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Thursday, November 9, 2017

Opioid crisis taking toll on Florida's children

Posted By on Thu, Nov 9, 2017 at 10:46 AM

More than 4,000 babies were born addicted to opioids in Florida last year, an increase of over 1,000 percent from a decade ago.

Substance abuse played a role in two-thirds of the cases where children were removed from their homes within 30 days of birth last year.

And there's been a 38 percent increase in the number of children under the age of 5 who have been removed from homes because of substance abuse in the past four years.

Those are just some of the disturbing statistics rattled off by child welfare workers on Wednesday, in the latest round of hearings where lawmakers are groping to find a way to stem the opioid epidemic gripping the state.

“It's very difficult when you see a baby in the NICU, screaming and crying because they didn't have a choice to be born addicted,” Faye Johnson, CEO of the Northeast Florida Healthy Start Coalition, told the House Children, Families and Elder Affairs Subcommittee. “It's just very difficult to hear that high-pitched scream and to know that we're doing everything we can and to also know that this is not the end. …There are years of trauma that come behind this.”

The experts said the explosion of neonatal abstinence syndrome —- when babies are born addicted —- has skyrocketed due to a sharp increase in abuse of prescription opioids, like oxycodone, and street drugs, such as heroin.

According to Johnson, many mothers are so high during their first two or three trimesters that they don't even realize they are pregnant. And when they do find out, they are “flying under the radar” and reluctant to seek medical care “because they're afraid of the consequences if they get caught using while pregnant,” Johnson said.

But newborns aren't the only children impacted by the opioid crisis, which is responsible each day for the deaths of an estimated 14 Floridians and twice that number of non-fatal overdoses.

Florida has experienced “an increase in removals in almost every age group” and “in almost every region,” JoShanda Guerrier, assistant secretary for child welfare at the Department of Children and Families, told the House panel.

The agency doesn't specifically track child removals due to opioids, but instead keeps information about whether substance abuse was a factor in the decision to take a child out of the home, Guerrier said.

Nearly 40 percent of the children who were placed in out-of-home care were newborns, who also remain in foster care longer, Guerrier said.

A study of a sample of children conducted in 2017 found that 125 of 158 newborns were removed from homes where other children had previously been removed, she said.

“Those numbers are alarming,” Guerrier said.

Children who were removed from homes where substance abuse was present stay in out-of-home care longer and come from families that have been the subject of previous investigations, according to Guerrier.

Child welfare workers have implemented some changes in an effort to ensure the safety of children with opioid-addicted parents or guardians, Guerrier said.

For example, the state has sent out behavioral health specialists to assist child protective investigators.

And the child welfare agency is proposing a change in state law that would allow children to be removed from homes because of “prospective harm” instead of the current requirement of “demonstrative harm.”

Agencies are also using “family intensive treatment teams” to provide “intensive, family-focused, comprehensive services” to families in the child welfare system. And they're working with the Healthy Families program to try to address challenges with pregnant women and newborns.

“A lot is going on in the child welfare system to this, but much like the rest of the nation, it is a challenge,” Guerrier said.

Johnson said the state needs to pay for more crisis-stabilization beds for pregnant women and mothers.

Hospitals may release infants to addicted mothers without plans in place for close oversight. And the system is overloaded, with waitlists for services, the child welfare advocates said Wednesday.

John Bryant, assistant secretary of mental health and substance abuse at DCF, said he expects waitlists to grow as the drug- abuse epidemic continues to mushroom.

He also predicted that the number of deaths caused by opioids will continue to climb, as will diseases associated with drug use, such as HIV/AIDS and hepatitis.

The state is implementing medication-assisted treatment programs that rely on drugs like methadone and suboxone to wean addicts off prescription opioids or street drugs. The medication is paired with other types of treatment, including counseling.

But the state's history in helping addicts kick drug addictions hasn't been great, Bryant conceded when questioned by members of the panel.

“It tells us that recovery from opioid addiction is tough. It's very difficult,” he said. “You've got to have the right strategies in place … and before now we were not using medication-assisted treatment as a treatment option for these folks.

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