Anne Bissell knows firsthand the ravages of heroin. An addict for 18 years, she was unable to take proper care of her children. When her son was young, she often was passed out at home. Later she was homeless on the streets of Tucson, Arizona.
Eventually all three of her children were removed from her care.
Today, her experience is playing out nationwide as a surge of heroin use sweeps across the country — and corresponds with a surge of kids into the foster care system. Judges, caseworkers and child welfare administrators say the two are linked.
The number of children in foster care in the United States rose from 397,774 in 2012 to 415,129 in 2014, according to the federal Administration for Children and Families, reversing a seven-year downward trend.
Heroin use in the United States has also increased dramatically. In the past 10 years it has more than doubled among young people ages 18 to 25, according to the Centers for Disease Control and Prevention.
"The number of parents who are using heroin has skyrocketed,” said Judge Paula Sherlock, chief judge of the Jefferson Circuit Court in Louisville, Kentucky. Sherlock presides over family court, hearing two to four cases of child neglect or abuse each day.
“This is my 11th year on the bench,” she said. In the first eight years, Sherlock barely heard the word “heroin” when she presided over child welfare cases.
About three years ago it began to turn up as an issue.
“It has become a torrent,” she said.
The figures linking heroin to the rise of children in foster care are “not as clear as we would like,” said Nancy Young, director of the National Center on Substance Abuse and Child Welfare, a federally funded agency. States handle data very differently, she said, and federal reporting requirements for child removal cases don’t specify the types of drugs involved.
“But anecdotally, that’s what we are hearing,” Young said.
Alarm raised in states
Child advocates in Kentucky are alarmed by the surge, according to the Louisville Courier-Journal. The number of kids in Kentucky foster care is at an all-time high — 8,208, up from 7,000 five years ago, the newspaper reported in June.
The Vermont Department of Children and Families also reported that children were entering foster care in unprecedented numbers. Cases of abuse or neglect rose from 713 in 2012 to 992 in 2014, according to the 2014 Child Protection Report in Vermont
“This is primarily being driven by parental heroin use, which is causing children to be at risk in their own homes,” wrote Cindy Walcott, Vermont’s deputy commissioner for family services, in the report.
And in Ohio, 15 percent of child welfare cases in 2009 involved parents abusing heroin, cocaine or both. The figure rose to 25 percent in 2013, according to the Public Children Services Association of Ohio. A full 70 percent of cases of children age 1 or younger involved parental use of opiates or cocaine.
Sherlock, the Kentucky judge, said heroin is ravaging families. She sees addicted parents who don’t send their kids to school. Houses become filthy. “They don’t have food in the refrigerator,” she said. They may disappear for a while with the children.
“Kids can’t stay in those homes,” she said.
In previous years, she saw a lot of substance abuse involving alcohol and prescription painkillers.
“We were pretty successful in getting those people into treatment,” she said. But heroin addicts are less likely to go into treatment and be successful there.
Trouble with treatment
Anne Bissell tried treatment several times, but she fell back into the drug each time. She entered a short program that didn’t work for her. It wasn’t long enough, she said.
After 18 years of using, “you can’t turn it around in 30 days,” she said.
She had a chance to enter a “sober living house,” but only if she entered it free of heroin. At that point she had been out of treatment for a month. “I was not going to be clean,” she said.
Sometimes the requirements of programs work against people who are seeking treatment, and sometimes the circumstances of addiction aren’t understood.
For example, Bissell got arrested and told her lawyer she needed help with drugs. He asked if she could wait a couple of months. Addicts can’t wait, she said later.
To curb addiction, a number of issues need to be addressed. Addicts may be homeless, engaging in prostitution and their kids may have been taken away.
“Part of it for me was being in a domestic violence relationship,” Bissell said. When her daughter was removed by child protective services, the court required her to stay away from her daughter’s father, who was battering her. But she couldn’t do it, she said.
“People get back into dysfunctional relationships,” she said.
Only about 10 percent of the population that needs treatment for drug abuse gets it, Young said.
And the treatment that exists is not necessarily the kind of treatment needed by families who have had children removed.
“When are we going to provide the services needed by families?” she asked.
They need, for example, a focus on parenting in the early stages of recovery.
She strongly advocates a team approach, involving child welfare agencies, courts and drug treatment facilities.
Bissell’s family had the money to pay for the long-term treatment she needed. In 2006, Bissell entered a residential program at the Amity Foundation and was able to stick with it. She began to rebuild relationships with her two older children.
Well into her recovery, she got an internship with the foundation and went back to college for a master’s degree in social work. Today she works with homeless veterans at the Southern Arizona Veterans Affairs Healthcare System.
Her son, now 21, grew up in the custody of his father. Her middle child, 12, was cared for by her mother from the age of 18 months.
“My mom ended up adopting her,” she said. Now that Bissell has turned her life around, she and her mother work together as co-parents.
She and her two older children are now close. She has made a point of being open and honest with them about the past.
But she doesn’t know where her third baby, a girl, lives. The child was taken by child protective services and adopted.
“I say a little prayer for her every day … she’s on my mind every day.”