The opioid crisis in the United States has quickly escalated to critical levels. Opioid-related deaths since the year 2000 have skyrocketed, driving up mortality rates for Americans between the ages of 45 and 54. Nicholas Kristof’s column in the New York Times echoed these statistics: drug overdose is now the leading cause of death for Americans under the age of 50. In a recent Shared Justice article, Dan Carter wrote on the deadly cycle of opioid abuse that is claiming the lives of so many in rural America. Studies are being rapidly conducted in an attempt to find a solution to the epidemic; on June 5, Governor Ducey of Arizona declared a statewide health emergency to speed up analysis of data on the crisis and develop “targeted” solutions. Just as devastating, however, are the widespread ramifications this crisis has for families—and for children, in particular.
The increase in opioid abuse among middle-aged Americans comes with an increase in foster care entry for their children. The New York Times editorial board wrote a piece on this issue and cited that foster care entry increased by eight percent from FY 2012 to FY 2015, with substance-abuse constituting 32.2 percent of cases for removal. However, these statistics are rather modest due to difficulties in data collection. Most officials simply list “parental neglect” as the reason for removal, since reporting the specifics of parental substance use at the time of removal is not mandatory. Infant entrance into the foster care system has soared, as well. In a testimony to the Senate Finance Committee in 2016, Nancy K. Young, Director of Children and Family Futures, spoke of “alarming rates” of infant entry and stated, “It is imperative that the development of that child take place in a stable environment with a caregiver who fosters mutual attachment with the child.” The most critical development stage for children is in the first three years of life, and separating infants from parents with opioid addictions places children at great risk.
Much like America’s public health institutions, the foster care system was not prepared to deal with the fallout of the opioid crisis and lacks the resources it needs to properly address the situation. In Texas, for example, dozens of children have been forced to stay in state offices or temporary shelters. These conditions are harmful to child development, especially in the early years of life. These children don’t just lack parental care—they lack loving, nurturing, necessary care from anyone.
Government agencies, public health organizations, and many others are struggling to see a solution to the opioid crisis. As they work towards an end, the well-being of families and children is suffering. As this crisis continues to develop, it is imperative that work be done to mitigate the effects on children. Caring for these families will take efforts from the government, treatment providers, the church, and other families.
Justice for the Most Vulnerable
The Bible calls Christians to care for the needy. In the book of Deuteronomy, as God establishes the law for the Israelites’ new society, he makes numerous references to groups deemed the most vulnerable: the sojourner, the fatherless (orphan), and the widow. The nature of Ancient Near East society meant that each of these people did not posess the means to care for and sustain themselves. Towards the end of Deuteronomy, it is written, “Cursed be anyone who perverts the justice due to the sojourner, the fatherless, and the widow.”
In our modern-day context, children placed in the foster care system as a result of the opioid crisis are among the “fatherless”; they are without proper parental care and do not have the ability to care for themselves. Therefore, they should receive the utmost care and attention—from society and the government—in the same manner the Israelites were commanded to give. Deuteronomy also informs us that care for the most vulnerable required the Israelites to “open [their] hand[s] to him [the vulnerable] and lend him sufficient for his need, whatever it may be.” Care for these children must be done in a similar vein; provision must sufficiently fill their need, not just stave off the negative effects as far as it keeps them alive.
The government’s unique mandate to pursue public justice commands its service to children who have been rendered parentless by the opioid crisis. As outlined in the Center for Public Justice’s Guideline on Government, “The government of a political community bears responsibility to legislate, enforce, and adjudicate public laws for the safety, welfare, and public order of everyone within its jurisdiction.” The Guideline on Family states that “public support of families during childbearing and childrearing periods should be of particular concern.” When families are not able to perform their childrearing responsibilities, the government has established foster care systems to fill those responsibilities. However, the increasing influx of children removed from families as a result of the opioid epidemic has shown the foster care system to be ill-equipped to handle such a crisis. Thus, government has the responsibility to find a solution to the predicament of these children.
As the foster care system searches for the means to care for these children, many parents are struggling to gain access to treatment. In her 2016 testimony, Director Young spoke on wait times in Ohio, where people must wait at least one to three months before gaining access to drug treatment. The recently proposed federal budget and health care act have raised concerns about access to treatment, as well. The American Health Care Act (AHCA) calls for caps on Medicaid spending, which many states expanded during the previous administration. These caps could reduce access and affordability of the opioid antidote Narcan and drug treatment programs. Additionally, the federal budget proposes eliminating the Social Services Block Grant Program, which not only provides community-based funding for drug prevention and treatment but also helps fund case management and foster care services.
The delay in the recovery process of the parents leads to a delay in reunification with their children. The time in between poses a threat to the development of the child, which is currently exacerbated by the foster system’s lack of resources. In order to fulfill its call to pursue public justice, the government must seek restoration of the family.
What Does Public Justice Look Like?
If the family is the primary unit of care for children and is crucial to their development in the first few years of life, the main goal should be the reunification of children with their parents. In the context of the opioid crisis, one of the best options for achieving this is through in-home treatment.
In the early 2000s, methamphetamine usage rendered many parents unable to care for their children. In response, Congress made enormous investments to find a solution. The result was an in-home treatment, or “protective services,” option. Through this in-home treatment plan, children are allowed to remain at home in the custody of their parents. The parents receive treatment at home, and there is regular supervision to ensure the well-being of the child. This type of program was successfully implemented in Sacramento County, where 97.8 percent of children remained at home through the entire program and only 1.5 percent of children experienced a recurrence of the mistreatment that initially alerted social services.
Sadly, there will still be some children for whom in-home treatment programs are not an option. In this case, the government will need to continue sufficient funding of child placement services, and child placement services will need additional support ensure the care of the child. This is where the community and the church must play an active role, as the government cannot literally raise a child. By advocating for funding of child placement services and drug treatment programs, supporting the families who choose to take in children, or even deciding to take in a child themselves, members of the church can respond to their call to “open [their] hand to him and lend him sufficient for his need” (Deuteronomy 15:8). Care must also be given to the parents during this time; they need access to treatment, as well as support and accountability networks in the community. Director Young emphasized, “the imperative that child welfare service agencies, substance abuse treatment providers, and community partners work together to address the needs of parents.”
These are all areas in which we as members of our churches, local communities, and government can embrace our call to seek justice. The solution will not come solely from government policies or in church engagement—justice is achieved when all institutions utilize their unique strengths and work together. When institutions rise to their responsibilities, there is hope that parents stricken by the opioid crisis can return to fulfill their roles.
-Madylin Reno is a junior International Relations major at Wheaton College (IL), where she has served on Student Government. She is often found debating foreign policy and searching for breakfast food. She is currently an intern with the Center for Public Justice.