In Southern Ohio, the number of drug-exposed babies in child protection custody has jumped over 200%.\u00a0 The problem is so dire that workers agreed to break protocol to invite a reporter to hear their stories.\u00a0 Foster care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade<\/p>\n
Inside the Clinton County child protection office, the week has been tougher than most.<\/p>\n
Caseworkers in this thinly populated region of southern Ohio, east of Cincinnati, have grown battle-weary from an opioid epidemic that\u2019s leaving behind a generation of traumatized children. Drugs now account for nearly 80% of their cases. Foster-care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade. Funding, meanwhile, hasn\u2019t budged in years.<\/p>\n
\u201cMany of our children have experienced such high levels of trauma that they can\u2019t go into traditional foster homes,\u201d said Kathi Spirk, director of Clinton County job and family services. \u201cThey need more specialized care, which is very expensive.\u201d<\/p>\n
The problem is so dire that workers agreed to break protocol and invite a reporter to camp out in a conference room and hear their stories. For three days, they relived their worst cases and unloaded their frustrations, in scenes that played out like marathon group therapy, for which they have no time. Many agreed that talking about it only made them feel worse, yet still they continued, one after another.<\/p>\n
Hence the bad week.<\/p>\n
Given the small size of their community, they asked that their names be changed out of concern for their own safety and the privacy of the children.<\/p>\n
The caseworkers, like most, are seasoned in despair. Many worked in the 1990s when crack cocaine first arrived, followed by crystal meth in the early 2000s. In 2008, after the shipping giant DHL shuttered its domestic hub here in Wilmington and shed more than 7,000 jobs, prescription pill mills flourished while the economy staggered. Back then, a typical month saw 30 open cases, only a few of them drug-related. But the flood of cheap heroin and fentanyl, now at its highest point yet, has changed everything. A typical month now brings four times as many cases, while institutional knowledge has been flipped on its head.<\/p>\n
\u201cAt least with meth and cocaine, there was a fight,\u201d said Laura, a supervisor with over 20 years of experience. \u201cParents used to challenge you to not take their kids. And now you have them say: \u2018Here\u2019s their stuff. Here\u2019s their formula and clothes.\u2019 They\u2019re just done. They\u2019re not going to fight you any more.\u201d<\/p>\n
Heroin has changed how they approach every step of their jobs, they said, from the first intake calls to that painstaking decision to place a child into temporary foster care or permanent custody. Intake workers now fear what used to be routine.<\/p>\n
\u201cOccasionally, we\u2019d get thrown a dirty house, something easy to close and with little trauma to the child,\u201d said Leslie, another worker. \u201cWe\u2019re not getting those any more.<\/p>\n
Now they\u2019re all serious, and most of them have a drug component. So you may get a dirty house, but it\u2019s never just a dirty house.\u201d<\/p>\n
\u2018I had a four-year old whose mom had died in front of her and she described it like it was nothing\u2019 Children come into the system in two ways. The first is through a court order after caseworkers deem their environment unsafe, and if no friends or family can be found.<\/p>\n
Because of the added trauma, removing a child is always the last option, caseworkers said. But in a county with only 42,000 people spread out over 400 square miles, the magnitude of the epidemic has compromised an already delicate safety net. Relatives are overwhelmed financially. Multiple generations are now addicted, along with cousins, uncles, and neighbors. In many cases, a safe house with a grandparent or other relative will eventually attract drug activity.<\/p>\n
Law enforcement will also bring children in, usually after parents overdose. These cases often reveal the most horrendous neglect: a three-year old who needed every tooth pulled because he\u2019d never been made to brush them, or kids found sleeping on bug-infested mattresses, going to the toilet in buckets because the water had been shut off. Children are coming in more hardened, they said, older than their years.<\/p>\n
\u201cI had a four-year-old whose mom had died in front of her and she described it like it was nothing,\u201d said Bridgette, another caseworker. \u201cShe knew how to roll up a dollar bill and snort white powder off the counter. That\u2019s what she thought dollar bills were for.\u201d She added that many of the children could detail how to cook heroin. One foster family had a five-year-old boy who put his medicine dropper in his shoe. \u201cBecause that\u2019s where daddy hid his needles,\u201d she said.<\/p>\n
\u201cThe kids are used to surviving in that mess,\u201d added Carole, another veteran. \u201cNow all the sudden the system is going in and saying it\u2019s not safe. All their survival instincts are taken away and they go ballistic. They don\u2019t know what to do.\u201d<\/p>\n
During the first weeks of foster care, meltdowns, tantrums, and violence are common as children navigate new landscapes and begin to process what they\u2019ve experienced.<\/p>\n
One afternoon, the caseworkers brought in a foster couple who\u2019d taken in two sisters, an infant born drug-exposed, and her four-year old sister. The baby had to be weaned off opioids and now suffered chronic respiratory problems. Part of her withdrawal had included non-stop hiccups. The older girl had lived with her parents in a drug house and displayed clear signs of post-traumatic stress. Once, a family friend sitting next to her in a car had overdosed and turned purple. She\u2019d witnessed domestic abuse, and one day a neighbor shot and killed her dog while she watched (she\u2019d let the dog out). After a meltdown at a classmate\u2019s pool party, over a year after entering foster care, she revealed having seen a toddler drown in a pond while adults got high. Through therapy, she\u2019d also revealed sexual assault. The foster mother described how the girl suffered flashbacks, triggered by stress and certain anniversaries, like the day of her removal, and other seemingly random events. When this happened, she slipped into catatonic seizures.<\/p>\n
\u201cHer eyes are closed and you can\u2019t wake her,\u201d she said. \u201cIt\u2019s like narcolepsy, a deep, unconscious sleep. We later discovered it was a coping mechanism she\u2019d developed in order to survive.\u201d<\/p>\n
Despite what they\u2019ve endured, most children wish desperately to return to their parents. Many come to see themselves as their parents\u2019 caretakers and feel guilty for being taken away, especially if they were the ones to report an overdose, as in the case of a four-year-old girl who climbed out of a window to alert a neighbor. \u201cShe asked me: if I took her away, who was going to take care of mommy?\u201d Bridgette remembered.<\/p>\n
For caseworkers, reunification is the endgame. After children enter temporary foster care, the agency spends up to two years working closely with the family while the parents try to stay sober. The only contact with their children comes in the form of twice-weekly visits held in designated rooms here at the office. Each contains a tattered sofa and some second-hand toys. Currently, the agency runs about 200 visits each week. The encounters are monitored through closed-circuit cameras. For everyone involved, it can be the most trying period.<\/p>\n
Many parents use the time to build trust and re-establish bonds. \u201cDuring those first four years, a child gets such good stuff from their parents,\u201d said Sherry, the caseworker who monitors the visits. \u201cThe kids are just trying to get that back.\u201d Some parents bring doughnuts and pictures, while others need more guidance. Caseworkers hold parenting classes. Some moms lost newborns at the hospital after they tested positive for drugs; workers teach them how to feed and hold the child, and encourage them to bring outfits to dress their babies.<\/p>\n
For other children, the visits trigger a storm of emotion that churns up the trauma of removal. \u201cWe had one girl who\u2019d scream and wail at the end of every visit,\u201d Laura, the supervisor, remembered. \u201cEach time she thought she\u2019d never see her mother again. We\u2019d have to pry her out of mom\u2019s arms and carry her down the hallway.\u201d<\/p>\n
\u201cWe\u2019d sit in our offices and just sob,\u201d added another worker. \u201cBut that girl\u2019s cries weren\u2019t enough to keep Mom off heroin.\u201d<\/p>\n
The number of available foster families is dwindling, while the cost of supporting them has never been higher<\/p>\n
Perhaps the greatest difference with heroin and opioids, caseworkers said, is their iron grasp. Staying sober is a herculean task, especially in this rural community short on resources, where the nearest treatment facilities are over 30 miles away in Dayton, Cincinnati, or Columbus. At some point, nearly every parent falls off the wagon. They disappear and miss visits, leaving children to wait. One of the hardest parts of the job is telling a child that mom or dad isn\u2019t coming, or that they can\u2019t even be found.<\/p>\n
\u201cYou see the hurt in their eyes,\u201d Sherry said. \u201cIt\u2019s a look of defeat, and it just breaks your heart.\u201d She remembered a mother who\u2019d failed to show up for months, then made it for her twin boys\u2019 birthday. \u201cThe next day she overdosed and died.\u201d<\/p>\n
A tally sheet is used to track how many times prospective clients waiting to enter the program call a detox center, in Huntington, West Virginia. Photograph: Brendan Smialowski\/AFP\/Getty Images<\/p>\n
When parents fail drug screenings during the 18-month period, caseworkers use discretion. Parents might be doing better in other areas like landing a job, or finding secure housing, so workers help them to get back on the wagon. \u201cIt\u2019s all about showing progress,\u201d Laura said. Some parents make it 16, 17 months sober and fully engaged. \u201cAnd they\u2019re the toughest cases, because we\u2019ve been rooting for them this whole time and helping them. We\u2019re giving kids pep talks, saying: \u2018Mom\u2019s doing great, she\u2019s getting it together!\u2019 They\u2019re so happy to be going home. And then it all falls apart.\u201d<\/p>\n
With heroin, defeat is something the workers have learned to reckon with. Lately they\u2019ve started snapping photos of parents and children during their first visit together, getting medical histories and other vital information \u2013 something they used to do much later. \u201cBecause we know the parents probably aren\u2019t going to make it,\u201d Laura admitted. \u201cAnd if we never see them again, this is the info we need.\u201d When asked how many opioid cases had ended in reunification, only two workers raised their hands.<\/p>\n
The repeated disappointments come as resources and morale have reached their tipping point. The number of available foster families is dwindling, they said, while the cost of supporting them \u2013 over $1.5m a year \u2013 has never been higher.<\/p>\n
Spirk, the agency\u2019s director, said that all the agency\u2019s budget was paid for with federal dollars and a county tax levy, although they\u2019ve been flat-funded for nearly 10 years. The state contributes just 10%. When it comes to investing in child protection, Ohio ranks last in the country \u2013 despite having spent nearly $1bn fighting its opioid problem in 2016 alone.<\/p>\n
The Ohio house of representatives recently passed a new state budget with an additional $15m for child protective services, but the state senate has yet to pass its own version. The only bit of hope came in March, when the Ohio attorney general\u2019s office announced a pilot program that will give Clinton County, along with others, additional resources to help treat children for trauma, and to assist with drug treatment. It starts in October.<\/p>\n
The epidemic\u2019s unrelenting barrage has also taken a toll on mental health. \u201cOur caseworkers are experiencing secondary trauma and frustration at not being able to reunify children with their parents because of relapses,\u201d Spirk said.<\/p>\n
Almost every caseworker said they had experienced depression or some form of PTSD, although no one had sought professional help. The privacy of their cases also means that few can speak openly with friends or family members. Some chose to drink, while others leaned on their faiths. But most said coping mechanisms they once relied on had failed.<\/p>\n
\u201cI used to have a routine on my drive home,\u201d Laura said. \u201cI\u2019d stop in front of a church, roll down my window, and throw out all the day\u2019s problems. The next morning I\u2019d pick them back up. These days, I can\u2019t do that anymore.\u201d<\/p>\n
\u201cThere\u2019s no more outlet,\u201d added Shelly, another supervisor. \u201cYou think you\u2019re able to separate but you can\u2019t let it go anymore. You try to eat healthy, do yoga, whatever they tell you to do. But it\u2019s just so horrific now, and it keeps getting worse.\u201d<\/p>\n
At some point, the inevitable happens. When a parent can\u2019t stay sober, or stops showing progress, the decision is made to place the child into permanent custody and put them up for adoption. For everyone, including caseworkers, it\u2019s the most wrenching day.<\/p>\n
The final act of every case is the \u201cgoodbye visit\u201d, held in one of the nicer conference rooms. It\u2019s a chance for parents to let their children know they love them and will miss them, and that it\u2019s time to move on. Adoptive parents can choose to stay in contact, but it isn\u2019t mandatory.<\/p>\n
To make the time less stressful, Sherry, the worker who monitors the visits, has them draw pictures together, which she scans and gives to them as mementoes. She also tapes the meetings for them to keep. Watching from her tiny room full of TV screens, she can\u2019t help but cry. \u201cWhat people don\u2019t realize is that when a baby comes into our custody, they\u2019re still in a carrier seat. By the time the case is over, we\u2019ve helped to potty train them. Two years is a very long time with a child. So in a way, it\u2019s like my goodbye visit, too.\u201d<\/p>\n
Caseworkers have started making \u201clife books\u201d for kids once they come into the system. It\u2019s where they put the photos they\u2019ve taken, plus any pictures of birth parents or relatives they can find, report cards, ribbons and medals \u2013 the souvenirs of any childhood.\u00a0 \u201cIt\u2019s their history,\u201d Sherry said, \u201cso that one day they can make sense of their lives.\u201d\u00a0\u00a0 She noted that one kid, after turning 18, tore his to pieces, taking with him only the good memories.<\/p>\n
Source:\u00a0 https:\/\/www.theguardian.com\/us-news\/2017\/may\/17\/ohio-drugs-child-protection-workers<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" In Southern Ohio, the number of drug-exposed babies in child protection custody has jumped over 200%.\u00a0 The problem is so dire that workers agreed to break protocol to invite a reporter to hear their stories.\u00a0 Foster care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[73,85,41,11,22,14,27,19],"tags":[],"class_list":["post-13346","post","type-post","status-publish","format-standard","hentry","category-addiction","category-addiction-papers","category-drug-use-effects-on-foetus","category-effects-of-drugs","category-effects-of-drugs-papers","category-social-affairs","category-social-affairs-papers","category-usa"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/13346","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=13346"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/13346\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=13346"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=13346"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=13346"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}