The opioid epidemic not only strains police, firefighters and the coroner’s office, but also parents, families and the agencies designed to protect society’s most vulnerable members — children.
Fifty percent of children placed in foster care in Ohio in 2015 were placed because of abuse and neglect associated with parental substance use, according to the most recent figures from the Public Children Services Association of Ohio. That number may be even higher in Lorain County, Scott Ferris, executive director of Lorain County Children Services, said.
“The feeling has been, and this includes alcohol, that 75 (percent) to 80 percent of our cases involve substance abuse,” Ferris said.
When screeners take complaints from the community, the screener always ask this question: Is there a drug issue?
In other instances, Children Services caseworkers will respond to a case for another reason, such as domestic violence, abuse or neglect, and in the course of an investigation will discover the parents also are using drugs.
Andrea Hall-Miller, the agency’s continuous quality improvement manager, said Children Services is involved with 1,120 children in Lorain County. This caseload includes 101 children in agency custody, 80 of whom are living in foster care; 13 living with relatives; seven children living in residential placements; and one who is in independent living placement.
Despite Ferris’ estimation of 75 percent to 80 percent of the cases involving substance abuse, knowing the exact number of children directly impacted by the county’s opioid epidemic is not easy.
Designing a plan to help families and protect children is just as complicated.
Each case has different variables, which determine whether children will or should leave their homes.
Reunification with parents is always the goal, caseworkers said, but it is not always the reality. Is there another parent in the home or elsewhere who can take charge of the children? Is there a relative the child can go to?
Caseworker Elizabeth Glaude said she has 10 cases, six of which are ongoing and four of which are drug-related involving opioids specifically or combinations of drugs like opioids and benzodiazepines, drugs commonly prescribed for the treatment of anxiety, panic disorder, seizures, or sleep disorders.
“Two were clearly opioids and the others were a variety of drugs,” she said.
Caseworkers said the agency always has dealt with substance-abusing parents and will continue to encounter it forever, but they said dealing with parents addicted to opioids presents a new set of challenges.
“You cannot parent well when you’re addicted to heroin,” said Patti-Jo Burtnett, the agency’s spokeswoman. “It impacts every facet of your life. You can probably sustain for a short amount of time, but it takes over very quickly.”
Burtnett said the needs of the families are more intense and caseworkers are immediately considering court involvement, safety planning and a variety of other factors that they might not immediately have to consider in the home of an alcoholic parent, for example. Opioids just take over, caseworkers said, and in many cases, parents disappear, sometimes for months at a time.
Such homes also are full of dangers to children — from moms or dads passing out after using and leaving drugs within reach of children, to used needles lying around, or heroin dealers coming around and violent acts being committed.
More often than not opioid-abusing parents never really recover, caseworkers said, and children wind up being raised by grandparents or other relatives. With heroin, it takes a long time for people to recover, caseworkers said, and unfortunately, many never really succeed at parenting.
“I worry about my parents dying,” said Glaude, a caseworker who had case in January where a parent of a child died of an overdose. “I don’t think I used to experience such worry about whether parent would die or whether they will use again after treatment.”
And there is the task of telling children their parents have died, something that caseworkers said there is no amount of training or preparation for.
Caseworker Adelle Polasky said she recently arrived at a home where a child was napping and the mother overdosed and died in another room. She had to wait in the home until the child woke up and try to explain what happened.
“Mom was dead in another room for a few hours prior to anyone finding her,” Polasky said. “It was chaos, it was scary and it was hard to process.”
One of the groups Children Services work with is the Sheffield Township nonprofit Blessing House, which provides temporary housing for children from birth to age 12. Nearly 1,300 children have come through the home since 2005, which can house up to 10 children at a time.
Sister Mary Berigan, the organization’s executive director, said it is hard to pinpoint how many of the children they see have parents addicted to opioids, but substance abuse in general factors into many cases they see.
Yet, Berigan said the nature of the stays seems to have changed.
In 2005 Blessing House would generally see kids for a couple days, she said, but today cases are more complex likely because of opioid addictions.
Like caseworkers at Children Services explained, Berigan said the thought of parents dying while children are in their care is very real.
“We have had parents die while the kids are with us twice within the last two years,” Berigan said. “We spent months looking for the parents who had children with us and we eventually found out the parent had died. It never crossed my mind we’d be dealing with something like that. It certainly wasn’t part of our early experience.”
Donna Humphrey, Blessing House business manager, described one instance involving two parents with several children younger than 9. The children were at Blessing House because they were homeless due to their parents’ opioid addiction.
The father was in recovery and working to get documentation so he could get a job, and Blessing House was aiding him in finding living arrangements. Humphrey said the man was genuinely excited to see his kids and get back on his feet.
“We were working to find shelter so he wouldn’t be on the streets,” Humphrey said. “We had just made arrangements that day, but he never made it. He overdosed and died. Here was somebody motivated to care for his kids and had every intention of doing what he needed to do to achieve that, and the drug won.”