If you need more evidence that substance use includes a long-lasting and far-reaching impact, think about this heartbreaking data: The ongoing escalation of opioid use is driving a surge in children and youth entering foster care systems across the nation.
Even before COVID-19 upended global health, North Carolina's foster care system was already experiencing “record amounts of need” driven largely by opioid use. Throughout the 2022-18 fiscal year, parental drug abuse was the main reason children were taken off your family in nearly 40% from the cases.
In the wake from the pandemic, substance use has risen sharply and record numbers of opioid deaths have left even more families destabilized – and more children vulnerable.
This should be a call to action, not despair. Together, the health care industry, community organizations and community leaders can prevent overdose deaths. We are able to treat substance use disorder. We can help families reunite safely, and that we might help children develop skills to cope with the trauma that family substance use can provoke.
All of the demands a broad strategic response, guided through the knowning that a whole-person, whole-community approach to prevention and treatment methods are the surest route to minimizing the impact substance use disorders (SUDs) have on families.
What Works: A Whole-person Approach along with a Coalition of Care
Investing in prevention and treatment benefits everyone, not only the families directly associated with SUDs. A holistic system of care that emphasizes positive outcomes by means of family continuity and security assists in building stronger communities.
A child's security and safety ought to always be the top priority. But permanency of household and home possess a significant long-term effect on health, well-being and success. Parental substance use and entry in to the child welfare system are traumatic events for anybody. Reinforcing a proper family structure offers the best environment for healing from adverse childhood experiences. When the health care system and communities work together, we are able to put families in touch with the support and resources they have to manage substance use and become healthy, whole and functional once again.
This is one reason why it's so important to place both primary care and mental health providers at the center of patient care. For example, with the mixture of Blue Cross and Blue Shield of North Carolina's (Blue Cross NC) practice support and Quartet's technology platform, we're making it easier for physicians to recognize patients with substance use disorder and connect them with the best care in the proper time.
It's just as vital that you give patients as well as their families the right resources they require. Tools like ATLAS(R) – available through Shatterproof, a national nonprofit dedicated to reversing the addiction crisis in the usa – can help patients and their families make more informed treatment choices based on facility locations, standardized quality data and patient-reported feedback.
In addition, parents in recovery feel more empowered whether they have the resources they need to meet non-medical needs. Barriers to employment, food security, housing, and transportation provoke the strain that often results in substance use along with other household traumas. Unsurprisingly, research shows that when a parent or gaurdian gets support accessing these fundamental drivers of health, they are more prone to start and finish substance use treatment. Ultimately, this increases the odds of family reunification.
This is why Blue Cross and Blue Shield of North Carolina (Blue Cross NC) supports an array of community-based treatment and family-support programs, including:
- Triangle Residential Choices for Substance Abusers, Inc. (TROSA). TROSA is a multi-year residential and recovery enter in Durham that provides education, jobs and continuing care. Through work-based training at TROSA's own companies-TROSA Moving, TROSA Lawn Care, and TROSA Thrift and Frame Store-men and ladies gain the skills they have to transition in to the employment market during recovery.
- Home-based family trauma treatment services in Cumberland County. Healthy Blue, Blue Cross NC's Medicaid program has collaborated with Thompson Child & Family Focus to launch an evidence-based model of family centered treatment in Cumberland County, which will provide long-term stabilization services to families with youth who may move between the child welfare and juvenile justice systems and who might be at-risk of unfavorable, potentially traumatic situations such as removal in the home. The program's approach is extraordinarily effective: 90% of families who complete treatment maintain family placement, avoid out-of-home placement or are reunified using their families.
- Youth Villages' Intercept Enter in Hanover County. When children are at high risk of entering the foster care system or perhaps a group home, Intercept helps change the family's trajectory with intensive support, new parenting and communication skills and evidence- and strengths-based mental health intervention services. Family intervention specialists use both child and caregiver, meeting multiple times per week and providing around-the-clock on-call crisis support.
The Very high cost Inaction
Children and families shouldn't face the challenges of substance use alone. Even when viewed solely via a cost/benefit lens, the failure to supply whole-person, community-based support for substance use disorder is extraordinarily expensive.
According to one study, between 2011 and 2022, nationally, opioid overuse contributed a lot more than $2.8 billion in costs towards the child welfare system. The bulk of that money – between $1.6 and $1.9 billion – was targeted at foster care. Costs related to child protective services (screening, assessment, investigation, and so on) totaled between $852 million and $900 million. Crucially, between $162 to $174 million went toward in-home treatment services.
By comparison, our nation spends much less on in-home services than we do on foster care, but these investments go a long, long way. They provide the sort of whole-person, whole-family method of treatment that will get results: parental support and coaching; therapy; referrals for substance use and behavioral health treatments; support for job training; help with childcare, transportation and budgeting; and help addressing other drivers of health needs, for example food and housing security.
Of course, we can't only use dollars and cents to measure the value of any purchase of child welfare. Proactive interventions that keep families together – or that really help them reunite – impact lives making communities stronger. According to New york Department of Health and Human Services data, more children aged 0 to 8 years old entered the foster care system in 2022-19 compared to previous years. That narrow window of time is really a critical one in child development. By some estimates, 85% of a person's brain is promoting when they get to the age of five. This is the time when children form bonds with caretakers and develop indispensable cognitive skills. If physical, emotional and mental needs aren't met, a child is more likely to face long-lasting effects on emotional intelligence, emotional development and social skills.
Substance use doesn't determine any individual's fate. Making the best investments in the right time can help households in recovery change course. Youngsters are the living embodiment of North Carolina's future. Everyone with a stake in community health owes it to them and to our state to consider holistically about how exactly we are able to help families overcome the difficulties of SUDs.
