The Opioid Epidemic’s Forgotten Victims

The opioid epidemic has continued to make a devastating impact across the United States. Forty-five states have seen opioid overdose rates increase by 30 percent between July 2016 and September 2017. Despite public conversation and consistent news coverage of the individuals affected by the opioid epidemic, there remains a large segment of society that is often overlooked: children and youth.

After declining for several years, the number of children entering foster care has recently begun to rise again. Since 2012, the total number of children entering foster care has risen 10 percent. Many child welfare professionals have considered this increase a side effect of the opioid epidemic, and now their suspicions are confirmed: In March 2018, a study from the U.S. Department of Health and Human Services found that a 10 percent increase in opioid-related overdose deaths directly corresponded with a 4.4 percent increase in the rate of children entering the foster care system. Additionally, a 10 percent increase in opioid-related hospitalizations was associated with a 2.9 percent increase in children entering foster care.

Not a new trend: The foster care/drug epidemic connection

The increase of children entering foster care due to a substance-use epidemic is not new in American history. Near the end of the Vietnam War, heroin use reached epidemic levels, creating a death rate that was about one per 100,000 people. The crack-cocaine epidemic of the 1980s lead to a death rate that was about two per 100,000 people. In each of those periods, the child welfare system saw a significant increase in the number of children being moved into foster care.

During these past epidemics, the child welfare systems became completely overwhelmed. Parents who struggled with addiction were often criminalized, and there were few resources available to assist their children and other family members. Foster children were often placed in unsafe environments, and once they aged out of the child welfare system, they had insufficient resources helping them effectively transition to adult independence.

Hope in the form of new federal legislation

The nation is now seeing a similar connection between parental substance use and foster care placement. In fact, it is the fastest-growing reason for removing children from the home of their caregiver. In 2016, parental drug abuse was a factor in the removal of a child from the home in 34 percent of cases – a 6.5 percent increase from 2012. This leaves children in a precarious situation, and it leaves child welfare workers under-resourced, overwhelmed and burnt out.

However, there is some hope in the form of federal assistance for the child welfare system. In February 2018, Congress passed the bipartisan Family First Prevention Services Act, which allows states to spend federal child welfare dollars on preventative services to help keep families together. It also limits funds for placing foster youth into large congregate care placements, including group homes. It is the largest change to federal child welfare finance in almost 40 years.

Some highlights of the Family First Prevention Services Act include:

Services to Prevent Foster Care

These are the services meant to reduce the need for foster care in the first place. They include services to address mental health disorders, substance use disorders treatment and in-home parent skill-based programs.

Limiting Support for Congregate Foster Care

The monies available to be reimbursed for group home placements will be limited to only two weeks, encouraging child welfare agencies to place children with next-of-kin or in foster family homes. It holds an exception for qualified residential treatment programs, which must include a trauma-informed treatment model.

Adoption, Foster Home Recruitment, and Reunification Services

The act provides 8 million dollars in competitive grants to support the recruitment and retention of highly qualified foster families. It also eliminates the time limit for family reunification services and reauthorizes incentives to states to promote adoption and legal guardianship.

While this law provides much-needed resources to the struggling children, families and child welfare systems affected by the opioid crisis, it is difficult to determine if it will be enough. The ramifications of the epidemic and its effect on foster care youth can yield intergenerational trauma, as seen in previous drug epidemics. It took more than 25 years for the foster care system to stabilize itself from the cocaine epidemic of the 1980s.

How much damage will the opioid crisis cause? How long will it last?

If you serve children, youth or families affected by the opioid crisis, what can you do to reduce the need for foster care services and treat substance-using parents and caregivers?

Special thanks to Marissa Brinkman, Associate Product Manager at Relias, for her research and contributions to this article.