Tuesday, January 1, 2013

Ongoing Child Protective Services (CPS) with Methamphetamine Using Families: Implementing Promising Practices

Ongoing Child Protective Services (CPS) with Methamphetamine Using
Families: Implementing Promising Practices
August 2006
Prepared by
Diane DePanfilis & R. Anna Hayward
University of MarylandSchool of Social Work Center for Families
For the National Resource Center for Child Protective Services
A Service for the Children’s Bureau
Introduction and Purpose
Methamphetamine manufacture, use, and addiction and the effect on children and
families, are serious problemsconfronting child welfare agencies across the nation.
Similar to the crack epidemicof the 1980’s, the “meth problem” increases the risk of
child maltreatment, impacts family functioning, and seriously threatens the safety and
well-being of children.
It is the responsibility ofthe CPS worker to: (1) recognize methamphetamineor other drug
related symptoms; (2) collect information about methamphetamine use,abuse, addiction,
and/or manufactureaspart of riskassessmentand safetyevaluation;(3)develop and manage
safetyplans toaddressthesafety influences that jeopardize achild’simmediatesafety; (4)
conduct family assessments that evaluate the specificeffect ofmethamphetamine use,abuse,
or addiction and manufacture on parenting adequacy and toassess the effects of these
circumstances on children; (5) develop changeorientedcaseplansthataddress theimpact of
methamphetamineuse, abuse, oraddiction;(6) select and coordinatemeaningful
interventionsprovided by addiction counseling and other agencies; and (7) evaluate progress
of parentsand children in recovery.
A series of papers developed by the National Resource Center for Child Protective
Services focus on the responsibilities of the CPS worker at one or more of these stages of
the CPS process. The purpose of this paper is to focus on ongoing CPS intervention
when families are affected by methamphetamine use, abuse, or addiction by primary
caregivers.
It is assumed that there is a safety plan in place (see previous papersin this series) and
that the CPS worker is managing safety on anongoing basis. When a safety plan has
been developed to keep children in the home, intense supervision must manage the safety
ofchildren to assure that all safety servicesare controlling the negative influences that
jeopardize a child’s safety. When caregivers have a history of methamphetamine use,
relapse should be expected. Therefore, at least weekly in-home contact is essential to
assure that all components of the safety plan are fully implemented and that the caregiver
and other family members are meeting agreed upon obligations. Key questions that
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should be assessed during at least weekly visits include: (1) is the plan effective? (2) Are
safety responses adequate?(3) Are providersinvolved and active as prescribed by the
safety plan?(ACTION for Child Protection, 2006).
Other papers in this series will focuson safety management during ongoing services.
This paper focuses on promising or acceptable interventions that may be useful as change
based services once methamphetamine use by a caregiver has been identified. It
acknowledges that appropriate interventions may only be selected after a comprehensive
family assessment has been completed.
Conducting the Family Assessment and Assessing the Effects of Methamphetamine
Use, Abuse, or Addiction on Parenting Adequacy and on Children
The primary purpose of conducting a comprehensive family assessment is to gather and
analyze information that will guidethe interventionchange process with families and
children. Targeting changestrategiesto the uniquerisk and protective factors present in
families affected by methamphetamine will lead to increased safety, permanency, and
well being ofchildren and families.
During the assessment process, the family isengaged in a process to understand their
strengths and needs and in particular to understand the way in which methamphetamine is
affecting parenting and children. It isassumed that a safety plan is in place and the focus
of the assessment is on the factors that need to be addressed through change focused
intervention strategies.
Information about risk and protective factors related to the child, parent, family, and
environment should be identified and assessed. Outlines for assessment of families (e.g.,
DePanfilis and Salus, 2003) are useful and should be supplemented by assessing the
specific ways in which methamphetamine affects parenting, family functioning, and
children.
Three areas of assessment are important: (1) assessing the degree of use, abuse, or
addiction to methamphetamine; (2) assessing what specific effects are evident for the
individual who uses, abuses, or is addictedto methamphetamine; and (3) assessing the
specific ways in which this use, abuse, oraddiction affects children in the family.
Assessing Use, Abuse, or Addiction
Aswith allsubstances, the firsttask of theongoing CPS worker is to understand whether the
methamphetamineproblem is one of use, abuse, or addiction (Zuskin and DePanfilis,
1995).
Use. Use ofalcohol orother drugs involves the ability to use drugs in a responsible
way. Use may beexperimental, occasional, recreational, or social. Users experience no
psychosocialproblemsand maintaincontrol over the amount, time, place, and duration of
their use (Griffin, 1993). Methamphetamine may be used initially for practical reasons:to
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stay up for extended hours for work orschool or toloose weight. Women especially may
initiate methamphetamine use for appetite control and weight loss (Rawson, Anglin & Ling,
2002). Becausemethamphetamineislessexpensive thanotherstimulant-type drugs(such as
cocaine),itmay bemorelikely tobeusedfor these reasons.
Abuse. Substanceabuse refersto theuse of drugsinanirresponsiblemannerwhich
results inpsychosocial problems; or, substance abuse refersto the useof adrug forthe
purpose of intoxication. Psychosocialproblems experienced may bedirectlyrelated tothe
abuse of substances, or may result from exacerbation of existing problems. The substance
abuser retains control overdrugusage, and thereisno progression of thediseaseprocess (no
abnormaltolerance, withdrawal, or pathologicorgan damage)(Griffin, 1993). Substance
abuse ismost typicallyseen inadolescents;although manyparents on CPS caseloads may
be substanceabusers, careful assessment may reveal that many are morelikely tobe
chemically dependent/addicted. This is particularly truewithmethamphetamine (see
appendix).
DependencyorAddiction. Dependency, or"addiction", referstoaphysiological
diseaseprocess which canbe identifiedbehaviorally. Inaddition topsychosocialproblems,
the chemically dependentperson loses controloveruse withregards to amount,time, place,
and duration Griffin, 1993). A progression of the diseaseprocess isevident and includes
abnormaltolerance, perhaps fromthe onset ofusage, withdrawal, and pathologicorgan
changes inlate stagesof addiction. The addicted person demonstratesa compulsion touse
drugs, disregarding any negative consequencesand exhibiting toleranceto the drug and
withdrawal symptomswhen he orshe cannothavethe drug. Preoccupation withacquiring
and using the drug results in poorjudgment.For example, drug-dependent parentsmay
leaveaninfant unsupervised while theyseek the next "fix".Intheir denial, theseindividuals
often believethattheir drugged state isnormaland strive to sustain it. Such psychological
dependence isdifficultforthedrug-dependent individual toovercome. These personsare
unableto controltheir drug use and their addiction usually has negative effects on their day
to day functioning (Griffin, 1993).
Assessing Effectson theIndividual
If parental use of methamphetamineis suspected, it is important that the parent undergoes
a specific assessment of the effects ofthis use, abuse, or addiction on their everyday
functioning. (See examples of effects in the appendix). The worker may observe
physical, behavioral, cognitive, and psychological consequences. Physical problems
include skin lesions (SAMHSA,1999); dental problems (Brandjord, 2006); increased risk
of stroke and heart problems (Maxwell, 2005),and potential long termdamage to neuron
cells (NIDA, 2005; SAMSHA, 1999). In terms of behavior, the parent may be observed
with periods of heightened energy and feelings of euphoria (NIDA, 2005); impulsivity
(Simons, Oliver, Ghaer, Ebel, and Brummels, 2005); and episodes of violence,
aggression, and agitation (Maxwell, 2005). Impairments to cognition, memory, and
attention including ADHD may also be observed (Maxwell, 2005; Simon,Domier,
Carnell, Brethen, Rawson, & Ling , 2000). Finally, someparents may experience
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depression and anxiety, especially with withdrawal (Cretzmeyer, Sarrazin, Huber, Block,
& Hall, 2003; NIDA, 2005)
Assessing Effects on Children
Because of the range of serious effects on the user, methamphetamine affects children in
multiple ways includingincreasing the risk ofchild abuse and neglect. The specific ways
in which this translates to concern for children need to be understood as part of the
assessment process. Once the specific ways in which the problemis affecting children is
understood, safety and change oriented changestrategies need to be tailored to the
specific needs of each family. Examples of these effects follow.
Prenatal effects. Infants exposed to methamphetamine prenatally may experience
developmental and learning delays (Rawson, Anglin, et al.,2002), research in this area is
ongoing. Children with these effects may need specific treatment to address these issues.
Household safety. Exposure to environmental toxins(arsenic, lye, mercury, lead)
during the manufacture process is especially risky for young children (USDOJ, 2003). A
complete assessment of household safety must be conducted with a specific eye to
potential household hazards associated with methamphetamine manufacture and use.
Childhood supervision and neglect.Parents may sleep for excessive periods of
time following drug binges and during periods of withdrawal. This may lead to a lack of
supervision and to other forms of child neglect. Because methamphetamine use
suppresses appetite, users may not regularly purchase or prepare food leaving children at
risk of nutritional neglect (Rawson, Anglin, et al., 2002).
Physical abuse. Agitation and violent behavior associated with withdrawal may
increase risk for physical abuse.
Sexual abuse.When parents are using methamphetamine, children may be
exposed to sexualized behavior in adults which may also put themat risk for sexual
abuse.
Lack of positive social support systems. Parents involved with
methamphetamine may have few positive supportsystems and only be associated with
others involved with methamphetamine. These conditions increase concern for child
safety, and make it more difficult to change negative behaviors.
Using Results of the Family Assessment to Target Outcomes
At the conclusion of the family assessment, the CPS worker should target client outcomes
that ifachieved will reduce the risk offuture maltreatment and address effects ofchild
maltreatment. This usually means selecting risk factors and protective factors uniquely
relevant to each family and then selecting interventions that will help parents, children,
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and familiesachieve these intermediate outcomes. An example ofhow this all comes
together is provided in a sample logic model. See Figure 1. Each service plan should be
unique and interventionsshould be selected that have the bestchance of helping families
achieve their individually targeted outcomes.
Selecting Evidence-Based Practices
Because methamphetamine addictiontreatment isrelatively new, an exhaustive search of
the literature was unsuccessful in finding treatment programs with extensive research
support of their effectiveness. As an alternative, this paper identifies promising or
acceptable practices that may be useful withfamilies affected by methamphetamine.
The selection of programs orinterventions was partially based on recommendations
offered to child welfare administratorsfor selecting evidence-based interventions (Wilson
& Alexandra, 2005) and by the California Evidence-Based Clearinghouse for Child
Welfare (CEBC). This CEBC hierarchy suggests the following classification of
programs:
1.  Well-supported, proven effective practice
2.  Supported efficacious practice
3.  Promising practice
4.  Acceptable emerging practice (effectiveness is unknown)
5.  Evidence fails to demonstrate effect
6.  Concerning practice
A series of efforts are underway to classifythe degree of effectiveness of evidence of
programs relevant to families served by childwelfare agencies (e.g., California Evidence-Based Clearinghouse for Child Welfare, 2006). Readers are encouraged to continue to
search for interventions with the best research support available. Other hierarchies (e.g.,
Gambrill, 2006) may also help workers selectprograms relevant for families affectedby
methamphetamine based on acceptable, promising, efficacious, or effective results.
Based on this review of promising or acceptable programs, it is recommended that
intervention for methamphetamine affectedfamilies include the following four
components: (1) a process for assessing safety and implementing appropriate safety
plans; (2) substance abuse treatment for addicted parents; (3) parent and family-focused
interventions; and (4) child-focused interventions. Since other papers in this series focus
on safety, this paper focuses on promising or acceptable practices acrossthe other three
domains.
Substance Abuse Treatment
Substance abuse treatment, preferably treatment with somepromise ofeffectiveness with
individuals addicted to methamphetamine, isrequired in order to reduce the risk of
maltreatment in affected families. While methamphetamine users share someofthe same
needs as users of other stimulant-type drugs such as cocaine, there are alsodifferences.
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In particular, methamphetamine users may function adequatelyin their work or social
lives before methamphetamine results in obvious consequences (Cretzmeyer et al., 2003;
Rawson et al., 2002). In addition, methamphetamine users may be more likely to be
poly-drug users (Brecht et al., 2004; Stoops, Tindall, Mateyoke-Scrivner, & Leukefeld,
2005); have high rates of psychiatric disorders, (Semple, Grant, & Patterson, 2004), and
experience serious depressive symptomsduring withdrawal (Rawson, Huber, et al., 2002;
Sweben et al., 2004).
During the beginning stages oftreatment, cognitive problems and ADHD may become
worse and increase the likelihood of relapse (Maxwell, 2005, Zweben et al., 2004). To
increase motivation, the CPS worker and drug treatment provider should provide
education about the consequences of methamphetamine, interpret any apparent cognitive
problems as related to the recovery process, and help the parent get through this stage of
the treatment process.
Promising or acceptable models for treatment of parents withmethamphetamine
problems are reviewed. The sametreatment models that have shown effectiveness in the
treatment of cocaine seem to also have promising outcomes in the treatment of
methamphetamine (Huber et al., 1997; Maxwell, 2005; SAMHSA, 1999a) and
methamphetamine treatment may actually be associated withmore favorable criminal
justice outcomes (WSDHS, 2004).
The Matrixintervention. This model is considered an effective outpatient
treatment for methamphetamine addiction (SAMHSA, 1999a). The Matrix intervention
is recommended by the Substance Abuse and Mental Health Services Administration
(SAMHSA) and the Center for Substance Abuse Treatment (CSAT). This intervention
includes the following components:
•  outpatient treatment,
•  information/education,
•  relapse prevention,
•  family involvement,
•  cognitive-behavior based individual therapy,
•  group sessions,
•  self-help (12 step program participation), and
•  urine toxicology monitoring (Obert et al., 2000).
Evaluation of Matrix programparticipants relapse rates suggests that longer treatment
decreases the risk of relapse. Factorsthat increasethe risk of relapse include: (older) age
of user, Hispanic ethnicity, involvement withdrug sales, and previous treatment episodes
(Brecht, Mayrhauser, & Anglin, 2000). Comparisons between methamphetamine and
cocaine users in Matrix treatment indicate similarpositive benefits oftreatment, but
depressive symptomsare generally higher for methamphetamine users at admission and
may be slower to change over time(Rawson, Huber et al., 2002). Because of these
differences, someexperts suggest that Matrix treatment needs to be enhanced with
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cognitive and educational interventions to address methamphetamine-induced cognitive
impairments (Cretzmeyer et al., 2003), and psychiatric symptoms.
The IowaCase Management Project (ICMP).This model is a comprehensive
intervention for parenting addicts (Cretzmeyer et al., 2003). This methamphetamine
specific treatment includes:
•  Up to 12 months of case-management,
•  homevisits,
•  assistance with transportation,
•  referrals, and
•  solution-focused therapy.
Unfortunately, preliminary research reveals that the intervention did not improve relapse
outcomes over standard care, but was shown to significantly improve employment rates
and decrease depression among participantsat follow up (Cretzmeyer et al., 2003).
Further research on thismodel is warranted.
Family focused substance abuse treatment. Research with other drug use
confirmsthat substance abuse outcomes (programretention, lower rates of relapse) are
enhanced when social and health needs of parents and their children are addressed (Smith
& Marsh, 2002). The Substance Abuse MentalHealth Services Association (SAMHSA)
recommendsthat family related substance abuse treatment include:
•  parent education on child development;
•  attention to early adverse experiences in the clientin an attempt to “break the
cycle” of child maltreatment;
•  development of social support networks; and
•  focus on treatment issues and parent-child relationships and family dynamics
(SAMHSA, 1999b).
Studies of cocaine addicted parenting women suggest benefits of treatment programs that
focus on a range ofneeds including recovery fromtrauma, life skills, parenting
education, and family engagement (Magura & Laudet, 1996). Furthermore, allowing
children to enter care with addicted parents may have positive benefits for parenting,
child behavior, family functioning, employment, substance abuse, and criminal justice
involvement (Jackson, 2004; Sowers, Ellis, Washington, & Currant, 2002). Adding the
involvement of families seems to result in better outcomes than routine drug treatment.
Comparing a methadone maintenance treatment enhanced with a family programto
treatment as usual, participants in thefamily programachieved greater benefits in the
areas of problemsolving, family factors, social network, decreased drug use, and parental
involvement with children (Catalano, Gainey, Fleming, Haggerty, & Johnson, 1999).
This trend suggests that family centered methamphetamine treatment could have better
outcomes than methamphetamine treatment focused only on the addicted individual but
evaluation of this premise has yet to occur.
.
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Parent & Family Focused Interventions
Separate from substance abuse treatment, other types of parent and family focused
interventions are neededto address the effects ofmethamphetamine on families and to
reduce other risk factors for child maltreatment.
Social support interventions.Social isolation and/or connections with drug-using social networks may increase risk for continued substance abuse and child
maltreatment. Positive social support may increase treatment retention and prevent
relapse (Dobkin, Civita,Paraherakis,& Gill, 2002). Social support intervention may
consist of individual support (in the formof parent-aides, or homevisitors), be a
component of parent education and support groups, or be provided as part of a multi-service intervention (DePanfilis, 1996).
Network therapy, for example, uses the therapeutic relationship to help families develop
positive social networks and stresses the use of social networkmembers to support
recovery (Galanter, Dermatis, Keller, & Trujillo, 2002). Preliminary findings suggest
that participants may maintain abstinence when they havea supportive network (Galanter
et al., 2002).
Parenting skills interventions.Many families involved with child protective
services are mandated to attend parenting skills education and training (Barth et al.,
2005). While not universally needed, some parents affected by methamphetamine may
benefit from parenting skills interventions. Based on a review ofeffectiveness ofparent
training programsfor use with biological parents involved with child welfare services,
Barth et al. (2005) stress the need for tailored interventions for specific populations (e.g.,
age-specific, child or parent problem-specific, and population specific interventions).
Bringing together parents of children with disruptive behaviors problems in Multi-Family
Groups, shows somepromise for improving parenting skills and child behavioral
problems (McKay, Gonzales, Quinana, Kim, &Abdul-Adil, 1999). This approach may
be an appropriate alternative to traditional parenting classes which do not tend to focus on
the unique needs of children who have mental health or behavioral problems. Because of
the importance of understanding which parenting programs are most promising for
working with parents involved with the child welfare system, a review ofparenting skills
programs is among one of the first types ofinterventions reviewed by the California
Evidence Based Clearinghouse (2006).
Experts suggest that interventions to increase positive parenting behavior should be
selected on a “case-by-case basis” inorder to match parenting needs, child behavior
problems, and interventions (Barth et al., 2005, p. 368). Parenting programsdeveloped
for substance abusing families such as Focus on Family (FOF), have demonstrated lower
rates of druguse, more positive parenting, and lower rates of child behavioral problems
up to 24 months after participation when compared to a non-treatment group (SDRG,
2000).
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Interventions to address concrete needs. Parents who use methamphetamine
often have multiple needs beyond substance addiction (e.g.,employment, child care,
housing, employment, and medical care) (SAMHSA, 1999a). The multiple needs of
methamphetamine users may be related to the multiple problemsthey sometimes face
such as poverty, risk taking behaviors, and psychiatric disorders (Semple et al., 2004).
Therefore, SAMHSA recommends that substance abuse treatment beenhanced with the
availability of other servicessuch as mental and physical health care, housing assistance,
and job training. In addition, because a drug using life style may have taken resources
away froma parent meeting other basic needs, it is very important to respond to the
concrete needs of families for food, clothing, housing, etc. before family functioning
issues can be successfully addressed.
Child Focused Interventions
It is the role ofCPS to both reduce the risk of future maltreatment and to address the
effects of maltreatment on children, thereby enhancing the well-being of children. Living
with a methamphetamine using parent may result in a range of consequences for children
including problems with their physical and mental health, development, and social skills.
Interventions to address physical health & developmental needs

Because of
the serious health risks associated with methamphetamine exposure, a comprehensive
medical examination for children should be conducted to assess any effects of exposure
to drugs or toxic chemicals. Accidental ingestion or exposure may result in side-effects
for children including breathing difficulties, heart palpitations, vomiting, irritability and
agitation (Hohman, Oliver, & Wright, 2004). Ongoing medical care will likely be
necessary if toxic exposure has resulted in these symptoms.
Services for children may also be needed to address developmental delays. Since studies
of children of parents in substance abuse treatment reveal that children have high rates of
cognitive impairments (69%), speech and language delays (68%), emotional or behavior
problems (16%) and medical problems (83%) (Shulman, Shapira, & Hirshfield, 2000),
developmental evaluations of children of methamphetamine users are a necessary part of
any intervention. If specific delays are detected, then appropriate intervention and
treatment must be provided.
Services to address child mentalhealth and behavior problems. Children of
methamphetamine-addicted parents may suffer froma variety of psychosocial challenges
including aggression and anti-social behaviors in younger children and conduct disorders
in older children. These anti-social behaviors (including lying and stealing) may be
evident evenwhen children have been removed fromdrug using environments (Haight et
al., 2005). Both individual and group interventions may be used to model and rebuild
social skills to increase pro-social and decrease anti-social behavior.
Social skillsinterventionsprovided to children as part of parent training models or
delivered in child focused (individual or group) cognitive-behavioraltherapy has
consistently shown to be effective in helping children achievea range ofpositive
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outcomes such as decreasing aggressive and antisocial behaviors, increasing problem
solving and conflict management skills (Corcoran, 2000), and decreasing internalizing
and externalizing behaviors (Harrison, Boyle, & Farley, 1999).
Child-focused therapy, often conducted in school-based settings, can also help children
increase social competence, improve peer relations, and enhance problem solving skills
(DeMar, 1997). Individual or family focused therapy, such as Brief Strategic Family
Therapy, has also been shown to be effective in not only decreasing substance use in
adolescents, but decreasing behavior problems and increasing family functioning as well
(Austin, Macgowan, & Wagner, 2005).
Finally, Trauma-Focused Cognitive BehavioralTherapy (TF-DBT) has been identified
by SAMHSA as a model program. Children who have been exposed to traumatic life
events and receive TF-DBT may experience a reduction in depressivesymptoms,
oppositional defiant behaviors, and anxiety and experience positive increases in social
competency (SAMHSA-CSAP, 2005). Children exposed to maltreatment, drug abuse, or
criminal activity (and/or parent arrest) may benefit frominterventions that address PTSD
reactions as well as other mental health needs.
Summary and Conclusions
The ongoing CPS responsibility when working with methamphetamine affected families
is to control for safety, address the effects ofchild maltreatment and methamphetamine
use on children, and to implement change strategies that will help toincrease protective
factors and reduce risk factors for continued maltreatment. Assessments must address the
unique needs ofthese families and then the CPS worker must select interventions that
best match those needs in order to increase child safety and increase child and family
well-being. Whenever possible, interventionsshould be selected based on the best
available evidence of their effectiveness.
Interventions must be comprehensive, intensive, and long term in order to prevent
relapse, strengthen family functioning, and address seriouschild mental health and
behavioral consequences that may present as a result of parental use,abuse, or addiction
to methamphetamine. Because of the complex needs of these families, interdisciplinary
collaboration is required to manage changes in conditions and behaviors over time.
Safety should be continually assessed as relapse is common. Continued opportunities for
support should be available to reinforce and maintain the risk reduction process.
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Appendix:
FACTS about Methamphetamine and its effects on children and families
What is Methamphetamine?
Methamphetamine, also known by the street terms “speed”, “meth”, “crank”, or “crystal,”
is a stimulant drug that is produced either in a powder (similar to cocaine)or crystallized
form. Depending on the formof the drug, it can be snorted, injected, smoked, or
dissolved in water and swallowed. The crystallized form(also sometimes referred to as
“ice”) is thought to be more addictive and destructive, although all forms of the drug are
extremely addictive. Methamphetamine is asaddictive as cocaine, and the effects last
much longer (from6-8 hours after administration). Methamphetamine is usually
produced in small scale operations in homes, trailers, or abandoned buildings; these
locations are usually in isolated rural areas. Over the counter coldmedicines containing
pseudophedrine or ephedrine are the base ingredients with car starter fluid, fertilizer,
drain cleaner, hydrochloric acid, mercuric chloride, sodium hydroxide (lye) and a variety
of other toxic and highly explosive chemical solvents also included as ingredients in
methamphetamine “recipes” (NIDA, 2005).
Howextensive is the problem?
In 2003, 5.2% of adults in the U.S. had tried a formof methamphetamineat least once in
their lives (NIDA, 2005), and in 2004 1.4 million people over the age of 12 had used the
drug in the past year (SAMHSA, 2005); most users are young adults (18-34 years old).
Methamphetamine use grew substantially during the 1990’s; between 1993 and 2003,
treatment admissions increased by close to 600% (from21,000 to 117,000) (SAMHSA,
2005).Females in particular may initially use the drug to help withweight loss and to
increase energy (Brecht, O'Brien, Mayrhauser, & Anglin, 2004).
Howdoes the problem affectchildren and families?
Use of methamphetamine can be detrimental on individual users, their children, and
entire family systems.
•  Methamphetamine can be manufactured in homes where children live,
introducing the risk of exposure to toxins;
•  Use is associated with promiscuous sexual behavior, putting children at risk for
both pre-natal exposure and sexual exploitation;
•  Withdrawal can be characterized by long periods of sleep after binge use, leading
to lack of supervision of children; and,
•  The drug can lead to violent and paranoid sideeffects which may increase risk of
child maltreatment and threaten child safety.
Individual Effects
Individual effects impactthe entire bio-psycho-social systemof an individual.
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Effects of Methamphetamine Use on Individuals
•  Heightened energy and feelings of euphoria (NIDA, 2005);
•  Personality changes, violence, aggression and agitation (Maxwell, 2005);
•  Depression and anxiety (Cretzmeyer et al., 2003) especially with withdrawal
(NIDA, 2005);
•  Impairments to cognition, memory, and attention including ADHD (Maxwell,
2005; Simon et al., 2000);
•  Possible long-termdamage to neuroncells (NIDA, 2005; SAMHSA, 1999);
•  Increased risk for stroke and heart problems (Maxwell, 2005);
•  Dental problemscaused by dry mouth and grinding teeth (Brandjord, 2006);
•  Skin lesions (SAMHSA, 1999).
Effects on Children and Families
All of the individual effects listed above, in turn may impact the ability of the parent or
caregiver to meet the basic needs of children.
•  Exposure to environmental toxins (arsenic, lye, mercury, lead) during the
manufacture process, especially risky for young children (USDOJ, 2003).
•  Risks fromprenatal exposure including developmental and learning delays
(Rawson, Anglin, et al., 2002).
•  Exposure to sexualized behavior in adultsmay put children at risk for sexual
abuse.
•  Agitation and violent behavior associated with withdrawal may increase risk for
physical abuse.
•  Long periods of sleep after drug binges may lead to neglect of children’s basic
needs (Cretzmeyer et al., 2003; USDOJ, 2003).
•  Chronic drug use has long been associated with increased rates of child abuse and
neglect, inadequate nurturance, and increasedrates of associated problems such as
depression and violence which affectparenting and child development
(Zuckerman, 1994).
•  Compromises parenting support systems especially in small, isolated communities
(Haight et al., 2005).
•  Someestimates find that as many as 35% of methamphetamine labs are homes to
young children (CADEC).
What factors may protect against these negative impacts?
•  Temperament ofchild
•  Positive early childhood experiences
•  Positive andaccessible positive role modelswithin the extended family network
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•  Positive school experiences – school may be a refuge fromchaotic home
environment and allow opportunities for helping professionals to identify and
intervene with affected families and provide alternate role models (Haight et al.,
2005).
Drawing on factors thought to contribute tothese protective factors, while providing
effective interventions for the known effects of the methamphetamine culture on children,
may reduce the impact ofthis drug onchildren and families.
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