As heroin use spikes, Ohio children feel the brunt

As heroin use took over her life about six years ago, Alexis Maffett just stopped caring about her family and her kids.

The physical pull of the drug kept the Mansfield native focused on finding it or prostrated in bed from withdrawal. A friend helped make sure Maffett's daughter got dressed and off to school.

Children services had been called several times, but they could never prove anything.

"I grew up in the system, in foster care. I knew how to talk to people. I knew how to tell them what they wanted to hear," Maffett said.

Maffett, who graduated from drug court this month, began using heroin when Ohio's children services staff began noting an uptick in claims of heroin abuse in Ohio. Between 2009 and 2013, the frequency of heroin noted in children services cases more than doubled statewide, and it did the same in Richland County.

Patricia Harrelson, director of Richland County Children Services, said the increase came as no surprise.

"I applaud the effort to deal with prescription addiction but not our political failure to see ahead and also deal with the inevitable rise in the use of heroin. We all (in our social services communities) could see this coming five years ago," she said.

Next month, judicial, treatment and child welfare officials from across the state will come together to discuss the problem and approaches to combat it.

Growing concerns

While the statewide data on the increased mention of heroin in child welfare cases was released late last year, the Ohio Department of Mental Health and Addiction Services recently computed rates of mentions by county.

Richland County rose to the top of the state, with 21 mentions per 1,000 families in 2013, followed by Marion County with 17 mentions per 1,000 families, but state officials say the data is best used for self-comparison.

"It's the best data we have, so most likely there are more families with substance abuse issues than what our data is telling us," said Jennifer Justice, deputy director of Job and Family Services' Office of Family and Children

The data was collected using a program to detect specific drug names — heroin, cocaine and methadone — from computerized children service case notes. As such, a case that referred to heroin as opiates or just drugs instead wouldn't be reflected in the numbers. While mentions of heroin spiked, mentions of cocaine and methadone remained relatively flat.

In Ross County, mentions of heroin in child welfare cases grew from 3.4 per 1,000 families in 2009 to 6.3 in 2013.

Families hide addiction

Children are often on the sidelines watching the drug use — watching the police raids, watching the overdoses, having access to drugs — said Marion County Children Services Director Jacqueline Ringer.

"We've had children as young as 2 years old testing positive (for drugs) as a result of inadequate supervision. ... That's what we're dealing with on a daily basis," she said.

In early drug use, before family finances are affected, there may be no signs of neglect. But as drug use spirals out of control, that's when problems arise, such as chronic neglect, providing children service agencies the ability to intervene, Harrelson said. Once the situation is bad enough for removal, Harrelson said most times the parents don't end up getting their children back.

"I often see parents who know their kids are safe and continue to use. We remove one of the things that may make them think twice. Heroin pretty much makes you forget you have kids, at least when you're high," she said.

For Maffett, she decided to sign over temporary custody of her children two years ago to a relative. She had overdosed while trying to get clean on her own, and, with the help of her sister, subsequently sought formal treatment. In December 2013, she was indicted for possession of drugs from the overdose and was accepted into drug court.

In addition to continued drug treatment and regular drug tests, drug court involves intensive supervision and support from the court team. Maffett said she thinks the regular support from her probation officer really helped her.

The reward for completion was not only sobriety but also not having a felony conviction on her record. Her goal now is to trade in her part-time job for a full-time one and find a place of her own. Maffett also hopes to regain custody of her children. While she has visitation rights, full custody was given to their grandmother a year ago.

"It's hard to overcome, but it is possible," Maffett said. "It took me five years, but it can be done."

Cry for action

In September, a report from the Public Children Services Association of Ohio pointed out that while Ohio legislators have adopted more than a dozen bills in response to the opiate epidemic, the Legislature has yet to directly address the effect of opiates on children.

"The child welfare system in and of itself is not going to solve this problem," said Tim Dick, co-chairman of the committee that did the report and assistant director for Clermont County Children Services.

The problem needs a team approach from child welfare, judicial and drug treatment agencies, Dick said, adding that the primary purpose of the report was to get people talking and planning. That conversation will continue in a big way next month at an Ohio Supreme Court symposium that aims to bring together people from all three agencies for every county in the state.

Maffett was part of a common pleas drug court, but Ohio also has at least 16 similar courts targeted for families. Expanding those courts is among the solutions mentioned in the report.

Ever since Marion County's family drug court began in 2011, Ringer said she's been more likely to see successful reunification of families.

The biggest hurdle is ensuring there is treatment not only available in the family's county but also that there's enough to serve the community's needs.

"Regardless of what county these addicts live in and where their children are removed from, the treatment needs to be in that county. ... We can't have them be on a waiting list," Dick said.

The waiting list is especially problematic in child welfare cases because children services agencies are required to eventually file for permanent removal so children aren't languishing in temporary families, Dick said.

"With drug addiction, especially with an addiction like opiates, recovery takes a lengthy period of time. So to have a six-month delay, they're already being set up (for failure)," Dick said.

Harrelson said she thinks Ohio also needs to create and implement structured training on how to manage child welfare cases involving drugs.

"We have been slow to react to the needs (in a standardized way) of our caseworker staff and supervisors and, therefore, of our families who suffer from addictions. ... If you don't understand what we're dealing with, then you don't know how to manage it," she said.

Although there is work to be done, Dick said he thinks Ohio is moving in the right direction.

"I think we have a governor who has been very aggressive in his approach with the opiate epidemic since his first days in office," Dick said, noting Gov. John Kasich's creation of a cabinet-level opiate action team. "I think we are getting some movement, the state as a whole, not just child welfare."

jison@gannett.com

Twitter: @JonaIson

By the numbers

•There were five mentions of heroin in child welfare cases per 1,000 families in Ohio in 2013, compared with two per 1,000 families in 2009.

•Seventy percent of children age 1 or younger in foster care have parents with an addiction to opiates and cocaine.

•Sixty to 80 percent of child abuse and neglect cases nationally involve a parent or guardian abusing drugs.

•Fifty percent of the children whose parents are using heroin or cocaine are in foster care nine months, compared with four months for those whose parents aren't battling addiction.

Source: September 2014 report, Public Children Services Association of Ohio

More online

For an interactive map showing the growth of heroin mentions across Ohio, go to ChillicotheGazette.com