{"id":20775,"date":"2026-02-21T18:57:39","date_gmt":"2026-02-21T17:57:39","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=20775"},"modified":"2026-02-21T18:57:39","modified_gmt":"2026-02-21T17:57:39","slug":"how-harm-reduction-fails-families","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2026\/02\/how-harm-reduction-fails-families\/","title":{"rendered":"How \u2018Harm Reduction\u2019 Fails Families"},"content":{"rendered":"
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\"The<\/span><\/h6>\n<\/div>\n<\/div>\n<\/div>\n
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Opinion\u00a0 By\u00a0Emily Putnam-Hornstein\u00a0and\u00a0Sarah Font – imprintnews.org<\/span><\/h2>\n<\/div>\n<\/header>\n
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A 9-year-old\u00a0boy in Washington lives in a tent with his fentanyl-addicted parents. He waits outside in the bushes while his mother exchanges sex for money and drugs. He doesn\u2019t attend school or see a doctor. He appears underweight and ill.\u00a0<\/span><\/p>\n

Repeated offers of assistance \u2014 including housing \u2014 from social workers are refused by his parents. Now what?<\/span><\/p>\n

The state\u2019s answer is clear: the child protection system (CPS) will do nothing to protect this child because homelessness and drug use are \u201cnot neglect.\u201d<\/span><\/p>\n

Chronic drug use is increasingly seen as something that can be managed alongside caring for children, even\u00a0medically fragile\u00a0newborns. Parents in Oregon are\u00a0encouraged\u00a0to ask for naloxone (Narcan) without fear of stigma so that they can revive their\u00a0children\u00a0if their drug supply is inadvertently ingested. Lock boxes are\u00a0recommended\u00a0or distributed by CPS and other public agencies, often under the pretext of preventing accidental ingestions of\u00a0prescription fentanyl,\u00a0legal cannabis\u00a0or other medications.\u00a0America\u2019s Poison Centers\u00a0reminds adults who use fentanyl that naloxone can be safely used on children.\u00a0<\/span><\/p>\n

At a recent national forum, a former New Mexico state legislator described how CPS safety plans often ask parents to please dispose of their foils and clean their\u00a0spoons\u00a0before their children return home from school or child care. Parents in\u00a0Arizona,\u00a0Connecticut,\u00a0Illinois,\u00a0New Mexico,\u00a0New York\u00a0and\u00a0Texas\u00a0(to name just a few) are led \u2014 consistent with CAPTA-funded federal\u00a0trainings\u00a0and\u00a0guidance\u00a0\u2014 to believe that despite their addiction, they are capable of implementing \u201csafety plans\u201d alongside continued use of their drug of choice.\u00a0<\/span><\/p>\n

In a growing number of jurisdictions, CPS agencies tell\u00a0doctors\u00a0they do not have to report a parent or newborn\u2019s positive drug test, while telling other community members that an active\u00a0substance use\u00a0disorder is not a basis for investigating whether a child has been harmed or endangered.\u00a0<\/span><\/p>\n

Parent\u00a0advocates\u00a0who argue that \u201cdrug tests are not parenting tests\u201d seem to have convinced child welfare leaders across the political spectrum that, even though it is illegal to drive a car while intoxicated, parenting under the influence should not evoke similar concerns. Even the federally funded National Center on Substance Abuse and Child Welfare\u00a0discourages\u00a0the use of drug testing to inform whether it is safe to retain young children in the home: \u201cThe punitive use of drug testing can inhibit recovery and prove harmful to families,\u201d noting also that \u201cdrug tests can perpetuate stigma about substance use disorders.\u201d\u00a0\u00a0<\/span><\/p>\n

These practices fall under the umbrella of harm reduction. Harm reduction is a\u00a0normative framework\u00a0that \u201ccenters the lived and living experience of people who use drugs\u201d and\u00a0focuses on\u00a0\u201cminimizing the negative consequences associated with substance use without requiring abstinence.\u201d Influential groups such as the\u00a0Drug Policy Alliance\u00a0describe harm reduction as \u201csimply common-sense safety,\u201d no different than \u201cseatbelts, bike helmets, sunscreen, or flu shots.\u201d The Harm Reduction Coalition\u00a0describes\u00a0a \u201cmovement for social justice built on a belief in, and respect for, the rights of people who use drugs.\u201d<\/span><\/p>\n

Under this framework, we are obligated to assume that people who use drugs \u201cknow their own bodies\u201d and \u201care capable of making rational choices\u201d;\u00a0the assertion that drug use poses a danger to children or that treatment must be mandated is stigmatizing and therefore counterproductive.<\/span><\/p>\n

These harm reduction strategies focus on reducing harms to adults who use drugs, not on safeguarding children who may be endangered by parental substance use.\u00a0<\/span><\/p>\n

Prioritizing expressed preferences of the parent to continue their drug use over the long-term health and safety of both parents and children has foreseeable consequences. In 2023 in Westchester County, New York, an early term, jittery, cocaine-positive\u00a0newborn\u00a0was deemed \u201cunaffected\u201d by substance exposure and released to her parents. Despite several subsequent calls to CPS about the parents using heroin and other drugs while caring for the child, the subsequent birth of a drug-exposed sibling, and parents\u2019 nonparticipation in voluntary services, agency lawyers prevented caseworkers from petitioning for court intervention because there was \u201cno impact\u201d on the child.\u00a0<\/span><\/p>\n

The infant girl died of drug ingestion shortly after caseworkers requested to petition the court and were denied \u2014 for the third time. The parents were charged with manslaughter.\u00a0<\/span><\/p>\n

Some may argue that the cases of the 9-year old in Washington and this Westchester infant reflect aberrations in practice, and that taking these failures seriously will inevitably lead to\u00a0unnecessary removals. Yet,\u00a0statements\u00a0from agency personnel rationalizing their decisions not to intervene reveal a\u00a0consistent\u00a0logic.\u00a0<\/span><\/p>\n

Prior advocacy\u00a0sought\u00a0\u2014 reasonably \u2014 to ensure that CPS approached addiction as a chronic disease in need of treatment rather than a character flaw. Now, the\u00a0message\u00a0is that parents\u2019 untreated addiction is not the\u00a0business\u00a0of CPS. Empowered with\u00a0pieces of paper\u00a0listing possible services, and legally unenforceable safety plans, parents are left to figure it out on their own. Even recent federal efforts to expand\u00a0access\u00a0to medication-assisted treatment may be read as a signal that getting parents to begin medication is enough \u2014 and that CPS need not remain involved \u2014 despite high rates of\u00a0discontinuation,\u00a0relapse,\u00a0overdose\u00a0and concurrent use of\u00a0other\u00a0illicit drugs.<\/span><\/p>\n

No one is suggesting that a single positive drug test or instance of drug use should automatically trigger the removal of children from the home. But we must abandon the delusion that parents who are drug-addicted will enter treatment voluntarily before serious harm falls to them or their\u00a0children, or have the capacity to make their addiction safe and inconsequential while parenting. Such beliefs are contradicted by the\u00a0neuroscience\u00a0of addiction, the massive death count of the opioid epidemic, and piles of research and personal accounts documenting what happens to children reared by parents with active drug addictions.\u00a0<\/span><\/p>\n