“Opioid orphans”: Foster care systems in US buckle under weight of drug epidemic

By Naomi Spencer
29 December 2016

Social services and foster care programs across the United States are overwhelmed by the influx of children from families shattered by the opioid epidemic. In West Virginia, Kentucky, Ohio, and other states, thousands of children have been orphaned and placed into foster care or living arrangements with relatives who struggle to make ends meet with inadequate compensation.

In West Virginia, 5,182 children were in foster care this year, a 13 percent increase over 2015 and 24 percent higher than 2012. Substance abuse has been cited as a factor in 80 percent of cases where children were removed from their homes between 2011 and 2015, according to the state Department of Health and Human Resources. Cuts to social safety net programs have compounded the difficulty of caring for these children with fewer resources and staff.

Ohio confronts a similar problem, with a 19 percent rise in the number of children removed from parental custody since 2010. “Honestly, if something doesn’t happen with this addiction crisis, we can lose a generation of kids,” Robin Reese, executive director of Lucas County Children Services, told the Wall Street Journal in an article published December 15. “God knows I would hate to see orphanages come back, but the child-protection system is being inundated now.” In Lucas County, which includes the industrial city of Toledo, billboards advertise the need for new foster parents to try to meet a 20 percent increase in the number of children removed from parental custody.

Kentucky has the highest rate of children placed into the “kinship care” of grandparents or other relatives in the country. Statewide, 7 percent of children—70,000 kids—are living with neither parent. Kentucky also has the highest rate of child homelessness in the US. Drug overdoses are a prime factor in this social crisis. In eastern Kentucky, like in West Virginia, where the coal industry was once the foundation of the economic life of communities, drug addiction has soared. In Harlan County, once a major coal-mining center, 26 percent of children are reported as homeless.

Deaths from drug overdoses have spiraled upwards in recent years, surpassing gun homicides and contributing to a decline in life expectancy in the US. Most of the drug overdoses are due to opioids like prescription painkillers and heroin. In the past year, drugs like fentanyl, an opioid at least 50 times stronger than morphine, and carfentanil, an elephant tranquilizer thousands of times stronger than morphine, have circulated into the heroin market and contributed to a sharp increase in overdoses and deaths. The number of babies born suffering from drug withdrawal, a condition called neonatal abstinence syndrome, is also on the rise.

When parents die of drug overdoses or are arrested and jailed, children are placed into the custody of the state or with relatives. Many grandparents and even great-grandparents must assume responsibility for caring for young children, creating financial and sometimes health hardships on them.

“They never expected to be raising their grandchildren, but are thrilled to have them in their home,” explains a West Virginia caseworker in an appeal for charitable donations to a struggling elderly couple in a Charleston Gazette-Mail piece November 26. Their grandchildren are ages two and four and their grandparents were unable to afford winter coats for them. “They have struggled greatly at the loss of their son and his wife and cannot understand the circumstances surrounding their deaths. They only want what is best for their granddaughters and they want to give them a good start in life.”

One private non-profit child welfare organization, the Children’s Home Society of West Virginia, reports that it has provided emergency shelter to more than 14,600 children in the last year at its 13 locations across the state. On any given night, according to Chris Freeman, the society’s director of communications, the shelters are near or at capacity, with an average of 100 children at the shelters.

Many children suffer serious emotional trauma at the loss of their parents. They may have witnessed overdoses or discovered their deceased mothers and fathers. Often they have been living in poor conditions, including homelessness, with spotty school attendance, or experienced malnutrition, abuse and neglect. They frequently have symptoms of post-traumatic stress disorder, or develop learning and behavioral problems.

While they need urgent care, children with mental distress face a waiting list of two months or more even in metropolitan regions. Those in rural areas have little to no resources beyond their families.

In the absence of adequate social services and counseling, these children are vulnerable to slipping into truancy, homelessness, or drug addiction themselves. The response of the state, as it has responded to the drug epidemic and the collapse of the economy, has been to resort to a law-and-order crackdown and prisons.

West Virginia incarcerates rising numbers of young people, mostly for low-level offenses that would not be considered crimes if perpetrated by an adult. “In the last 16 years, youth confinement has declined in almost every state except West Virginia, where the confinement rate has grown by almost 50 percent,” noted Kim White, a member of the Mental Health Matters organization and assistant professor of social work at Marshall University.