At Tracey Maholland’s home in Bethlehem this summer, a typical family scene unfolded.
Her 16-year-old daughter was getting ready for work. Her 10-year-old son played video games in front of the TV. Her youngest was out on a basketball court in the neighborhood.
When the cable guy dropped by the family’s new house, Maholland hurried to help him. It was a typical afternoon picture of a mother and her children, on a sunny day when school was out.
Typical, yet remarkable, considering the rocky path of Maholland’s life: At 37, she is a recovering drug addict who abused both heroin and methamphetamine, even as her three daughters and two sons looked to her to guide them through the pitfalls of childhood.
Maholland’s children have seen a lot. Domestic violence, unstable homes and their mother going to jail and rehab.
Her eldest, now 20, spent much of her school years being raised by her grandparents. Maholland’s 16-year-old ended up battling addiction of her own. There were days in which, to meet their basic needs, they were forced to rely on relatives or neighbors or to fend for themselves.
“As close as you can come to losing them, I came,” said Maholland, who has been sober nearly 18 months and says her family is doing better than ever. “Before, I didn’t want the kids to see what I was doing. Now, I’m happy and they’re happy because of it.”
Struggles like Maholland’s are only becoming more commonplace, as Pennsylvania grapples with a heroin epidemic fueled by cheap access to the drug and the overprescription of painkillers that act as a gateway. But seldom do families speak publicly about addiction and its impact on children, given the stigma and shame that surrounds it.
Instead, the story of drug abuse’s reach is often kept to hospital intensive care units, where babies born dependent on opiates cry inconsolably as their first weeks of life are spent in withdrawal. Or in the halls of social work, where caseworkers struggle to keep families together while ensuring that mom or dad’s drug problem doesn’t bring their children harm.
Or in police logs, which document parents who overdose in front of their children, endanger them in unkempt homes or bring them in tow to drug deals. Or in early-morning drug raids, when investigators are surprised to find a young son or daughter living with the person they arrested.
“To have a child with them, your first reaction is you’re furious over it. ‘How could you be doing this?’ ” said Bethlehem Township police Sgt. Rick Blake, who heads vice investigations for the department. “The problem is, they’re no longer thinking rationally at that point. The addiction is the center of their universe.”
Jump in foster placements
On track with the heroin crisis, the number of children in foster care in Pennsylvania has leapt in three years, reaching 15,995 at the end of 2015, state statistics show. That’s a 14 percent increase from the 14,004 of 2012.
In one of those years, 2014, parental substance abuse was a factor in more than 56 percent of the cases in which infants were removed from their homes, according to the Center for Children’s Justice, a nonprofit in Berks County.
Alongside that, more than 7,500 babies were born from 2010 to 2014 with drug dependencies they received in utero, according to Pennsylvania Medicaid statistics obtained by the children’s justice center. And those were tip-of-the-iceberg numbers that do not account for newborns whose mothers had private insurance, as six in 10 Pennsylvanians do.
Dr. Kimberly Costello, the director of neonatology at St. Luke’s University Health Network, estimates that at least once every two weeks, a newborn is diagnosed at St. Luke’s with neonatal abstinence syndrome – a medical term for the problems faced by infants exposed to opiates in the womb.
“It is very unusual for us not to have a baby suffering from NAS,” said Costello, who described the numbers as “absolutely” on the rise.
Weaning the babies from their addictions typically takes three weeks in intensive care, in which they slowly receive lessening doses of morphine to combat their symptoms, Costello said. Even treated, their conditions are heart-rending, she said. The newborns vomit from crying so much, have repeated diarrhea that causes severe diaper rash, and constantly scratch their faces in their agony. When they are finally ready to go home, they are at greater risk of abuse such as shaken-baby syndrome, given the difficulties in keeping them consoled, Costello said.
“It is really possibly the most pathetic situation you can see in our NICU,” Costello said. “It is just a very difficult thing to watch.”
When parents are addicts
If there is a message that social service caseworkers want to send to parents with addiction, it is this: We are here to help your family, not take away your kids.
Caseworkers get involved with families for any number of reasons: a parent who gets arrested, a child found wandering away from the home, a relative or teacher who was concerned about the child’s well-being. Often, parents will try to hide their addictions from social workers, who learn of them only after that first drug test comes back. “Families that are drug addicted are the hardest to get on board,” said Shannon Snyder, a caseworker at the Northampton County Children, Youth and Families Division. “Because it is such a shameful, secretive thing.”
Addiction presents a special problem for the social services, which operate under strict time frames once a child is removed from the home. Under the law, children are entitled to a permanent home in 15 to 22 months of their removal – preferably with their parents, but if not, through adoption. Sobriety is an often lengthy process pitted with rehab and relapses, officials said. That can make those mandated time limits harder to meet, especially if parents are resistant to social workers.
In the end, Northampton County Children and Youth Administrator Kevin Dolan estimates that 85 to 90 percent of parents who end up losing their parental rights have substance abuse problems.
Monroe County Judge Jonathan Mark is the co-chairman of a state workgroup established by the Office of Children and Families in the Courts to study substance abuse and its impact on child welfare. Mark said more needs to be done to identify parents with addictions early in the process.
Treating drug addiction as a public health issue – and not a moral failing – would go a long way toward helping families be more frank about the problems before them, he said. “If you can get those people into the services early, you’d be amazed at the results you can get,” Mark said.
The heroin and opioid epidemic is the rare issue that’s grabbed the attention of lawmakers on both sides of the aisle, said U.S. Sen. Bob Casey, who came to Allentown in early August to tour Lehigh Valley Hospital’s neonatal intensive care unit. The Pennsylvania Democrat co-authored the 2015 Protecting Our Infants Act, which requires more federal research on addicted babies and their mothers.
“When it comes to opiate abuse and the addiction problem we’ve heard so much about and learned so much about, it’s almost impossible to describe the scope of the problem,” Casey said. “This is a crisis. We’ve got to meet it head-on.”
By Riley Yates and Laurie Mason Schroeder
20 August 2016
http://www.tnonline.com/2016/aug/20/heroin%E2%80%99s-reach-extends-children-addicts
