FAMILY PRESERVATION AND SUBSTANCE ABUSE

National Coalition for Child Protection Reform / 53 Skyhill Road (Suite 202) / Alexandria, Va., 22314 / info@nccpr.org / www.nccpr.org

FAMILY PRESERVATION AND SUBSTANCE ABUSE

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They may be the parents most of us would most like to punish. Mothers who seem to care so little for their children that they'd rather get high than take care of them. Mothers who can't or won't kick their habit even while they're pregnant.

No one really knows how many there are. The huge numbers bandied about by child savers are guesses, and the child savers have a vested interest in guessing high. Furthermore, guesses about the extent of "substance abuse" by parents lump together everything from the parent who sells her child for crack to the parent who had her child taken for a week at birth because she smoked one marijuana cigarette to ease the pain of labor. [1]

Myths about those who abuse drugs -- and their children – die hard. Even though the apocalyptic claims about children born with cocaine in their systems – and their mothers – proved to be false, the same false claims are being made now in connection with another drug: methamphetamine.

But the problem cannot be minimized either. The problem of drug abuse, like the problem of child abuse, is serious and real. And there is an enormous temptation to punish addicted parents. But do we want to punish their children?

We favor providing Intensive Family Preservation Services and other help to some families with substance abuse problems. But not because it's another chance for the parent. We favor such programs because they may be the only chance for the child.

Consider the case of Alice Porter (not her real name) of Newark, New Jersey.

She was a drug-addicted single mother with a 12-year-old boy. The boy was angry, unruly, defiant, and hitting his mother. She was too overwhelmed by addiction to give him the order and stability he needed. One option would be to take the boy away because his mother doesn't "deserve" another chance.

But what would happen to an angry "acting out" 12-year-old in foster care? Probably foster home after foster home, as foster parents found they could not cope with him. Then group home after group home. The odds that he would have been adopted are slim. The odds that he would have been abused in foster care are excellent, (See Issue Paper 1). And the odds that he would emerge unable to love or trust anyone after all those placements are overwhelming.

But none of that happened. Alice Porter's family was referred to a family preservation program in Newark. The mother became active in Narcotics Anonymous. She built her skills, getting the education she needs to find employment. Her son joined Al-Ateen and did well in school. Because he stayed at home, he saw his mother fight -- and win -- her battle with addiction. "That's one less negative role model in his life," says family preservation worker Marcello Gomez. "He's learning he can have a positive lifestyle, drug free."[2]

But what about infants? Would they do better taken from parents who have abused drugs? Often, the answer there too, is no. After examining what really happens to such babies Time Magazine concluded: "Staying at home with an addicted mother who is actively participating in a rehabilitation program can, in many cases, be the more promising and safer route for the child [Emphasis added]."[3]

In a University of Florida study of children born with cocaine in their systems – children often stigmatized with the label “crack babies” -- one group was placed in foster care, another group with birth mothers able to care for them. After one year, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out. Consistently, the children placed with their birth mothers did better. For the foster children, the separation from their mothers was more toxic than the cocaine [4]. Why help addicted mothers? Because it is extremely difficult to take a swing at "bad mothers" without the blow landing on their children. And if we really believe all the rhetoric about putting the children’s needs first, then those needs must come before everything, including how we may feel about their parents.

That doesn’t mean we can simply leave children with addicted parents. It does mean that drug treatment for the parents, including inpatient programs where parents can live with their children, are almost always a better first choice than foster care for the children.

Not all cases work out like the case of Alice Porter. In some cases, a parent's addiction and lack of interest in treatment combine to create a situation that requires immediate removal of the child. But Intensive Family Preservation programs have developed their impressive record of safety while working with drug addicted parents. Michigan's program, for example, has an exemplary safety record, (See Issue Paper 1) even though 58 percent of the families it works with in Detroit have substance abuse problems. In the Newark program, 75 percent of families stayed together one year after the intervention. The fact that 25 percent did not indicates the care with which such families are approached and the willingness of family preservation workers to recommend removal of children when necessary.

An exhaustive 1999 report on child welfare and drug abuse found that, again contrary to the stereotype, "national treatment outcome studies clearly show that treatment can be effective."[5] [Emphasis added]. A federal report concluded that one-third of addicts recover on their first attempt and another third recover "after brief periods" of relapse.[6] And family preservation can increase the chances that treatment will work. And another federal study found that the chances of success increase dramatically when parents are allowed to keep their young children with them during inpatient treatment.[7]

But what about “meth”?

When use of crack cocaine was at its worst, so was the hype about what it did to children, and their parents.

The claim that children born with cocaine in their systems were doomed to become, in the words of one hyperventilating columnist, “a biological underclass” [8] was false. The claim that crack cocaine destroyed all maternal instincts was false. And the claim that addition to crack cocaine could not be treated was false.

But now the same false claims are being made about methamphetamine. In fact, methamphetamine addiction can be treated with just as much success and in the same time frame as addiction to crack cocaine and other substances.[9]

In part, there is a political motivation for the false claime about meth. There have been proposals to allow states to use billions of dollars now reserved for foster care for various prevention programs, including drug treatment. But the child savers want to hoard the money for foster care.

The child savers want us to believe that methamphetamine is virtually untreatable because they want us to believe the only option for their children is foster care. They want us to believe the only option is foster care in order to justify their demand that those billions of dollars be reserved for foster care, and nothing else.

Family preservation is not drug treatment. But Intensive Family Preservation Programs work with parents to determine which of the many forms of drug treatment is most likely to work, advocate to get them into treatment, and support them as they enter that treatment. They also prepare the family for the possibility of relapse, so even if that happens, the children remain safe. And perhaps most important, family preservation programs provide concrete services, so parents with substance abuse problems can marshal their energies and focus on freeing themselves from their addiction.

By providing such concrete help, Family Preservation programs provide something even more important: Hope. "A lot of our families are hopeless," Gomez says. "When you've been using for a long time, you think you'll never be able to get yourself together again." Often it is hopelessness that caused the addiction in the first place. "People get high for a lot of reasons," Gomez says. Sometimes, it may be a personal trauma. Often, it is the despair brought on by a life surrounded by seemingly intractable poverty.

Family preservation can't do it alone -- and the people who run such programs have never claimed that they can. There is an urgent need for a wide variety of substance abuse programs, particularly programs geared to the needs of mothers and children.

"They are doing [drugs] to anesthetize themselves," Gomez says. "They have a pain to deal with. We're always offering other options."

Updated January 1, 2008


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1. Brief for Defendant Appellant and Brief for Petitioner-Respondent, Nassau County (N.Y.) Department of Social Services v. Theresa Back to Text.

2. Personal Communication with Marcello Gomez, Clinical Supervisor for Family Preservation Programs at The Bridge, Inc., Irvington, N.J. Back to Text.

3. James Willwerth, "Should We Take Away Their Kids? Often The Best Way to Save the Child is to Save the Mother as Well," Time, May 13, 1991, p.62. Back to Text.

4. Kathleen Wobie, Marylou Behnke et. al., To Have and To Hold: A Descriptive Study of Custody Status Following Prenatal Exposure to Cocaine, paper presented at joint annual meeting of the American Pediatric Society and the Society for Pediatric Research, May 3, 1998. Back to Text.

5. National Center On Addiction and Substance Abuse at Columbia University, No Safe Haven: Children of Substance-Abusing Parents (New York: January, 1999). Back to Text.

6. Department of Health and Human Services, Blending Perspectives and Building Common Ground: A Report to Congress on Substance Abuse and Child Protection (Washington, DC: April, 1999) p.14. Back to Text.

7. U.S. Department of Health and Human Services, Center for Substance Abuse Treatment, Benefits of Residential Substance Abuse Treatment for Pregnant and Parenting Women (Washington DC: September, 2001). Back to Text.

8. Mariah Blake: “The Damage Done: Crack Babies Talk Back,” Columbia Journalism Review, September/October 2004.

9. Richard A. Rawson, Ph.D, Challenges in Responding to the Spread of Methamphetamine Use in the US: Recommendations Concerning the Treatment of Individuals with Methamphetamine-Related Disorders (Los Angeles: UCLA Integrated Substance Abuse Programs, David Geffen School of Medicine). See also, Maia Szalavitz, The Media’s Meth Mania, (Aug. 4, 2005) and The Media Go Into ‘Crack Baby’ Mode Over Meth (August 10, 2005) both at www.stats.org.