ADULTS may be the ones misusing drugs, but children are the opioid epidemic's greatest collateral damage. In New York's Sullivan County, for instance, we have heard stories of loss--of parents losing their children to drugs, but also of children losing their parents. We have heard of children witnessing their parents' deaths and witnessing their parents being revived, sometimes multiple times, and of children being separated from their families and communities.
Children of parents with substance use disorders are at an increased risk of experiencing maltreatment. The Department of Health and Human Services has estimated that escalating rates of drug-related hospitalizations and drug overdose deaths are related to rising child welfare caseloads--an increase of 10% in drug-related hospitalizations.
After a decade of out-of-home placement reductions, the foster care population has been growing, from almost 400,000 in 2012 to a little over 500,000 at present, an increase that has been attributed, mostly anecdotally, to the opioid crisis. Researchers have estimated the number of children removed because of parental substance or alcohol abuse rose from 14% in 1998 to 35% today.
The consequences for children might be even more acute than in prior drug epidemics. Opioid dependency among adults living in households with children is increasing. Forty percent of new opioid-dependent adults are estimated to live in households with children. Moreover, parents involved in the child welfare system who use opioids are less likely than other drug users to retain custody of their children. Finally, there has been a substantial increase during the past 15 years of in utero exposure to opioids in mothers involved in the child welfare system.
Although, nationally, drug overdose hospitalizations and drug overdose deaths are related to increased child welfare caseloads and people on the frontlines (judges, caseworkers) describe a sharp increase in foster care placements due to opioids, we do not have solid data that demonstrates it. In New York, for example, the overall number of children in foster care has dropped significantly since 1995. So, what can the numbers tell us? What happens to children during the opioid epidemic? What is the potential impact on foster care and, more importantly, what impact does foster care have on children?
Numbers, though, may not necessarily tell the whole story. Mark Courtney, professor in the School of Social Service...