OVC Provider Forum Transcript

Working with Drug Endangered Children
Lori Moriarty  -  2007/11/28
Can you comment on examples on how, through DEC efforts, child welfare agencies are better giving law enforcement information that leads to charges of criminal endangerment? Thanks! Chris
1.  jbbinder
 In my experience, law enforcement refuses to file child endangerment charges unless they actually catch the parent in the act, even when there are positive hair stats & parent admissions.
2.  Angela Keen
 Where do we find those examples and resources?
3.  Loir Moriarty
 The working relationship between Law Enforcements and Social Services has been a very enlightened experience in many areas to include the gathering of evidence that assists in filing criminal charges against the parent or care giver. This allows the entire process to come together using the criminal charges to hold the person accountable and assist in the intervention.
Our region has a DEC Protocol that defines the coordinated response to Drug Endangered Children. However, a drug endangered child is defined as a child living in an environment where meth is being manufactured. This limited definition ignores the children most at risk - those living with caregivers who use and/or sell drugs - all kinds of drugs. Efforts to change the Protocol to include these children have met with resistance from police and prosecution. They say that the numbers are too "voluminous" and they don't have the resources and time to provide a coordinated response. If the child needs to be placed, police simply calls a family member or friend to take care of the child while the parent goes to jail. Have other regions been successful in "redefining" drug endangered child?
1.  Jenny Difilippo
 It was my understanding that Children and Youth would need to be involved for the children to be placed. Is it acceptable for the police to call friends or family? This does not sound like a safe practice.
2.  Kathy and Trina
 Washington has been successful in getting some jurisdictions to consider drug endangered children for other drugs, not just meth. Law enforcement in Spokane doesn't limit DEC referrals to just meth.
3.  Angela Keen
 To the author of the question...where are you and are you able to share your protocol?
4.  Loir Moriarty
 You are correct. Drug Endangered Children are not just defined by meth labs. Drug endangered children (DEC) are those children who suffer physical or psychological harm or neglect resulting from exposure to illegal drugs, to persons under the influence of illegal drugs, or to dangerous environments where drugs are being manufactured or chemicals used to make drugs are accessible.
What studies are being conducted regarding Meth smoke and the children that are exposed to it.
1.  Wanda Rochelle
 Thank you very much for this information.
2.  Chuck Salocks
 By the way, two very good studies of meth absorption from smoking have been conducted. The drug is very well absorbed by the inhalation route, which probably explains why it's the preferred method that addicts use to get high.
3.  Chuck Salocks
 When we conduct a human health risk assessment for a hazardous waste site, inhalation usually represents a minor route of exposure. Ingestion and dermal absorption account for the majority of exposure. However, this will vary depending on the physical and chemical properties of the contaminants and the nature of contaminated media (air, water andor soil). A child's inhalation exposure to meth is likely to be episodic: high while the drug is being smoked and low or non-existent when it isn't.
4.  Chuck Salocks
 We have very precise age-specific data on the inhalation rate of children - even children as young as 1-2 years of age. To estimate the absorbed dose of meth, you just multiply the airborne concentration by the age-specific inhalation rate: concentration (mgm3) x inhalation rate (m3day) absorbed dose (mgday)
5.  Chuck Saolcks
 Children's inhalation exposure to smoked meth can easily be calculated as long as the airborne concentration (units: mgm3) of meth is known. Unfortunately, as far as I know, there is not much data on airborne meth levels in a user environment other than the concentrations that Dr. John Martyny measured in his studies.
6.  Wanda Rochelle
 Is anyone else besides the National Jewish Medical doing research on how meth smoke affects children?
7.  Loir Moriarty
 The project will initially concentrate on providing information to researchers, physicians, and government personnel but will be broadened over time to serve the interests of the concerned public. The information will be presented at a location on a national website that will be easily accessible by computer. We believe that the project will significantly speed up information gathering for interested parties.
8.  Lori Moriarty
 The goal of this project is to establish an annotated reference library that will provide information regarding the best and latest information regarding the hazards methamphetamine use and manufacture.
9.  Loir Moriarty
 Research conducted by National Jewish Medical and Research Center and reports from the California Drug Endangered Childrens Group, suggest that simply using methamphetamine results in significant exposure to individuals entering the use area and results in many children testing positive for methamphetamine even though a laboratory was not present.
10.  Loir Moriarty
 There continues to be a significant need for reliable information regarding the hazards of clandestine methamphetamine laboratories and the hazards associated with the use of methamphetamine. Although the number of clandestine laboratories appears to have been reduced by new restrictions on manufacturing precursors, the use of methamphetamine within the U.S. does not appear to have been reduced.
11.  Nathan Anderson
 Here's a link to a study conducted by Dr. John Martyny and his associates, http://www.colodec.org/medandresearch/documents/Methຈsmokingຈexperiment.pdf It is titled Methamphetamine Contamination on Environmental Surfaces Caused by Simulated Smoking of Methamphetamine.
Is there any free teaching materials that you know of that will be appropriate for teenagers most likely already exposed to certain types of drugs?
1.  Lori Moriarty
 You might want to contact Dr. Nancy Young with the National Center on Substance Abuse and Child Welfare directly. There are several trainings posted on their website and she is a great presenter.
2.  Theresa William
 Does anyone know of any individuals who speak on this topic? In the midwest?
3.  Lori Moriarty
 There are two great resources for materials for teenagers. National Center on Substance Abuse and Child Welfare --http://ncsacw.samhsa.gov/resources.asp and the National Institute on Drug Abuse -- http://www.teens.drugabuse.gov
It is important for treatment agencies and community partners working with DEC children and families coordinate services and communicate with the Adult Probation and Parole Officer that supervise the parents/caregivers of these children. Are there any areas in the United States that DEC teams include Adult Probation and Parole as memebers of their teams.
1.  Loir Moriarty
 Probation and Parole play a critical role in transitioning the families out of the criminal justice system and back into the community (which is critical for sustainability)Transition is the 6th stage of the NADEC Comprehensive Response. Transition is a stagesometimes initiated at the onset of case managementto develop a strategy for success and support of the child and parent in the community. Individual and family plans emphasize the support and interventions necessary to sustain behavior changes realized in the case management cycle. Prisons, jails, community corrections, child welfare, and probation clients cycle through this stage of the process on the way to sustainability
2.  Kathy and Trina
 We would be really interested in the information generated from this work group and would like to share it with our DEC team. Is there a way to keep in contact with him? Or keep up with the results? The Spokane DEC team is pretty involved and interested in this and includes Law Enforcement and probation and parole.
3.  Lori Moriarty
 In 2008, NADEC will be creating a new work group with an emphasis on the criminal justice system. The group will be facilitated and guided by Dr. Brian Mattson who is an expert in the field of risk assessment in the criminal justice system.
4.  Lori Moriarty
 You are absolutely correct. Effectively solving these problems requires the involvement of community members, representing multiple professions who can collaboratively build and execute a tailored plan. Community members include first responders, child protective services, law enforcement, medical and mental health professionals, prosecutors and county attorneys, probation, parole officers, child advocates, substance abuse prevention and treatment providers, and other community leaders, as well as the general public.
While working with drug endangered children in a residential treatment facility setting and from the perspective of the substance abuse treatment provider, is it best to approach the children from a parental, mentor, professional, friend or teacher point of view? Or is it best to combine all elements of approach? Or does it depend upon the age of the child? I have read and heard mixed reviews. As a professional in health care, I would think that it would depend upon the nature and sensitivity of the case. Please share your thoughts concerning this subject matter.
1.  Lori Moriarty
 I will forward this question onto the members of our NADEC Working Groups, so you can get the perspective of many different professionals working in this area.
What is the proper protocol for placing children in tyvek suits?
1.  Lori Moriarty
 There really is no proper protocol for putting a child in a tyvek suit. The NADEC Medical Research Group has been working on this issue and believes that it is important to get children who have been in meth labs decontaminated in the most child friendly way possible. This could mean just changing clothes on scene and decontaminating at the hospital in a more friendly, warm environment.
Regarding state laws allowing judges to order a child to be detained for 6 months during which time the parent has to have "clean" drug tests. I have seen this type of situation in cases where drug use is only alleged and/or CPS admits the child is not in danger. What solutions would you suggest to protect families in such a situation? Thank you very much. Dorothy Kernaghan-Baez Georgia Family Rights, Inc.
1.  Loir Moriarty
 The case management process is an iterative process where agencies work with individuals navigating the change process and facilitating progress toward specific, measurable outcomes. Case progress may be measured over the course of months and years involving reassessments, case planning revisions, and a variety of treatment approaches leading to a decision to transition off of formal services.
2.  Lori Moriarty
 Many children who come to the attention of the child welfare system present with unmet and complex supervision, treatment, and developmental needs. These needs often require deliberate and focused services, engaging the family system when appropriate, to help ensure successful development. In response to these needs, systems are challenged to tune-up organizational competencies for effectively engaging these evidence-based services and delivering these services to those most likely to benefit.
3.  Lori Moriarty
 This is a great question and needs some committed time and attention to the answer, but I will do my best in this forum. The NADEC is working on a blueprint that brings all disciplines together to assist in providing the appropriate response to children and families.
I have little knowledge of the effects of methamphetamines on babies, in utero, and would appreciate info on how newborns and toddlers reflect a mother's drug use. Thanks.
1.  Lori Moriarty
 This is a frequently asked question and The NADEC Medical Working Group has several doctors who are experts in this field and can provide a more detailed response. So, I will refer you to our website at www.nationaldec.org for information on how newborns and toddlers reflect a mother's drug use. If you would like to connect with one of our doctors please send me an e-mail and I will assist with that.
Aloha Lori! How would you recommend generating participation from Child Protective Services in a DEC initiative/alliance, when your Administration's agenda has changed and they are no longer supporting DEC efforts, thus CPS participation ceases as well? I heard a little about the community based efforts at DEC in Kansas City but how are they effective & how is the sustainability with that type of direction? Thanks for all you do with DEC!
1.  Lori Moriarty
 Aloha Lani. This is a great question and I want to let everyone know that it is important to bring all disciplines together in response to drug endangered children. Every effort across the nation has strengths and weaknesses and some disciplines work together great in some areas and not so great in other areas. NADEC is working on a blueprint that brings everyone to the table to work together in their response to drug endangered children to include the community.
Are there specific roles victim advocates can play in the prosecution of such cases? Are there coordinated responses and protocols out there? (Coordinating first responders, law enfocrment, medical, prosecutors, victim advocates and child protective services)
1.  judibankhead
 The problem seems to be in working with drug endangered young children is that they look like ADD, PTSD, Fetal Alchohol Syndrome, Truamatic Brain Injury and Nonverbal Learning Disabled but do not quite match in any category, therefore any protocol for evidenced based interventions could serve as springboard for decreasing violence in USA. Since we have no protocol at this time these students end up being a part of the vicious circle of expanding the number of drug endangered children world wide.
2.  Lori Moriarty
 Across the nation, disciplines are starting with awareness presentations on the drug endangered children issues and not specifically on training a particular response. The goal of NADEC is to determine what is currently taking place so we can understand how to respond more effectively in a Comprehensive Response where each discipline has a role and responsibility and we have a better understanding of each others role (breaking out of our silos and tunnel vision approach).The solutions will involve developing a shared understanding of outcome objectives, the practices that will be used to achieve these outcomes, an understanding of the rationale that supports these practices and guides decision making, and a thorough understanding of the type and scope of need.
3.  Angela Keen
 I'm planning a statewide training in PA for victim advocates and encouraging them to bring other members of law enforcement and prosecution, as well as CPS, with them. I'm open to suggestions for trainers. My hope is that at least the advocates will leave with info that they can take back to their communitites to get things organized and coordinated. Any suggestions? Is this type of training happening in other places?
4.  Lori Moriarty
 Yes, victim advocates are also a critical part of the drug endangered children response and some states (or more specifically, local jurisdictions) use them regularly in accordance with their guidelines for using a victim advocate. Unfortunately, like a lot of these efforts right now, it is a matter of time to get everyone educated on the DEC response to help bring the disciplines together and to have each discipline understand that working together makes each of us stronger in our response and more effective in meeting the needs of the children.
Would you talk about best practices in working w/ DEC?
1.  Lori Moriarty
 This is a very complicated question to answer in this forum, but I will at least give some background and an idea of the NADEC goals in this area.NADEC has evolved so much in the last few years, moving from an initial response between LE, SS, medical personnel and prosecutors with a goal of identifying children living in meth labs to a Comprehensive Response bring more disciplines together to more effectively respond to the needs of these children and their families. NADEC is focusing on social change and not just a quick fix. We are working with professional from across the nation to determine what evidence based practice is out there to help us improve our responses to drug endangered children and their families. This process will continue to evolve as we learn more about our current responses and how we need to improve the practice as we bring disciplines together. NADEC's goal is to create a website that will help share this knowledge.The NA Working Group's will be gathering a lot of this knowledge along with data to support the efforts.
Do you have examples of coordinated response protocols that you can share? (Coordinating law enforcement, prosecution, medical professionals, victim advocates and child protective services)
1.  Angela Keen
 That would be great! I'm trying to get my hands on as much specific info as possible...that's what people want at trainings. Would it be okay to copy and share the Spokane protocol at the training as an example?
2.  Kathy and Trina
 You can see some of the protocols at wadecalliance.org That webiste is the Washington DEC alliance, but the Spokance DEC team has specific guidelines I could send you if you would like them.
What about the secondary effects on children living w/ parents who are using and/or manufacturing? Specifically the danger they are in when a guardian is high...they are at greater risk for sexual assault and other forms of abuse. How is this being addressed by law enforcement, prosecutors and child protective services? Are there laws identifying this as a prosecutable offense?
1.  shirley
 What is the percentage risk of children getting the drug or components of the drugs on their hands or bodies as they are in the home and on surfaces. Crawling infants are on the floor and everywhere that the substances would be. How likely is it that they would get enough product to injure them fatally?
2.  Lori Moriarty
 As mentioned in the previous response from Lynn, there are several effects on children living in substance abusing environments. These harms may include: injury from explosion, fire or exposure to toxic chemicals found at clandestine lab sites; physical abuse; sexual abuse; medical and emotional neglect and lack of basic care including failure to provide meals, sanitary and safe living conditions or schooling, chaotic home environment and much more. Parents and caregivers who use illicit drugs such as methamphetamine, cocaine, and heroin create these dangerous and abusive environments for their children.
3.  Lynn S.
 Children do frequently suffer effects as a result of the parent's drug use. These families operate under a code of secrecy about the activities in the home. So the children rarely have anyone they can talk to about their fears and feelings. The children can also tend to be hypervigilant. Many of them aren't allowed to have friends come to the home. The children are at greater risk for abuse in many instances as individuals have under the influence can have reduced judgement, lowered inhibitions and lower tolerance for frustration. And particularly for neglect, i.e. lack of supervision, lack of meeting the child's basic needs for food, shelter, etc. There are laws to address these situations where there is evidence of abuse or neglect. Unfortunately, in some instances where the parent uses but there is no clear evidence of harm to the child, it can be difficult to have a finding of abuseneglect, remove a child from the home or prosecute the case.
I am interested in information relating to direct service with current or recovering drug users with small children. I do home visiting with first time parents of children 0-3. I would like ideas and information on how to encourage familes to stay drug free as well as how parenting is affected by past drug use. Also what are the signs of various kinds of drug use?
1.  Lori Moriarty
 This is a great question. I will forward this question onto the NADEC Working Group Program Manager, Susannah Carroll and she will be able to provide feedback on this question from the Working Group members. I believe Dr. Nicolas Taylor from the Treatment Working Group will be able to give some examples on this one, so I will refer to his expertise and the expertise of other working group professionals and get back to this question.
What role does the schools play in identifying these type of children?
1.  Lori Moriarty
 There are seven stages in the Comprehensive Community Response to DEC. The schools play a critical role in several. The first stage is prevention. Prevention activities are fundamental to the operation and success of the criminal justice and human service system. These activities target general education to prevent the onset of problem behaviors related to methamphetamine and other drug use. Prevention activities emphasize education, opportunity structures, capacity building, social support, and skill development for the general population and for populations at risk of developing problem behaviors.
2.  Lori Moriarty
 The schools play a critical role in identifying drug endangered children, especially since they see these children (or know their patterns of missing school) on a daily basis. In the NADEC blueprint (which was discussed at this years National DEC Conference) it will be important to bring the schools into the process. The blueprint identifies stages of the Comprehensive Response to DEC and the schools are critical in several stages to include initial identification.
I am also interested in direct service working with children and mothers who may be affected by drugs. Working in a shelter environment, I have experienced children who witnessed or were surrounded by parents and/or relatives and friends using. Are there direct physical symptoms that may appear? Is talking about these situations with the children always an appropriate response?
1.  Holly
 Although there may be physical symptoms of drug exposure, children's words may be the greater indication of exposure. Children may describe stinky stuff which is usually marijuana--they know the difference between this and cigarettes. They may talk about cooking medicine or taking vitamins. Remember that children's perspectives are shaped by their environment. Sleep disturbance due to fear is a complaint many children have as well as the stress associated with the pressure of adult responsibility they must take because of adult addiction. It is appropriate to talk with children who initiate conversation. The rules of a drug home are: Don't talk, don't trust, and don't feel. Children take a great risk to share information at all. It is the role of adults in their lives to hear their stories and to assist if they are in danger. Hope this helps.
2.  Lori Moriarty
 I will forward this question onto the members of our NADEC Working Groups, so you can get the perspective of many different professionals working in this area.
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