Trauma, Opiates and Child Welfare: How Family-Serving Agencies Can Do Better

By all outward appearances, I grew up in a normal American family. My parents had respectable jobs in construction and nursing, a four-bedroom home, family dog and a playhouse my father built from the ground up. My sister and I participated in cheerleading and orchestra, and earned straight As in school.

But my parents struggled with untreated mental health issues — my mother likely had PTSD, while my father struggled with depression. After both my paternal grandparents died (in 1999 and 2003), my parents’ attempts to self-medicate with heroin started to overrule their lives.

That’s a story that millions of families in the U.S. can relate to. Last month, President Donald Trump declared the opioid epidemic a national emergency. Overdoses kill 142 Americans a day, according to a recent report.

Nico’Lee Rohac

But another result of the current opioid epidemic is that the number of children entering foster care due to parental substance abuse has risen sharply in recent years. Therefore, it is more crucial than ever that child welfare systems focus on keeping families together to prevent unnecessary entry into foster care.

My story in foster care began one winter morning during a placement hearing for my sister’s juvenile justice involvement. I was in the courtroom as my sister accused my parents of being drug addicts. The judge’s solution was to order random drug screenings, and if my parents tested positive for substances or failed to show for the screenings, I would be removed from their care.

On the day of their first scheduled drug test, my parents were arrested for falsifying vehicle inspection stickers on our old pick-up truck. As a result, my parents failed to appear for the drug test. Unaware my parents had been arrested, my caseworker placed me in a group home, followed by a kinship placement, another group home and then a second final kinship placement — where I stayed until college before aging out at age 21.

After I was taken, my parents’ ability to function severely deteriorated. They lost their jobs and their driver’s licenses. They weren’t allowed to be in a room with me unsupervised, despite my age (I was already 14 years old at that point) and although they had never laid a hand on me.

The system mandated my parents attend a drug and alcohol treatment program but didn’t account for their co-morbid mental health needs or their lack of transportation. (Our home wasn’t easily accessible via a bus line, hence the need to falsify our registration stickers.)

When my mom or dad did attend inpatient rehab, the caseworkers didn’t indicate that as progress. As a result, our visits didn’t increase, and I wasn’t reunified. At the time, I remember my mom said, “They’re railroading me at every court hearing; why don’t the good things I did before count for anything?” It wasn’t until much later that I understood what she meant.

There’s a common misconception that because parents don’t jump through every hoop in the drug rehab process, they don’t love their kids, or that they’re not trying. That’s far from true. Sometimes the obstacles are stacked too high, and when mental health needs aren’t being addressed, those obstacles become even harder to overcome.

My mom and dad were great parents, and I miss them dearly. They raised me properly for 14 years and instilled within me the values of education, compassion and love. They are the reason I knew I wanted to attend college from a young age. They were part of the reason why I graduated third in my high school class, completed my bachelor’s degree with cum laude honors and earned my master’s degree in social work with a 3.9 cumulative GPA.

Yes, my parents were drug addicts. But they also provided a solid and healthy foundation for me, from which I have grown to achieve great things.

As I reflect back now as an adult and a therapist, I realize that the child welfare system only saw my family as the sum of our worst, most broken parts. They didn’t see the love and commitment. They didn’t consider my parents’ years of stability or the stressors that helped lead to drug use when devising a course of action. They didn’t acknowledge that I was doing well when I lived with my birth parents. After entering care, I got the first C grade of my life and cried all the time.

The system only acknowledged the allegations of drug abuse, and removing me was their first solution. There were no mental health or drug and alcohol assessments prior to my first day in foster care.

Current child welfare frameworks do not assess for these needs prior to removal. Further, child welfare agencies are currently unable to provide intensive interventions prior to a child being formally removed from the birth parents’ care.

The child welfare system absolutely must catch up with current knowledge about mental health and substance abuse in order to actually help families and children in crisis. For example, as the adverse childhood experiences study and other research has shown, there’s a clear link between mental health disorders and drug and alcohol abuse as a result of childhood trauma.

One way child welfare systems can change is to adapt their child and family assessments to gauge for these mental health and substance abuse needs. Moreover, child welfare systems must have access to the necessary funding to be able to provide these services.

By the time child welfare becomes involved with parents dealing with substance abuse, they may have lost their jobs or sources of income. Consequently, they are unable to access mental health or substance abuse treatment without medical assistance or funding from the child welfare agency.

Ensuring funding and therefore access to these services not only saves money, but it will save lives. While I was still in care, my mom died from drug-related issues. Six years later, my father also died of his addiction.

With the correct substance abuse and mental health treatment, maybe my parents would be alive today. With better support for them, maybe I wouldn’t have spent 2,555 days in foster care. The research is out there to do better, and now is the time for the child welfare system to change.

Nico’Lee Rohac
is an alumni of the foster care system in Pennsylvania, and is also an advocate for federal foster care reform. She holds a master’s degree in social work and works as a licensed trauma therapist with children and families.

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  1. We saw with our now adopted children that it was completely different… they treated the parents like they had all the rights..they gave the mother her rights back 4 times ..drug the children through painful visits where the mother brought new boy friends & other children or would come pick up her gas voucher & leave never staying for her visit the children would sit in an empty room with the caseworker waiting for her to show…the documentation of this was flawed! Ugh our children were abused neglected beyond words to the point of eating their on poop to survive yet all we heard was reunification over & over! Both parents had drug addictions yet never had to complete drug treatment. Or test before visits.. My daughter was born addicted to meth & yet they sent her home with the mother where she was neglected for 18 months! After multiple suicide attempts by the mother which the children were witness to the mother herself called & asked that the children be removed! That is how they got into care..then the state still with the knowledge of every thing & more still tried to return them! It’s is so hard to make laws that are one size fits all!!

    • I agree. I’m sorry your children had to go through all that they did. I can say that reunification is always the first goal in child welfare and sometimes it is very frustrating to see the system at work while knowing that things are happening that are not in the child’s best interest. As a child welfare worker, I see so many things in your post that should have never happened. It sounds like, possibly, there are more issues with agency policies in addition to the laws. The laws absolutely need to change for sure but ineffective agency policies don’t help either.

  2. Thank you for sharing your story. It is valuable to hear perspectives of those who are often left voiceless…the children. As a child welfare worker, we could do so much more for children if the system itself weren’t so broken. Law reform and budgets are absolutely necessary. Also, placing importance on the family as a whole system rather than sole focus on the children…after all, if reunification is going to be possible, we have to help the parents become their healthiest and best they can be in order to reunify (of course, this looks different for every family). I am proud to say that our agency does its best when it comes to viewing the family as a system (it goes without saying that a child’s safety is number one priority regardless). We do consider all facets when doing assessments and link parents with as many services as possible. With safety in mind, we keep children with their families for as long as is possible even when there are both drug and mental health issues (I reiterate child safety first). From the time we changed our practice model until the time our county became overwhelmed with the heroin epidemic, we had fewer removals of children. I do agree that mental health services and substance abuse services are sorely lacking all over…there are just never enough and for those in existence, it is near impossible for parents to get access for one reason or another with insurance often being a major barrier. Again, I thank you for sharing your story. I am truly sorry for your loss. Never stop sharing and never stop advocating.

  3. Thank you for sharing your story to point out a critical flaw in the child welfare system. I had a colleague that often talked about how we are a child centered system when we need to be a family centered system. I think your perspective validates that opinion.

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