Guest Opinion Essay

A Case Study in Misleading Legislators, Everyone Else About Child Welfare & Opioids

richard wexlerWant to see how to pull the wool over the eyes of state lawmakers? Check out the testimony at a legislative hearing in Florida on child welfare and the opioid epidemic.

The problem of drug abuse, like the problem of child abuse, is serious and real. But when the hysteria over one meets the hysteria over the other the result is catastrophic for children: a surge in needless foster care. That surge affects children where drug abuse really is a problem — and where it isn’t. The latest “drug plague” becomes the all-purpose excuse to take the child and run.

That brings me to a hearing of a Florida House of Representatives subcommittee. On display was every tactic in the child welfare establishment arsenal for misdirection. Consider this paragraph in a story about the hearing from the News Service of Florida:

“It’s very difficult when you see a baby in the NICU [neonatal intensive care unit], screaming and crying because they didn’t have a choice to be born addicted,” Faye Johnson, CEO of the Northeast Florida Healthy Start Coalition, told the House Children, Families and Elder Affairs Subcommittee. “It’s just very difficult to hear that high-pitched scream and to know that we’re doing everything we can and to also know that this is not the end. … There are years of trauma that come behind this.”

Now, let’s unpack the claims in this paragraph:

“… they didn’t have a choice to be born addicted …”

Of course infants have no choice. But the real purpose of stating the obvious is to imply that, unlike the children, their mothers did have a choice — that they supposedly “chose” addiction over their own children.

No one ever says a parent “chose cancer over her children,” yet even as we pay lip service to the reality that addiction is a disease, we portray any mother who succumbs as someone so inhuman that they just up and decided one day: “Who cares about the kids? I think I’ll become a drug addict.”

But by taking that swing at “bad mothers” the blow lands on the children.

The parent punishment system in action

That is clear when you look at the rest of that paragraph. The very fact that the baby is in the NICU means Florida is not “doing everything we can …” On the contrary, Florida is systematically making the problem worse. That’s because the worst place for an infant born with opioids in his system is a bright, noisy NICU. As The New York Times explained:

“a growing body of evidence suggests that what these babies need is what has been taken away: a mother. Separating newborns in withdrawal can slow the infants’ recovery, studies show, and undermine an already fragile parenting relationship. When mothers are close at hand, infants in withdrawal require less medication and fewer costly days in intensive care.

“‘Mom is a powerful treatment,’ said Dr. Matthew Grossman, a pediatric hospitalist at Yale-New Haven Children’s Hospital who has studied the care of opioid-dependent babies.”

So why isn’t Florida doing that? Because the “child protection” system is not about protecting children. It’s about punishing parents. The instinct to hate the mothers overwhelms the science about what is best for their children.

New ‘drug plague,’ same old myths

And finally, we’re told “this is not the end. … There are years of trauma that come behind this.”

That is a throwback to the kind of mythology that fueled child welfare’s botched response to an earlier drug plague.

Remember “crack babies”? Back in the 1980s, they were the infants supposedly doomed to a life of “certain suffering, of probable deviance, of permanent inferiority.” The predictions were accompanied by graphic depictions of infants going through withdrawal, and condemnation of their mothers for “choosing” addiction over their children.

None of the dire predictions came true. By 2004, Columbia Journalism Review was, in effect, urging reporters to please knock it off. A few years later, The New York Times ran a story headlined “Crack Babies: The Epidemic That Wasn’t.” Years after that, the Times returned to that theme in a short documentary. And when W. Joseph Campbell wrote a book called “Getting It Wrong: Debunking the Greatest Myths in American Journalism,” he devoted an entire chapter to “The Fantasy Panic: The News Media and the ‘Crack Baby’ Myth.”

Not only were the predictions untrue, researchers from the University of Florida found something that was demonstrably worse for infants than crack cocaine: foster care.

The researchers studied two groups of children born with cocaine in their systems; one group was placed in foster care, another left with birth mothers able to care for them. After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out. Typically, the children left with their birth mothers did better. For the foster children, the separation from their mothers was more toxic than the cocaine.

One of the authors of that study, Dr. Marylou Behnke, was among 50 experts on substance abuse who signed this open letter begging policymakers — and journalists — not to make the same mistakes concerning opioids.

But crying “drug plague” is a wonderful way to cover up long-standing systemic failings.

We saw that in Arkansas, where independent consultants found that the state was blaming drug abuse for a surge in foster care entries when the real cause was needless removal of children. In Ohio, which story after story calls the epicenter of the opioid epidemic, two counties have reduced foster care by embracing safe, proven alternatives.

Child welfare agencies should be responding to the opioid epidemic two ways:

  • Where opioid abuse really is a problem, make high-quality drug treatment, not foster care, the first-choice response. That’s the approach Connecticut is taking.
  • Take another look at all those other cases that don’t involve drug addiction — such as the ones in which poverty is confused with “neglect” and stop taking away children in those cases.

Why Florida is failing

The data suggest Florida is doing neither. Entries into foster care skyrocketed in 1999, long before the opioid epidemic. Child safety improved from 2007 through 2011 when first Bob Butterworth and then George Sheldon ran the Florida Department of Children and Families and emphasized reducing needless foster care. But those gains were wiped out starting in 2014, not because of opioids but because of grossly misleading news coverage of child abuse deaths that set off a foster care panic.

And so in Florida we see cases such as this, in which a newborn was taken from a mother solely because the mother was poor — only to die less than three months later in foster care, apparently a result of a tragic accident.

That tragedy was due to the real addiction problem in child welfare — the system’s addiction to foster care.

Richard Wexler is executive director of the National Coalition for Child Protection Reform.

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