if any, should

opioid-dependent mothers or fathers have supervised visitation with their

children? If a parent is taking methadone, is he or she merely trading one

addiction for another?7 Traditional family courts often lack the resources

to address underlying substance use problems. Parents with an opioid

use disorder may want help, but without treatment or support, they are

frequently headed toward the permanent loss of custody of their children.8

This difculty has resulted in a skyrocketing number of children in out-of-

3. Opioid use disorder is dened in the Diagnostic and Statistical Manual of Mental

Disorders, Fifth Edition, as the repeated occurrence within a twelve-month period of two or

more of the following: tolerance, inability to control opioid use, heightened focus on opioids,

cravings, a failure to carry out important roles due to opioid use, continuing to use opioids

despite a negative impact on one’s life, and withdrawal. am. psyChiatriC ass’n, diaGnostiC

and statistiCal manUal oF mental disorders (5th ed. 2013).

4. In a study of the impact of opioid, alcohol, and cocaine addictions, researchers concluded

based on a sample of 183 mother-child dyads that mothers with substance use disorders were

more likely to experience difculties with parenting, discipline, and parent-child interaction.

See Natasha Slesnick et al., Parenting Under the Inuence: The Effects of Opioids, Alcohol and

Cocaine on Mother-Child Interaction, 39 addiCtive Behav. 897 (2014), https://www.ncbi.nlm.

nih.gov/pubmed/24589871.

5. Commonly experienced family problems associated with substance dependence are

child neglect, domestic violence, family dissolution, economic issues such as unemployment

and housing instability, child behavioral problems, and psychological disorders. See Dennis

C. Daley, Family and Social Aspects of Substance Use Disorders and Treatment, 21 J. Food &

drUG analysis (sUpplement) s73, s73 (2013), https://bit.ly/2HjbwAY.

6. Many individuals with opioid use disorders are also dependent on other substances. See

generally Deborah Dowell, Tamara M. Haegerich & Roger Chou, CDC Guideline for Prescribing

Opioids for Chronic Pain—United States, 2016, 65 CdC: morBidity & mortality weekly

rep. (mmwr) 1 (Mar. 18, 2016), https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.

7. Methadone is a prescribed medication-assisted treatment used to treat individuals

addicted to opioids. The World Health Organization has established that access to free medication-

assisted treatment is a best practice. world health orG., GUidelines For the psyChosoCially

assisted pharmaColoGiCal treatment oF opioid dependenCe (2009), https://www.who.int/

substance_abuse/publications/opioid_dependence_guidelines.pdf.

8. Kentucky recently passed legislation that expands the grounds for termination of

parental rights to include a diagnosis of neonatal abstinence syndrome, a condition that occurs

when a child is repeatedly exposed to a substance in utero and then experiences withdrawal

symptoms post-birth. See Tom Latek, Bill Overhauling Adoption, Foster Care in Ky. Moves to

Governor’s Desk, kentUCkytoday (Apr. 2, 2018), https://bit.ly/2HkRYjK.

Published in Family Law Quarterly, Volume 52, Number 1, Spring 2018. © 2019 American Bar Association. Reproduced with permission. All rights reserved. This information or any portion thereof

may not be copied or disseminated in any form or by any means or stored in an electronic database or retrieval system without the express written consent of the American Bar Association.