CHAPTER SEVENTEEN

THE HEALTH CONSEQUENCES OF MOTHERS USING DRUGS AND THE LEGAL SYSTEM’S CALL TO ACTION

Kathy Barnett

The National Institute on Drug Abuse (2014) reports that an estimated 23.9 million Americans aged 12 years and older have abused drugs in the past month. It is estimated that only about 2.5 million or 1% of all those addicted to drugs received treatment at a specialty facility (National Institute on Drug Abuse, 2014). To combat this ever-evolving drug problem, health policies are being developed on the national, state, and local levels. These drug policies are focused in three areas. The first type of health policy is designed to prevent drug use. The second type of health policy concentrates on providing services to treat those with chronic substance abuse. Finally, the third type of drug policy is related to controlling the supply of drugs such as incarceration for someone caught selling drugs (Barbor et al., 2010). Barbor et al. (2010) list drug use as the eighth leading cause of disease, death, and disability in developed countries of the world. Because of the significant health impact drug use has not only on the health and well-being of the substance abuser, but also on the “public good” of the nation, successful health policies play a vital role in the drug epidemic (Barbor et al., 2010, p. 1137). This chapter discusses the health implications of chronic substance abuse and one local judicial system’s call to action in creating a family drug court to ameliorate substance abuse.

SUBSTANCE ABUSE AND ITS IMPACT ON SOCIETY

Drug use has both significant negative health consequences as well as financial implications to the nation including drug-related automotive accidents, spread of infectious disease, and suicide and unintentional death (Barbor et al., 2010). Substance use also plays a major role in most acts of violent crime and property crime (Barbor et al., 2010). The National Criminal Justice Reference Service (NCJRS, 2015) estimates that the social and health consequences of illicit drug use, including drug-related illness, death, and crime, cost the nation approximately $66.9 billion annually.

Drug use during pregnancy contributes to serious problems and birth defects for the unborn child (Sachdeva, Patel, & Patel, 2009). Infants born to mothers using opioids go through a long process of withdrawal from the opioids after birth. Drug-exposed infants are considered to be at high risk from exposure in utero, and this exposure may be further exacerbated by their living conditions after discharge from the hospital because of the parent’s drug lifestyle (NCJRS, 2015). One study referenced by the NCJRS (2015) showed an increase in infant mortality from 10.7 per one thousand for non-drug users compared with the infant mortality of 14.9 per thousand for those who admitted to using drugs during the pregnancy.

Conners et al. (2003) estimate that 6% of all children in America have a parent who is in need of treatment for illicit drug use. Children whose parents are addicted to drugs experience negative health and behavior consequences. A study conducted by Conners et al. (2003) suggests that children of those addicted to drugs are placed at “increased vulnerability for physical, academic, and socioemotional problems” (p. 752). Children living with a parent who uses drugs are more likely to be victims of domestic violence, have sleep disturbances, anxiety, and depression (Conners et al., 2003). Moreover, the children of substance abusers are more likely to have eating disorders and commit suicide (Conners et al., 2003). Many children grow up to continue the cycle of drug abuse that they saw during their childhood growing up with a parent abusing drugs.

The U.S. government recognizes the nation’s drug problem as one of the leading health problems in the country. In 2011, the Obama administration requested $20 million or a 40% increase in funding for drug treatment programs as an alternative to funding for prisons (Humphreys & McLellan, 2010). This increase in funding was designated to be used to train probation officers and judges on how to operate drug court programs.

DEVELOPMENT OF DRUG COURTS

In response to the nation’s increasing drug problem, several judicial systems across America are using a nontraditional court system called drug courts to treat those with substance abuse instead of the traditional judicial system using incarceration as a punishment. The first drug court was established in Miami, Florida, in 1989 (McKean, 2014). By 2005, more than one thousand drug court programs were in operation across the country (McKean, 2014). The purpose of a drug court is to place drug addicts who have committed a nonviolent crime into a treatment program instead of incarceration. Drug courts focus on combining accountability to the criminal justice system with a substance-abuse treatment plan. Typically, the drug user is arrested for a nonviolent crime related to drug use such as committing thefts or buying drugs (McKean, 2014). If the addict is eligible for drug court, the requirements for the program are explained to the accused, and the drug user can choose to enter the treatment program instead of incarceration. Treatment includes long-term substance abuse treatment, random drug tests, and accountability to the judge and court. If the addict agrees to enter the program and completes the program successfully, many times the criminal charges will be dropped, or the criminal case dismissed.

Because of the success of the drug court model, judicial systems across the country began to adapt the model for use with parents of minor children addicted to drugs. These parents did not necessarily have to be involved in a crime, but instead were brought into court because of delinquency of their minor children related to their drug use. This new model of drug court is known as a family drug court. The first family drug court was created in 1995 in Reno, Nevada (Marlowe & Carey, 2012). Today, nearly 300 family drug courts are in operation across the United States. These programs use the judicial court system in combination with a substance-abuse treatment plan to collectively ameliorate substance abuse issues and reunite children in foster homes with a drug-free parent. Unlike the traditional drug court model where the incentive for participation might be to have their criminal record cleared of charges and the participant avoid incarceration, the family drug court model is designed to provide incentives for participation and reduce the time the participant’s children spend in foster care (Marlowe & Carey, 2012). Several pathways to entering into the family drug court program exist. One path to entering the program is when child protective services have removed the child from the home because of delinquency of the minor children related to the parent’s drug use. In order for the parents to regain custody of their minor children, they are required to attend the family drug court program. Another pathway to entering the court system is when a mother tests positive for drugs at the birth of her baby or her infant has had a positive drug screen right after delivery. Others have entered the system because their children have been involved in criminal activity and are seen in juvenile drug court. If the judge determines the juvenile is not being well cared for because of the mother’s or father’s drug addiction, or the mother or father admits to drug use, the judge may order the parent to attend the family drug court program. Finally, some mothers and fathers enter the program through the traditional adult drug court. The mother or father has committed a nonviolent crime related to drug use and because they have minor children, the judge orders the parent to the family drug court program.

The Success of Family Drug Court

One large county in the southeast United States started a successful family drug court program in 2006. In 2015, an interview was conducted with the judge who initiated the local family drug court program, as well as a parent attorney, a child protective services attorney, the coordinator of the family drug court as well as the juvenile drug court coordinator. Because of confidentiality, the name of the county court, and all of those interviewed have been changed to protect their identification. The Central County family drug court was started by Judge Cheryl Thomas in 2006. Over the years, several hundred mothers and fathers have participated in the 2-year family drug court treatment program. When Judge Thomas was first elected to the county judge position, she saw a need to keep nonviolent drug offenders with minor children out of the jail system and instead offer treatment for their addiction so that the families could be reunited. Soon after taking office, Judge Thomas began researching drug court models to determine which system would work best for her county. After many hours of meeting with legislators, community members, and judges from across the country, Judge Thomas created the county’s first family drug court program. This program is designed to keep mothers and fathers with drug addiction out of the prison system and instead provide them the substance-abuse treatment necessary to get healthy and reunite the children that have been placed in a foster home. Judge Thomas explains:

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