Transcript document

METHAMPHETAMINE AND CHILD WELFARE:
National Statistics and Clermont County, Ohio
Experience
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Background
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Will Meth affect your
county?
Will Meth affect your Child
Welfare Department
Explanation of Ohio Boards’
Role and Funding
Current Status of
Substance Abuse
Treatment Services and
Priorities for Services in
Clermont County, Ohio
WHAT IS METHAMPHETAMINE?
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Methamphetamine is a
powerful central nervous
system stimulant that strongly
activates multiple systems in
the brain.
Use of Methamphetamine can
lead to psychosis, eating and
sleeping disorders, dental
deterioration, and skin
scratching.
Methamphetamine is more
toxic than other drugs, but if
an addict completes treatment
and stays abstinent, brain
function returns to normal in
about 24 months.
BRIEF HISTORY OF
METHAMPHETAMINE USE
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Abundant in West/Southwest for
decades
In 1979, key ingredients outlawed
in U.S.
Ephedrine method simplified
production
Internet spread the formula
Production moved to rural areas
Laws restricting sale of ephedrine
products impacting production
New supply from Mexico
Historically, shooting or snorting
only option for ingestion; in early
1990’s, smoking
methamphetamine greatly
expanded demographics and
increased addiction liability
The Faces Of Meth
APPROACHES TO
METHAMPHETAMINE PROBLEM
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Supply intervention
Precursor control
Treatment
Law enforcement
Prevention
Meth Stats
National Stats
From the NACo Survey
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40% of all child welfare officials report an increase in out of home
placements because of meth in the last year
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87% of law enforcement agencies report increases in meth related arrests
(starting three years ago)
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NACo Survey of 500 County law enforcement officials in 44 states consider
methamphetamine their primary drug problem.
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Recently, there has been a decrease nationally in methamphetamine lab
busts (due to effects of laws restricting access to needed ingredients), but
access to drug still high.
Ohio Stats
According to the Ohio Attorney General
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Ohio had 345 meth lab busts in FY 04
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More in FY 05
Where are the
Meth Labs in
Ohio??
How has Meth
Impacted Clermont
County??
Clandestine Labs Discovered in
Clermont County
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2004
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2005
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30 Methamphetamine labs busted
84 persons arrested on meth related charges
42 Methamphetamine labs busted
88 persons arrested on meth related charges
2006 (thru June 30th)
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24 Methamphetamine labs busted
38 persons arrested on meth related charges
Children Removed From Meth
Labs in Clermont County
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2003
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2004
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# of children removed – 30
# placed with relatives - 10
# placed in foster care – 20
Estimated cost
- $430,000
# of children removed – 40
# placed with relatives - 15
# placed in foster care – 25
Estimated cost
- $540,000
2005
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# of children removed – 40
# placed with relatives - 10
# placed in foster care – 30
Estimated cost
- $613,000
Community Killer
As a direct result of the growing
methamphetamine problem in Clermont County
more than 100 kids, at a cost of more than a
million dollars, entered our system in the last 3
years…
Clermont Stats
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Clermont County led the state of Ohio in the discovery of meth labs in 2003,
we were second in 2004
From January of 2003 to January of 2004 we saw a 37% increase in the
number of children in Foster Care…the increase was due, almost exclusively
to Meth
Placement costs in Clermont County went from $ 3.6 million dollars in 2001
to $6.4 million in 2004. Much of the increase can be associated with the
increase in drug abuse
We currently investigate about one meth lab case a week
We failed in an attempt to pass a Replacement Levy to address the
additional costs – we found that while people were sympathetic to the
children they were not sympathetic to the drug addicted parents- we
subsequently passed a levy in May 2006 shifting focus away from Meth
A recent survey of registered voters showed 57.2% identified the sale and
abuse of Meth as a major problem in Clermont County. Another 26.5%
identified it as somewhat of an issue for the county.
Other impacts on Children’s
Services
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Clothing vouchers – children
can’t take anything from a
meth lab with them to their
foster home
Medical examinations
Staff time – investigator,
ongoing worker, transportation
worker, court personnel,
assistant prosecutor, public
defender
Worker safety (both with
clients who are using meth
and by being exposed to the
toxic chemicals)
Lack of adequate treatment
programs
Who are these Children and
What Happens to them??
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Often the children are forced by their parents to be INVOLVED in
the production of the methamphetamines
Most of the children taken from homes with meth labs are youngunder the age of 8yrs old
Often other relatives are also involved in the “family business”…thus
when removed many end up in foster care
Many of the parents are unable to kick the addiction to the drug and
end up losing permanent custody of their children
Depending on the circumstances of the lab, these children may be
affected emotionally, psychologically, and physically…FOR LIFE
At this point, the long term effects of exposure to meth for children
is unknown
What are we Doing??
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CPS staff working closely with the Sheriff’s Department & community partners
Multi-Discipline training for our staff (SWORTC, Sheriff’s Department). Training included staff from
CPS, Mental Health, Home visitors, Board of Health
Established a committee to address these issues:
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Policies for staff safety (ex: no pregnant workers assigned to these cases.)
Look to other states who have had this issue for an extended period of time
Educating the public about this crisis
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Launched “Death2Meth.com” website
Produced a local documentary on the meth issue in Clermont County – called “Deadly Ice”
Provided testimony to Sub-Committee on Criminal Justice, Drug Policy & Human Resources
Continue to work with the Ohio department of Job & Family Services to develop meth awareness
Commissioner Proud is now a member of NACo’s national “Meth Action Task Force”
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Meth kits
Protocol for medical treatment
Task force has established the “PETE-V” philosophy (Prevention, Education, Treatment, Enforcement, and
Victims)
Commissioner Proud and Director McCartney members of Ohio’s Advisory Committee on
Methamphetamine
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This group successfully lobbied the general assembly to pass Senate Bill 53 which restricted the sale of
pseudoephedrine in Ohio
There is a growing awareness of the
Impact of Meth
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NACo has made Meth a priority
Meth was featured as the cover story in Newsweek
Magazine (8/8/05) and many other publications
Meth was the focus of sub-committee on Criminal
Justice, Drug Policy and Human Resources….
Locally….we lauched a website… www.death2meth.com
and Clermont County was featured on NBC Nightly
News…
The Federal Government launched the website
www.methresources.gov
The Website
www.death2meth.com
The National News
NBC Nightly News
The Documentary
“Deadly Ice”
Clermont County Office of Public
Information
Summary
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Will Meth effect your county?
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Will Meth effect your Children’s Services
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Yes the extent is up to you
Yes begin the partnerships now
Meth is a community, state and national problem
Meth tears at the fabric of our society
Meth is devastating to the people who make or
use it, and the communities that they do it in
We must make it unpopular to use it or make
it…
The News is NOT
ALL BAD
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MYTH AND REALITY OF TREATMENT FOR
METHAMPHETAMINE
MYTH: Clients addicted to methamphetamine do
not complete treatment and do not recover.
REALITY:
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Data show that methamphetamine treatment
completion rates are not very different than those for
other addictive drugs.
People addicted to methamphetamine can and do
recover.
If methamphetamine addicts complete treatment,
they are no more or less likely to require re-admission
to treatment program, lose their job or be arrested
than those who were treated for other drug use.
“Good news – some of the bad news
about methamphetamine is wrong.”
Alternative View of Current
Methamphetamine Situation
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A report released in June by The Sentencing
Project, an advocacy group, states that
methamphetamine use is dangerous but not the
national threat portrayed by political and law
enforcement officials.
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Not an epidemic – “highly localized”, even though
more widely used than 10 years ago.
Positive outcomes achievable for people with primary
methamphetamine addiction.
“Mischaracterizing impact of methamphetamine by
exaggerating prevalence and consequences.”
SAMHSA Treatment Episode Data
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Number of people admitted to addiction
treatment programs for methamphetamine
use rose 25% between 2002 and 2004.
Methamphetamine users:
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8% of treatment admissions nationally.
20% or more in Arkansas, California,
Hawaii, Idaho, Nevada, Oklahoma and
Utah.
Lifetime, Past Year, and Past Month
Methamphetamine Use among Persons
Aged 12 or Older: 2002-2004
Numbers of Users (in Thousands)
14,000
12,383 12,303
11,726
12,000
2002
2003
2004
10,000
8,000
6,000
4,000
1,541 1,315 1,440
2,000
597
607
583
0
Lifetime
Past Year
a = Significant change 2003 to 2004; b = Significant change 2002 to 2004
Past Month
Methamphetamine Users
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High rate of use among women and the
homosexual community (45% of admissions are
women – higher percentage of women
admissions than for any drug except
tranquilizers).
Traditionally considered Caucasian drug – mainly
blue collar.
Increasing use among Hispanic and Asian
population.
Use highest among the 25-34 age group.
Methamphetamines as Primary Substance by
Gender and Pregnancy Status: 1994-2004
Percent of Total Admissions
23%
20%
18%
15%
13%
10%
8%
5%
3%
0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Pregnant Females
Non-Preg Females
Source: Analysis of Treatment Episode Data Set (TEDS) Computer File
Males
IMPACT on CHILDREN
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Since women more likely caretakers of children, more
children affected by methamphetamine.
80-90% of children in homes where methamphetamine
manufactured test positive for drug.
Methamphetamine in children’s systems due to inhaled
fumes, direct contact with drug, second hand smoke, or
direct ingestion.
Children uniquely susceptible because of their natural
curiosity (touching, putting things in mouth), because
their nervous systems and brains are still developing,
and because thinner skins absorb chemicals faster than
adults.
Impact on Fetal Development
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Exposure early in pregnancy: fetal death,
small size for gestational period.
Exposure later in pregnancy: learning
disabilities, poor social adjustment.
Parents Entering Publicly Funded
Substance Abuse Treatment
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59% had child(ren) under 18.
20% had child(ren) removed by Children’s
Protective Services.
10% who had child(ren) removed lost
their parental rights.
(Based on CSAT TOPPS-II Project)
Various Scenarios of Methamphetamine Use
Impacting Children
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Parent uses or abuses methamphetamine.
Parent dependent on methamphetamine.
Parent “cooks” small quantities of methamphetamine.
Parent involved in trafficking.
Parent involved in super lab.
Mother uses methamphetamine while pregnant.
Each situation poses different risks and requires different
responses.
Child welfare workers and treatment staff need to know
the risks and responses.
Parent Uses or Abuses Methamphetamine – Risks
to Safety and Well-being of Children
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Parental behavior under the influence: poor judgment,
confusion, irritability, paranoia, violence.
Inadequate supervision.
Inconsistent parenting.
Chaotic home life.
Exposure to secondhand smoke.
Accidental ingestion of drug.
Possibility of abuse.
HIV exposure from needle use by parents.
Parent Dependent on Methamphetamine
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All the risks of parents who use/abuse, but children may
be exposed more often and for longer periods.
Chronic neglect is more likely.
Household may lack food, water, utilities.
Chaotic home life.
Children may lack medical care, dental care,
immunizations.
Greater risk of abuse.
Greater risk of sexual abuse if parent has multiple
partners.
Parent Involved in Manufacturing,
Trafficking, etc.
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All the previous risks.
Exposure to the drug.
Possible fire or explosion.
Presence of weapons.
Possibility of violence.
Possibility of physical or sexual abuse by persons
visiting the household.
Possibility of parent incarceration and
permanency issues for children.
Relationship of Methamphetamine
Use and Child Welfare
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Not solely use of specific substance that
affects child welfare system – it’s complex
relationship between:
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Substance use pattern.
Variations across state and local jurisdictions
regarding policies and practices.
Knowledge and skill of workers.
Access to appropriate health and social
supports for families.
Substance Abuse Treatment Services
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Outpatient
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Individual Counseling
Group Counseling
Intensive Outpatient (IOP)
Day Treatment
Detoxification (outpatient and inpatient)
Residential/Inpatient
12 Step Programs (AA, NA)
Recommended Treatment Approaches
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Psychosocial Treatment
Contingency Management
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Technique employing systematic delivery of positive
reinforcement for desired behaviors (e.g., vouchers or rewards
earned for methamphetamine-free urine sample).
Relapse Prevention
Matrix Model
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Manualized, 16 week, non-residential program
Includes individual counseling, cognitive behavior therapy,
motivational interviewing, family education groups, urine testing,
and participation in 12 step program.
Effective Methamphetamine Treatment
Components
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Minimum of 6 months -1 year of
treatment.
Structured, intensive and comprehensive.
Focus on coping mechanisms.
Cognitive and behavioral in nature.
Strategies for Working with
Methamphetamine Abusing Parents
Use of Motivational Interviewing
Techniques
 Role modeling
 Accountability
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Obstacles to Client Change
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Late stage addiction.
Resistance to the “System”.
Lack of hope.
Methamphetamine addicts often dismissed
in dependency cases or prejudged.
Methamphetamine affects brain chemistry,
often leading to reduced memory and
attention rates.
Limitations on Current Treatments
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Training and development of knowledgeable
clinical personnel are essential elements to
successfully address challenges of treating
methamphetamine users.
Training alone is insufficient if funding necessary
to deliver the recommended treatment is not
available.
Treatment funding policies that promote short
duration or non-intensive outpatient services are
inappropriate for providing adequate treatment
for methamphetamine users.
Models of Improved Services
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Many communities began program models in the
1990’s.
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Paired counselor and child welfare worker.
Counselor out-stationed at Child Welfare office.
Multidisciplinary teams for joint case planning.
Persons in recovery act as advocates for parents
(peer support).
Training and curricula development.
Family Treatment Courts.
More Advanced Models of Team Efforts
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Workers out-stationed in collaborative settings: at courts,
at child welfare agencies, at treatment agencies.
Increased recovery management and monitoring of
recovery process.
New methods and protocols on sharing information.
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Increased judicial oversight and family drug courts.
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New priorities for treatment access for child welfare
involved families.
New responses to children’s needs.
Sacramento, California Model of Effective Child
Welfare and Substance Abuse Services
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Comprehensive training – to understand substance
abuse and dependence and acquire skills to intervene
with parents.
Early Intervention Specialists – social workers trained in
motivational enhancement therapy stationed at Family
Court to intervene and conduct preliminary assessments
with ALL parents with substance abuse allegations at the
first court hearing.
Improvements in Cross-System Information Systems – to
ensure that communication across systems and methods
to monitor outcomes are in place, as well as
management of the County’s treatment capacity.
Sacramento, California Model of Effective Child
Welfare and Substance Abuse Services (cont.)
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Prioritization of Families in Child Protective Services
(CPS) – county-wide policy to ensure priority access to
substance abuse treatment services.
Specialized Treatment and Recovery Services (STARS) –
to provide immediate access to substance abuse
assessment and engagement strategies conducted by
staff trained in motivational enhancement therapy.
STARS provides intensive management of the recovery
aspect of the child welfare case plan and routine
monitoring and feedback to CPS and the Court.
Dependency Drug Court – to provide more frequent
court appearances for ALL parents with allegations of
substance abuse.
Recommendations
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Improve data systems that help paint a better
picture of addiction and child welfare issues.
Improve intervention for children.
Improve and increase availability of staff
training.
Increase timely access to addiction treatment.
(Nancy Young, Ph.D., Testimony before the U.S.
House of Representatives Government Reform
Subcommittee on Criminal Justice, Drug Policy,
and Human Resources, July 28, 2005)
Cost Issues re: Increased Substance Abuse
and Methamphetamine Treatment
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Policy makers may view cost of providing
substance abuse treatment services prohibitively
high.
Estimates state as few as 10% of those needing
substance abuse treatment actually receive
treatment – costs of meeting needs too high.
Focus on costs savings that balance treatment
costs when treatment readily available – costs
savings due to reduced crime, increased work
productivity, decreased health costs, decreased
child welfare involvement.
Cost Issues re: Increased Substance Abuse
and Methamphetamine Treatment (cont.)
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Research by Ettner et al. confirms previous studies,
finding that treatment of substance abuse results in net
benefits.
“Benefit vs. Cost in the California Treatment Outcome
Project: Does Substance Abuse Treatment pay for
itself?”
Every dollar invested in substance abuse treatment
yields $7 worth of economic benefits to society.
Study looked at effects of treatment on medical care,
mental health services, criminal activity, employment
earnings, and government payments (e.g.,
TANF/welfare).
Future Directions
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Family-Based Methamphetamine
Treatment Access Act of 2006 – providing
resources and tools to reduce substance
abuse among mothers and non-violent
offenders.
White House Drug Policy Office – goal to
cut methamphetamine use by 15% and
increase seizures of methamphetamine
labs by 25%.
Resources
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NATIONAL CENTER ON SUBSTANCE ABUSE AND CHILD
WELFARE (NCSACW)
A Program of the Substance Abuse and Mental Health
Services Administration,
Center for Substance Abuse Treatment,
and the
Administration on Children, Youth, and Families
Children’s Bureau
Office on Child Abuse and Neglect
www.ncsacw.samhsa.gov
Contact Information
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Bob Proud, Clermont County Commissioner
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Karen Scherra, Executive Director of Clermont
County Mental Health & Recovery Board
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[email protected]
(513) 732-7300
[email protected]
(513) 732-5400
Tim McCartney, Director, Clermont County
Department of Job & Family Services
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[email protected]
(513) 732-7212