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My Turn: Invest in family drug courts



For the Monitor
Wednesday, September 20, 2017

President Donald Trump called New Hampshire a “drug-infested den.” Although not a description we prefer, it is a crass simplification of New Hampshire’s second highest drug overdose death rate in the nation.

For each overdose death, at least 10 others are estimated to have survived. The number of living substance misusers expands further. Many are impaired but do not overdose. Many of them have children.

According to the New Hampshire Department of Health and Human Services, more than 20,000 reports of neglect and abuse are now made annually. Parental substance abuse is a factor in approximately 80 percent of cases referred to child protective services.

Sadly, 60 to 80 percent of parents whose children enter protective services were once referred as children themselves. Children learn the behaviors modeled by their parents. The problems that come from opioid addiction pass through generations.

Two years ago, 17-year-old Evangelique Tarmey, a Rochester teen struggling with addiction, died after she and her mother had used fentanyl together. In July, a 6-year-old Manchester boy inherited the legacy of neglect that results from addiction and was revived by Narcan, the opioid reversal agent after an accidental exposure. Countless children have less dramatic stories, but they share the collateral damage of their parents’ addictions.

Parents risk losing custody of their children once child protective services or the criminal justice system is involved. Parents fear the psychological and safety consequences their children could face from foster placement more than they fear their own addiction.

Their fight to win their court case is synonymous to fighting to keep their children out of foster care. Hoping the allegation or conviction against them is overturned, they deny their substance misuse. They may win their court case, but they lose the opportunity for help.

We need a different definition of winning. Family drug courts could provide that.

Unlike criminal courts, family drug courts focus on the best interests for the child, not the parent who may be at fault.

Family drug courts uphold that the best interest for a child is appropriate involvement with parents who achieve recovery in an intact home.

Family drug courts provide the safety parents need to seek rehabilitation while receiving support to keep their family together.

Research has shown the success of family drug courts in other states.

Twenty to 30 percent more parents who participate in family drug courts complete drug treatment than those who do not. Twenty to 40 percent more families remain intact long-term. Parents spent less time in criminal courts for other reasons.

It is a no-brainer. We should implement family drug courts. So why are there none in New Hampshire?

Earlier this month I attended a meeting in Concord to discuss implementation of family drug courts. Other representative stakeholders present included community social services, child protective services, law enforcement, the judicial system and experts from the National Family Drug Court Training and Technical Assistance Program.

The enthusiasm and initiative is there.

The barrier is the lack of resources. Successful family drug courts require more frequent meetings with judges, parents, lawyers and children’s advocates to assess progress. Parents need treatment and monitoring. Our threadbare system needs more staffing and funding.

Reports suggest twice the child protective services staff are needed to manage New Hampshire’s current caseload. Treatment is also limited by staffing shortages. Staff are asked to perform miracles with meager compensation.

Something must change. The current punitive and reactionary responses are not working. We need to rehabilitate parents and help children escape the legacy of addiction.

The family drug courts will pay for themselves. In 2007, $10,000 to $15,000 was saved in foster care fees per child whose parents participated in family drug court. The net overall savings was estimated to be $5,000 to $13,000 per family.

In today’s dollars, the amount saved would be even higher. Most importantly, the benefits of raising a child to be a well-adjusted contributor to society cannot be measured.

Second in the nation in drug overdose deaths: This notoriety demands action.

We must look beyond punishing a parent’s past and instead ensure the futures of their children. Those children are our children. They attend our schools, live in our neighborhoods and participate in our communities.

Family drug courts can help these children avoid the inheritance that comes with parental opioid addiction.

Evangelique Tarmey is an extreme example. But she was a girl nonetheless who might have lived today if her mother had access to a family drug court.

(Dr. Julie Kim is a pediatrician and associate professor of pediatrics at the Geisel School of Medicine at Dartmouth.)