Follow The Enquirer’s four-part series on heroin at cincinnati.com
Sheila McLaughlin reports:
Patti Jacobs first saw it on Christmas Eve 2007.
She was called into the office at Warren County Children Services, where a handful of crying small children had been taken away from their parents, who had been busted for heroin trafficking.
“I was like, ‘Heroin? What the hell? Are we back in the ’60s? What is going on?’” recalled Jacobs, who is now director of the agency where she’s worked for 24 years.
That marked the beginning of a surge of heroin-related cases at Warren County Children Services.
“And it’s gone downhill ever since. We are just inundated with these children. It’s horrific,” Jacobs said.
In Warren County – a primarily white, upscale area – only 6 percent of the cases in 2008 referred for ongoing services were related to heroin abuse. In 2011, that figure jumped to 73 percent.
That’s 106 cases involving 170 children.
Other counties in Greater Cincinnati are experiencing the same increase in their child protection systems.
• Thirty-three percent of Clermont County kids being removed from their parents are because of opiate abuse; 90 percent of opiate abuse is heroin.
• Half of the cases Hamilton County Children Services sees are heroin-related.
• The number of children being removed from their homes in Butler County because of heroin abuse doubled since 2010. In 2010, 25 percent of the children removed from their home because of parental substance abuse specifically involved heroin. In 2012, that figure jumped to 52 percent. Overall, since 2010, Butler County Children Services has experienced a 30 percent increase in the number of families receiving services due to any kind of substance abuse.
• Jim Grace, assistant director of the Kentucky Division of Protection and Permanency, said substance abuse accounts for half of all child protection investigations in the state: “We’ve seen a steady rise overall in all types of drugs through the years. But we really haven’t seen a specific rise in heroin.”
Jerome Kearns, who oversees Butler County Children Services, said the threat to children is significant.
According to the National Center on Addiction and Substance Abuse at Columbia University, children whose parents abuse alcohol and other drugs are four times more likely to be neglected and three times likelier to be sexually or physically assaulted.
Local child welfare officials say a majority of cases involve removal at birth, because the mother has been using heroin during pregnancy. They are expecting an even greater increase when hospitals in the region begin drug testing mothers, with their consent, who arrive to give birth.
Some hospitals are already taking that step, said Brenda Yablonsky, a spokeswoman for the Greater Cincinnati Hospital Council. The idea is to identify the problem and provide treatment before the baby leaves the hospital so it does not go through withdrawal at home without medical care.
It’s also aimed at keeping the children safe, Yablonsky said. Infants going through withdrawal are difficult to care for. They typically are irritable and difficult to console. That can lead to abuse by caregivers, she said.
“They are born (testing) positive. They are born going through withdrawal symptoms,” said Tim Dick, deputy director of Clermont County Children Services. Newborns always cry, but these babies’ cries are different, Dick said. “These kids come out crying because they need their next fix.” The babies are put on a methadone drip, depending on how much the mother has been using.
“They can’t just not give these kids something. They will die. They can’t just quit cold turkey,” Dick said.
In 2009, 11 of every 1,000 births were drug-exposed, according to seven local hospitals that participate in the Perinatal Institute Neonatal Abstinence Program (NAS).
That figure more that tripled by Sept. 30, 2012, when 36 of every 1,000 infants born were drug-exposed. Hospitals involved in the NAS program are University of Cincinnati Medical Center, Christ, Good Samaritan, Bethesda North, Mercy Anderson, Mercy Fairfield and Fort Hamilton.
Nationally, the average length of stay for an infant born drug-exposed, known as Neonatal Abstinence Syndrome, is 16.4 days. The cost is $53,400. The overall average is is 3.3 days and $9,500.
The heroin epidemic is pushing the limits of some child welfare agencies.
Kids are staying in the system longer, putting a strain on agencies that typically can’t find enough foster homes to take children in. Jacobs said that’s happening in Warren County.
Social workers usually first try to place the children with relatives – maybe a grandmother or an aunt – instead of sending them to foster care. But that’s not always possible, Jacobs said.
“We’ve had a couple of cases in the last couple of years where Grandma is using heroin. It’s an inter-generational thing. You just don’t know what to do with these folks,” she said.
More children also are being permanently committed to the child welfare system because the drug is so addictive, said Moira Weir, director of Hamilton County Job and Family Services.
By law, children’s service agencies have two years to reunite children with their families – or place them for adoption.
“Their parents just can’t get clean in the time frame that’s required, and there’s nobody able to care for them,” Weir said. “Relapse is a big part of it. It’s a hard drug for recovery.”
Drug treatment is part of the process for parents to get their children back. They are subjected to random drug screens to make sure they are staying clean.
That sometimes presents a dangerous situation when the parents see their children on supervised visitation, Jacobs said.
The users detox themselves in case they are drug-tested. It’s a new trend in Warren County, she said.
“They are coming to the visits and it’s ugly. They are out of their minds. They are vomiting. They are shaky and dangerous when they get to their visit with their kids,” Jacobs said.