Effects of Opiod Addiction on Children and Grandparent Care in the Opiod Crisis

Over the last 20 years, the addiction and abuse of opioids and other prescription drugs has become a major crisis here in the United States. Since the 1990s, this epidemic has contributed to having significant effects on the criminal justice system, health systems and child welfare within the country. According to the Centers for Disease Control and Prevention, “Opioids – mainly synthetic opioids – are currently the main driver of drug overdose deaths. Opioids were involved in 67.8% of all drug overdose deaths in 2017” (Centers for Disease Control and Prevention, 2019). Based on these appalling and repugnant facts, it is obvious that pharmaceutical companies and health care professionals are failing to realize the tremendous risks associated with this pain-relieving method. As the epidemic continues to ravage through major states and cities, a record number of children are entering the foster care system and hurting America’s families and communities. The health care system needs to recognize the increasingly growing impact of opioid addiction and take immediate action in order to solve this serious issue.

Drug Abuse and Child Welfare

Ironically, using opioids and other painkillers to ease emotional pain only results in unresolved emotional issues and severe physical trauma. Over the past few years, the U.S. Department of Health and Human Services began comparing the relationships between drug overdose deaths and hospitalizations to foster care caseloads. According to writer Meghan McCann’s article, “Drug Abuse and Child Welfare,” “when the Adoption and Foster Care Analysis and Reporting System began reporting “drug abuse of a parent” separately from “alcohol abuse of a parent” in 2015, the impact of parental drug abuse on foster care caseloads became clearer” (McCann, 2018). Based on statistical research, it was reported that drug abuse of a parent was among the top 3 leading reasons for the removal of a child, along with neglect and caretaker inability to cope. In fact, one of the reports released by the U.S. Department of Health and Human Service graphically revealed the percent of child removals tied to drug abuse by parents from 2006 to 2016. McCann states, “The potential effect of drug hospitalizations and drug deaths on foster care caseloads was striking: A 10 percent increase in the overdose death rate corresponds with a 4.5 percent increase in foster care placement rates, and a 10 percent increase in the drug hospitalization rate corresponds with a 3.3 percent increase in foster care placement rates” (McCann, 2018).

Another article, “Opioid crisis sending kids into foster care” by Emily Birnbaum and Maya Lora, supports these findings by providing more recent information on the progressively sharp number of America’s children entering state or foster care. “Among states hardest hit by the epidemic, the populations of children in foster care or state care has risen by 15 percent to 30 percent in just the last four years (2014 to 2018)” (Birnbaum & Lora, 2018). Since 2014, the foster population has increased by over 40 percent in West Virginia, one of the states with the highest overdose rates in the nation. Wendi Turner, executive director of the Ohio FamilyCare Association explains Ohio’s rising numbers of children in state care by saying, “Children that are coming into care are staying in care longer because there’s a higher risk of relapse with their parents. I don’t think our state was prepared for the number of children coming into care so quickly so now we have recruitment efforts going, trying to recruit more parents and also train those parents to handle some of the unique needs of the children” (Birnbaum & Lora, 2018). Reflecting back on the crack cocaine wave in the 1990s and the methamphetamine crisis within the 2000s, substance abuse has always been prevalent within the child welfare system. Yet, the state and foster care system is heading closely towards their capacities. If the infrastructure remains the same and no workable long-term solution is created, the numbers will only continue to increase and severely impact the foster care system.

The Expectation for Grandparents to Raise Their Grandchildren

“Screening mothers and their babies for the presence of opioids and treating positive tests as evidence of child abuse or neglect – as was often the case with crack cocaine – will result in much higher foster care placements” (Pérez-Chiqués, Strach & Zuber, 2019). However, due to the shortages of foster parents to meet the growing need, child welfare systems are now looking to place the responsibility upon grandparents and other relatives.

According to People magazine’s 2019 special report on grandparents raising their grandchildren during the opioid crisis, “Grandparents provide this protective web of love and roots and hope, whereas children who come into the foster-care system or into the care of law enforcement lose that sense of connection with their family and who they are and who loves them” (Fleming & Westfall, 2019). Although, by taking on this unexpected caregiving role, the additional pressures of caring full time for a grandchild can cause a negative impact on the grandparent’s health. “Grandparent caregivers may struggle with their own mental issues stemming from feelings of shame, loss or guilt about their adult child’s inability to parent. They may suffer from social isolation and depression because they do not want their peers to know about their situation, or because their peers are no longer parenting” (Lent & Otto, 2018).

Not only does stepping in to raise their grandchildren affect their health, but it also impacts their personal relationships with other relatives, such as siblings, adult children and other grandchildren. “Grandparent caregivers may feel concerned that they don’t have enough time to spend with other grandchildren. One grandparent caregiver said, “Our ability to ‘grandparent’ our other grandchildren drastically impacted by our need to ‘parent’ this child” (Lent & Otto, 2018). The adult children of the grandparent caregivers may even feel the loss of a parent or grandparent to their children, as their focus will be primarily on the ones in their care. “The adult daughter of one grandparent caregiver said, “It has thrown off the entire balance of our family roles. Even as an adult, I don’t want to share them sometimes – especially when I have been tapped out from the struggles and strains of raising my own kids” (Lent & Otto, 2018). Furthermore, hearing other family members express similar strong concerns about the grandparents’ decision to care for the child can lead the grandparents to exhaustion. While keeping the children within the family sounds beneficial for both parties, this demanding and overwhelming role will only damage the caregivers’ mental health and create tension among other family members.

The Financial Impact on the Foster Care System

Despite the amount of unconditional love and stability provided by grandparents, the biggest issue with raising their grandchildren was financial support. “The unexpected expense of raising a grandchild can be especially devastating to caregivers living on fixed incomes. Grand families report spending down their retirement savings to address the health, mental health, food, and clothing needs of the children, or to pay legal expenses incurred through seeking legal child custody” (Lent & Otto, 2018). Jacqueline Elm, a grandparent raising her daughter’s two toddlers (ages 2 and 4), recalled taking her grandchildren to Child Protective Services after finding them shut alone in a bedroom covered in dog bites. She proceeded to tell People magazine, “We have drained our retirement savings to raise these children. He, [husband, Stephan, 76], worked until he couldn’t work anymore” (Fleming & Westfall, 2019). Another couple from Ohio with six grandchildren in need of a stable home, even discussed how their savings for a new car instead went towards three sets of bunk beds. Wife Beth Murray says, “We live check to check. And if one of the kids – who range in age from 4 to 13 – volunteers to bring cookies to a school celebration, it can set back the family’s whole food budget” (Fleming & Westfall, 2019).

Although most prefer the children to be placed with biological family members, judges have the ultimate authority to place the children in foster care in order to receive high-quality treatment. However, these judicial decisions can greatly impact the foster system’s budgets. The authors of the recent 2019 article, “Opioid Crisis Hits Home – Foster Homes” explains, “the costs of foster care provision are substantial, running about $21,535 per year for each child in a regular placement, and up to $81,441 for institutional placements” (Pérez-Chiqués, Strach & Zuber, 2019). Looking specifically at the foster system in New York, “the average cost of placing a child in foster care is $51,943. However, money barely trickles down to children in foster care. Monthly payments (to foster families or homes) in upstate New York, for instance, range from $552 for infants to $2,016 for children with conditions such as HIV” (Pérez-Chiqués, Strach & Zuber, 2019). On top of that, the federal funds needed to keep the system running has steadily decreased while the overall costs have spiked tremendously. “According to data from the Sullivan County budget, foster care costs nearly tripled, from $551,895 in 2017 to $1,592,895 in 2018, while Federal funds for foster care decreased from $1,550,000 to $1,300,000 during the same period” (Pérez-Chiqués, Strach & Zuber, 2019). With the limited amount of money and resources provided, not all of the system’s expectations can be met and the county can, unfortunately, only do so much for each child. One public official even responded with, “Once you’ve hit your cap, you’re done. So, if you have 100 kids and that’s your cap, and all of a sudden you have 200, that’s all local cost; there’s no other Federal [or] state money for that” (Pérez-Chiqués, Strach & Zuber, 2019). Therefore, the federal money will instead have to go into housing children and receiving help from other outside group homes and facilities since the low-funded counties will not have the ability (or money) to do so themselves.

Children are the Biggest Collateral Damage

Although parents are abusing the drugs and the foster care system is being overloaded with cases, children are the opioid epidemic’s greatest collateral damage. Children are the ones who are first handedly affected by the crisis through being taken away from their parents, continuously watching them relapse or even witnessing their death. As stated before, children removed from opioid addicted parents stay longer in the system due to the parents’ risk of relapse, and the small likelihood of retaining custody of their children compared to other drug users in the system. This takes away their opportunity of living a normal life with their biological family, making it difficult for foster parents to bond with the children. In the article, “Opioid Hits Homes – Foster Homes,” one country administrator responded on the issue by saying, “If I’m taking a child out of a home, I want to make it possible for [him or her] in that transition, and, you know, kids go to birthday parties; they have sleepovers; they go out to Chuck-e-Cheese. That doesn’t happen in a lot of our foster cares … but again, they also live on limited resources and are taking in kids out of the goodness of their heart and giving them a safe home. So, I’m not knocking them, but sometimes… it needs to be more than just a safe home to feel normal” (Pérez-Chiqués, Strach & Zuber, 2019). With that being said, more foster homes need to provide a loving and supportive environment in order for children to heal and give them another chance to live with stability and normalcy.

Likewise, there have been more arrangements of unborn infants being placed into foster care based on the astounding increase of in-utero exposure to opioids in mothers involved in the child welfare system. “The frequency of Neonatal Abstinence Syndrome (NAS) – symptoms of prenatal opioid exposure while in utero – nearly doubled from 2009 to 2012 and has grown fivefold since 2000” (Welby, 2019). Children prenatally exposed to opioids and other painkillers are also proven to show lower academic performance compared to other non-exposed children. Within the article, educators reported that most kids are often distracted when it comes to learning after experiencing such trauma. “Teachers expressed feeling helpless about the impact the epidemic is having on their students, but they said their empathy drives them to continue hoping for ways to save them. This has led some teachers to focus less on academic achievement and more on ensuring students’ basic needs are met” (Welby, 2019). While teachers have done things like donate food and clothes to the children, the issues remain unresolved by the state and school board, which further increases their frustrations. “Of the educators I interviewed, 79% said that their students’ exposure to opioid addiction added to their own stress and trauma. The situation is so serious that multiple teachers have had to take medical leave for post-traumatic stress disorder and panic attacks” (Welby, 2019). On top of that, all the educators agreed to feeling unprepared for the influx of affected students. “Only 8% of the teachers said they have received training or professional development that focused on the opioid epidemic, and only 21% feel prepared to teach a student who has been exposed to it” (Welby, 2019). After considering all of the facts, school districts need to immediately invest in the mental health and well-being of both their students and staff. Both parties desperately need support, and the burden of caring for these children should not rest solely on educators.

Conclusion

To summarize, the opioid epidemic is a societal emergency, and policy makers and leaders need to take a collaborative approach in seeking a resolution. Substance abuse has always been prevalent within the foster system. However, if no workable solution is found, then the risk of drug overdose and death will only continue to spike. State and foster care systems are nearing capacity, placing more strain on them to find other outside homes and facilities to treat the child with the limited money and resources available. At the same time, the foster system needs to recognize the increasingly amounts of torn American families, and the pressures placed on grandparents and educators to care for and teach these children. But at the end of the day, the primary concern should be on the children. Despite the challenges they’ve endured from the opioid crisis, health practitioners and lawmakers need to seek justice, in order for them to successfully learn and live a normal American life.