Substance Abuse and Child Welfare: Clear Linkages and Promising Responses
Semidei, Joseph, Radel, Laura Feig, Nolan, Catherine, Child Welfare
Parental substance abuse is a significant factor in many of the families served in the child welfare system. This article examines: (1) the prevalence of substance abuse among families involved with the child welfare system; (2) the impact of substance abuse on child welfare practice; (3) how both the Adoption and Safe Families Act of 1997 and welfare reform legislation intensify the need to address parental substance abuse effectively; and (4) promising strategies for addressing these families' needs.
Children need safety and stability in their lives. They need nurturing parents who meet their needs consistently When parents abuse alcohol or illicit drugs, their ability to provide appropriate care to their children may be impaired. Addiction to alcohol or other drugs undermines the user's judgment and priorities in ways that may result in child abuse or neglect. One of the few prospective studies of children of substance abusers (in this case alcoholics and opiate addicts) found that nearly all suffered some level of neglect, and one-third of children whose parents abused each substance suffered serious neglect [Black & Mayer 1980]. Somewhat fewer parents abused their children (27% of alcoholic parents and 19% of opiate addicted parents) although these figures were also quite high. For comparison, the most recent National Incidence Study of Child Abuse and Neglect [U.S. Department of Health and Human Services 1996] estimated that 1.1% of children nationally suffered abuse in 1993 and 1.3% suffered neglect.
Many studies and reports have recognized that substance abuse is a critical factor in the families involved with the child welfare system [Child Welfare League of America National Commission on Chemical Dependency 1992; Young et al. 1998; U.S. Department of Health and Human Services (HHS) 1999]. Fewer have articulated the implications of substance abuse for child welfare policy and practice or for the courts that make custody and permanency decisions. The need is clear: child welfare agencies and juvenile dependency courts must have specific strategies to identify and address clients' substance abuse if they are to achieve positive outcomes for children and families. Although children may not be taken into care or may be returned home with an expectation of at least minimal safety, unless the parent has been engaged in a treatment program or is otherwise moving into recovery, the child's prognosis for long-term emotional, social, and physical well-being is poor. Children growing up in households with a substance-abusing parent demonstrate more adjustment problems, behavioral, conduct and attention-deficit disorders than other children and generally function less well on many measures of behavioral and emotional functioning [Johnson & Leff 1999]. This is not to say that the child welfare agency must be responsible for all aspects of family well-being. Clearly other community agencies must be engaged to assist in assuring that children and families have opportunities to be safe and healthy. Children who have come to a child welfare agency's attention once through an abuse or neglect report are likely to do so again (and even if they do not, may still be at significant risk) unless a parent's substance abuse is addressed [Berrick et al. 1997; Lighthouse Institute 1988].
Prevalence of Substance Abuse Among Child Welfare Clients
Few studies have specifically addressed how many child welfare clients have substance abuse problems. Child welfare agencies typically count how many children come to their attention because of abuse, neglect, or other types of maltreatment. Until recently, substance abuse was captured by child welfare information systems only if the community had a specific reporting category for drug-exposed infants. In recent years, states have been reporting to the federal Adoption and Foster Care Analysis and Reporting System (AFCARS) whether, for each child in outof-home care during the reporting period, parental alcohol or illicit drug abuse was a factor in the child's placement. …