Decades of research has demonstrated that treatment works for addiction disorders and substance abuse patients.
> > Studies of publicly supported treatment programs show a savings of $7 or more in other societal costs
for each dollar invested in treatment.1
> > Studies indicate drug treatment reduces use by 40-60% and significantly lowers criminal activity.
> > Counseling and other behavioral therapies are critical components of virtually all effective treatments for
addiction. For certain types of disorders, medications are an important element of treatment, especially
when combined with counseling and other behavioral therapies.2
> > A parent must be matched to the appropriate treatment program in terms of intensity, duration, and
treatment content. In addition to treating the addiction, for recovery to occur, the child welfare and
alcohol and drug services partnership must identify and treat othe r co-occurring psychological, physical,
and social problems.3
Community-based partnership is key when treating addictions disorders and substance abuse victims.
> > Most states identify substance use as one of the top two factors in child abuse and neglect.4
> > Studies suggest that 40-80% of children in the child welfare system have been affected by child abuse
or neglect because of a parents' addiction to drugs or alcohol.5
> > It is important for child welfare workers to recognize when alcohol or drug use is a factor in the case of
child abuse or neglect; to help parents obtain appropriate treatment; and to understand the concept of
recovery in the context of child safety.6
> > To help accomplish permanency for children, child welfare workers should partner with local alcohol
and drug addiction treatment professionals and programs. An effective partnership between the child
welfare and the alcohol and drug treatment systems can help parents with substance use disorders
retain or regain a parental role with their child, while not putting the child at risk of harm. Thus, the child
welfare-alcohol and drug services partnership becomes a cornerstone for long-term child protection, a key issue for child welfare workers.7
Co-occurring Disorders are Prevalent
> > The co-occurrence of substance abuse and substance dependence with mental illness is estimated
to affect between seven and 10 million adults each year. Child welfare workers should be aware of the
prevalence and complexity of co-occurring substance abuse and dependence and mental illness and
identify providers who are experienced working with both illnesses.8
> > Individuals with coexisting substance use and mental health disorders should have both disorders treated
in an integrated way.9
Gender-specific considerations are important in the treatment of addictions disorders and the recovery of substance abuse patients.
Research studies have begun to identify gender-specific components and issues to address in treatment. Research indicates that women are more likely to complete treatment in women-only programs and that women have different needs than men in treatment (such as dealing with a history of victimization). A high percentage of women who access addiction treatment have experienced physical or sexual abuse in childhood. Many have a history of family dysfunction or addiction. In addition, women who use substances may have experienced physical or sexual victimization as adults
(e.g., domestic violence).10
Shared planning and service delivery lead to practices that better meet the needs of children and
Families.
Through collaboration, multiple agencies working with the same family can reduce confusion and fragmentation for the family members and improve coordination of services. Collaboration with local treatment programs can provide the expertise that is needed for a family in the child welfare system.
If the protective services on-site investigation and screening of parents suggest that alcohol or drug use is a factor in the abuse or neglect, al cohol and drug addiction treatment providers are needed to:
> > Conduct a substance abuse assessment or evaluation;
> > Help identify the level and type of treatment program that is needed;
> > Provide treatment and aftercare services; and,
> > Participate in case management and monitoring.
In addition, alcohol and drug treatment agencies may be able to provide crisis intervention, trauma-related services, or other services needed by the parent.11
References
1. The National Center on Addiction and Substance Abuse (CASA) at Columbia University (2001). Shoveling Up: The Impact of Substance Abuse on State Budgets http://www.casacolumbia.org.
2. NIDA InfoFacts: Treatment Approaches for Drug Addiction, http://www.drugabuse.gov/Infofacts/treatmeth.html
3. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers, Available online at: http://www.ncsacw.samhsa.gov/ files/UnderstandingSAGuide.pdf
4. Id.
5. "Safe and Sound: Models for Collaboration Between Child Welfare and Addiction Treatment Services." Arthur Liman Policy Institute of the Legal Action Center. http://www.ncsacw.samhsa.gov/files/SafeSoundReport.pdf. 2003
6. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers, Available online at: http://www.ncsacw.samhsa.gov/files/ Understanding-SAGuide.pdf
7. Id.
8. U. S. Department of Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Substance Abuse and Mental Health Services Administration, Center
for Mental Health Services, National Institutes of Health, National Institute of Mental Health. U.S. Department of Health and Human Services (2002). Report to Congress on
the Prevention and Treatment of Co-Occurring Substance Abuse Disorder and Mental Disorders. Substance Abuse and Mental Health Services Administration. Young, N.K.
and Gardner, S.L. (2002). Navigating the Pathways: Lessons and Promising Practices in Linking Alcohol and Drug Services With Child Welfare. SAMHSA Publication No.
SMA-02-3639. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, p. 132.
9. NIDA InfoFacts: Treatment Approaches for Drug Addiction, http://www.drugabuse.gov/Infofacts/treatmeth.html
10. Understanding Substance Abuse and Facilitating Recovery: A Guide for Child Welfare Workers, Available online at: http://www.ncsacw.samhsa.gov/files/UnderstandingSAGuide.pdf
11. Id.
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