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The Opioid Epidemic’s Toll On The Foster Care System

Jo Teague, substance abuse counselor for Wake County Human Services-Child Protective Services and founder of Alcohol and Drug Assessment Services in Raleigh, North Carolina, discusses the impact of the opioid crisis on the foster care system in North Carolina, and how we can help.

Jo Teague discusses the opioid crisis and the foster system

Family Policy Matters
Transcript: The Opioid Epidemic’s Toll On The Foster Care System

Thanks for joining us for Family Policy Matters. I’m Traci DeVette Griggs, Communications Director at NC Family, sitting in this week for John Rustin.

The opioid epidemic, sadly, continues to be front-page news. The CDC recently reported that more people are now dying from opioid overdose than from car accidents. The drug crisis is taking its toll on individuals, families and entire communities, but there is a segment of our population being hit especially hard and you may not have even heard about it. Children of parents battling drug addiction are flooding into the foster care system at such a high rate that the system is literally bursting at its seams.

Our guest today is Jo Teague, LCAS, SAP, a substance abuse counselor for Wake County Human Services’ Child Protective Services [and Foster Care], and founder of Alcohol and Drug Assessment Services in Raleigh, North Carolina.

Jo, we are pleased to have you with us today to discuss both the effect this crisis is having on families and children, as well as what on earth we can do to help.

JO TEAGUE: Thank you for having me Traci. I want to thank the North Carolina Family Policy Council for focusing on our most vulnerable population, which is children, particularly those in foster care who’ve been affected by their parents’ substance misuse.

TRACI GRIGGS: Would you start by giving us a little bit of perspective on the size and scope of North Carolina’s foster care system?: How many children are in it; for what are the primary reasons; and usually for how long? And, is it true that these numbers are increasing?

JO TEAGUE: Yes it is. I’m going to give you an example: In December of 2015, there were 11,000 children in foster care, from April 2016 to March 2017 there were 16,545, and the year prior to that was 16,266. They haven’t done 2018 yet, but that’s a considerable jump. Children are in foster care due to abuse, neglect, or dependency—which is abandonment—which affects their permanence, safety and wellbeing. More so, 65 to 80 percent of all child welfare cases involve substance abuse. Mental health issues, as well as domestic violence are also huge percentages, and a lot of our clients have all three.

TRACI GRIGGS: We’ve heard a lot in recent years about the opioid crisis. What impact is this specifically having on families here in North Carolina?

JO TEAGUE: The impact on the family includes the death of a family member, and a lot of them do not get grief counseling. The family members are separated from each other and that’s very traumatic for children and the latest research says that that kind of trauma can change their brain chemistry. The family members themselves suffer secondary trauma. There’s an increase in the dropout rates from schools, increase in involvement in the legal system, certainly an increase in healthcare costs, physical, mental, emotional, behavioral, societal issues, and those are just to name a few.

TRACI GRIGGS: So why do you think the opioid crisis is so much more pervasive in all parts of our society really, than previous drug problems that we’ve seen in the past?

JO TEAGUE: The increase in the opioid epidemic and why it has come to the forefront: I believe that one of the main reasons is the demographics has changed. The highest demographic is white males from age 25 to 34. There’s not access to enough healthcare in North Carolina, as well as the United States. The federal government and state government are putting money into the treatment part, recovery part, but is falling short, budgets tend to do that a times but at least we’ve got $10 million additional to work with. Four to five people are dying every day in North Carolina.

TRACI GRIGGS: From your perspective as a substance abuse counselor, what unique risks does drug abuse pose to the children of users? And, are we going to continue to see some societal effects from having so many children in foster care at some point in their lives?

JO TEAGUE: Yes. Some of the unique risks due to drug use of the parents or caretakers: One of the acronyms that is used is ACE, which stands for adverse childhood experiences. There can be an increased risk of physical or sexual abuse or neglect, such as they don’t have enough food, they’re at risk of being homeless, of getting sick, they’re not getting medical attention, they have poor social relationships. And there are other issues such as improper supervision—they’re left alone like latchkey kids, and improper discipline and exposure to domestic violence. They are more likely to experience poor physical and mental health and negative social consequences later in life. There’s a greater risk of those children using drugs or alcohol, dropping out of school or joining gangs. If the child is told, “I love you” but at the same time told, “Don’t bother me,” as an adult, he or she may be attracted to relationships where they are rejected because that’s all they know. If a child is told, “I’ll be there for you,” and not show up, the child learns to not to want or expect things. They deny their needs because they don’t want to be disappointed, hence they don’t depend on others. If they’re told to tell the truth as long as it’s something the parent wants to hear, truth becomes an ideal and lying becomes reality. In adult life, the child lies automatically without guilt even when the truth would be easier. If the child is told, “Everything is fine” or “It’ll be alright,” but the family atmosphere is one of hopelessness with pressure and anxiety, they see everything is not all right. As an adult, they can suffer from distortion in their perception of reality. They feel powerless over their life, they’re often depressed and they distrust their own judgment. If the parent behaves in a negative or irresponsible way, like embarrassing the child in front of their friends by drunken or erratic behavior, the child is told, “Don’t get mad. It wasn’t their fault. They were drunk.” So the child learns, “Well, if I’m drunk or high I can do whatever I want.” There’s a great book that I recommend to all of my parents called, It Will Never Happen to Meby Claudia Black, and it discusses the roles that different family members play, particularly the children. They are told, ” Don’t talk to anybody,” “Don’t trust anyone,” and “Your feelings don’t count.” They take on roles just to survive and they did not ask for these roles. A child can play the role of a hero child and try to do things perfectly. They’re more likely to marry an abuser. The “scapegoat” child gets blamed for everything. They’re more likely to join gangs, drop out of school. The “lost” child, that’s who isolates from their family and others. In other words, they’re going to play video games in their room because they do not want to be around drama. As an adult, the lost child, at times, has a very high risk of being suicidal or homicidal. The “clown” child tries to make everybody laugh, but everything’s not funny. As an adult, they become irresponsible or dependent on others, in other words, they don’t grow up. Or the child might play the parent’s role. So the term that we use is, they’ve been “parentified.” They don’t know what being a child is like.

As far as the effect of being in foster care has on the children, both good and bad, it’s traumatic for children to be removed from their homes. They often experience a myriad of challenges, emotions and behaviors, such as: depression, anxiety, they feel guilty, they have a lot of fear, there can be bedwetting, confusion, they might run away, they have nightmares, feelings of hopelessness, some become very aggressive in the new home, they have attachment issues. On the good side, when a child goes into foster care, it’s encouraging to hear from the social workers that the child is beginning to thrive in their new environment. The child can be a child, be loved, be taken care of, not walking on eggshells, their grades come up significantly, their health gets better, behavior problems remedy themselves. So they’re fed, they’re clothed, they feel loved and safe, they have a permanent living environment. Foster parents can help build a child’s resilience by setting realistic and fair rules, routines, and experiencing celebrations and participating in traditions. And all of these things build resilience. Many children do not suffer some of the things that I’ve talked about, somehow on their own, they develop some resilience, but most of them have to be taught and encouraged to have resilience.

TRACI GRIGGS: What about policy recommendations? What do you think we could be doing that have become necessary because of the growing number of North Carolina families being torn apart by drug abuse?

JO TEAGUE: There are policies and programs and community resources and I’m going to list just a few. I feel that North Carolina’s becoming very progressive. We have a great Attorney General, Josh Stein, who has really been on board as far as enforcing one of the new acts called the STOP Act, which stands for Strengthening Opioid Use Prevention. He’s getting it from that end, as well as Mandy Cohen is the director of Department of Health and Human Resources for the State. Both of them have been to several workshops that I’ve been to on the opioid crisis. As far as other things that can be done: A person needs to ask themselves, whether it’s in politics, states, federal, other laymen, “What can I do?” “What can I give or receive?” “How can I work with others?” “How can I transform the community?” If we want something we have to go get it. At some our workshops, they’ve had testimonies from parents or loved ones who have lost a child—whether it be a child less than 18, or whether it’s been an adult child—and it has devastated them and they’ve become very strong advocates for helping other family members. It’s important for the community coalitions—there’s a specific opioid coalition in Raleigh itself. All of these things are developing 3-5 year plans, 5-10 year plans, based on reality. It’s important to get people around that have similar views. One of the main things that has been mentioned by Josh Stein and others is: this is a public health issue, this is a brain disorder, this is a chemical imbalance in the brain. It is not a character issue, it is a brain disease. We believe that all of the people involved in these programs and policies and community support, they need to get educated about the devastation of this disease, but they also need to learn the necessary skills in order to help their community and their loved ones.

TRACI GRIGGS: A lot of what you’ve discussed so far has to do with the foster care system, and how overburdened it is. I’m going to give you a chance to give us some advice for people who might hear this and be brokenhearted by what they’ve just heard, and they might want to get into the foster care system. What would you recommend to them?

JO TEAGUE: Yes. I always tell my family members, I want the adults to go to either Al-Anon or Nar-Anon. Those are the support groups for them that help them with their emotional health, physical health, mental health, they work their program and we let the person with the drug use problem work their program. The Alakids program is for kids aged 8-12. The Alateen program is for kids that are 13-16 years old, so they’re getting their support too. There are other community supports, any of the recovery meetings. There’s also Bible-based recovery meetings called Celebrate Recovery, Reformer’s Unanimous. There are behavior support groups that are very helpful. In North Carolina, we have something called “Recovering Communities.” They’re on Capital Boulevard. They also have meetings for family members. All of the things that I have mentioned are free, and all of them are about an hour. Also, foster care people, certainly they can be couples, but individuals can be foster parents as well.

TRACI GRIGGS: Thank you, Jo Teague, for your work to help North Carolina families affected by this horrible opioid crisis and thank you for joining us on Family Policy Matters!

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